title: Is culture associated with patient safety in the emergency department? A study of staff perspectives.
abstract: OBJECTIVE
  To describe the patient safety culture of Dutch emergency departments (EDs), to examine associations between safety culture dimensions and patient safety grades as reported by ED staff and to compare these associations between nurses and physicians.
  
  
  METHODS
  Cross-sectional survey conducted in 2007.
  
  
  METHODS
  Thirty-three non-academic EDs in the Netherlands.
  
  
  METHODS
  Four hundred and eighty nurses, 159 physicians and 91 other professionals.
  
  
  METHODS
  Self-reported level of patient safety.
  
  
  RESULTS
  In unadjusted analyses, all dimensions of safety culture were positively associated with the reported level of patient safety and six of these associations with patient safety were statistically significant after adjustment ('teamwork across units', 'frequency of event reporting', communication openness', 'feedback about and learning from errors', 'hospital management support for patient safety'). Differences between nurses and physicians were found on two dimensions ('frequency of event reporting' and ' hospital management support for patient safety'). Physicians tended to grade patient safety higher than nurses whilst having equal judgements on these two dimensions.
  
  
  CONCLUSIONS
  Staff identified several dimensions of safety culture that are associated with staff-reported safety in the ED. Physicians and nurses identified distinct dimensions of safety culture as associated with reported level of patient safety.
authors: Department of Public and Occupational Health, Room A-507, VUmc-EMGO Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. i.vannoord@vumc.nl.
authors: Inge
authors: I
authors: Verbeek-Van Noord
authors: Cordula
authors: C
authors: Wagner
authors: Cathy
authors: C
authors: Van Dyck
authors: Jos W R
authors: JW
authors: Twisk
authors: Martine C
authors: MC
authors: De Bruijne
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D016529:Emergency Nursing; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D019300:Medical Errors / Q000706:statistics & numerical data; D009426:Netherlands; D015279:Organizational Culture; D010348:Patient Care Team; D061214:Patient Safety / Q000592:standards; D010820:Physicians
keywords: emergency department; mixed model analyses; patient safety culture; perceived level of patient safety; prediction modelling