title: Are Spanish primary care professionals aware of patient safety?
abstract: BACKGROUND
  Knowledge about safety culture improves patient safety (PS) in health-care organizations. The first contact a patient has with health care occurs at the primary level. We conducted a survey to measure patient safety culture (PSC) among primary care professionals (PCPs) of health centres (HCs) in Spain and analyzed PS dimensions that influence PSC.
  
  
  METHODS
  We used Agency for Healthcare Research and Quality (AHRQ) Medical Office Survey on Patient Safety Culture translated and validated into Spanish to conduct a cross-sectional anonymous postal survey. We randomly selected a sample of 8378 PCPs at 289 HCs operated by 17 Regional Health Services. Statistical analysis was performed on sociodemographic variables, survey items, PS dimensions and a patient safety synthetic index (PSSI), calculated as average score of the items per dimension, to identify potential predictors of PSC. We used AHRQ data to conduct international comparison.
  
  
  RESULTS
  A total of 4344 PCPs completed the questionnaire. The response rate was 55.69%. Forty-two percent were general practitioners, 34.9% nurses, 18% administrative staff and 4.9% other professionals. The highest scoring dimension was 'PS and quality issues' 4.18 (4.1-4.20) 'Work pressure and pace' was the lowest scored dimension with 2.76 (2.74-2.79). Professionals over 55 years, with managerial responsibilities, women, nurses and administrative staff, had better PSSI scores. Professionals with more than 1500 patients and working for more than 11 years at primary care had lower PSSI scores.
  
  
  CONCLUSIONS
  This is the first national study to measure PSC in primary care in Spain. Results may reflect on-going efforts to build a strong PSC. Further research into its association with safety outcomes and patients' perceptions is required.
authors.affiliation: 1 Patient Safety Work Group of the Spanish Society of Family and Community Medicine, Spain 2 Health Centre of Caspe, Health Service of Aragón, SALUD, Zaragoza, Spain 3 Department of Medicine, Psychiatry and Dermatology, Medical School, University of Zaragoza, Zaragoza, Spain mpastier@gmail.com.
authors.forename: María Pilar
authors.initials: MP
authors.lastname: Astier-Peña
authors.affiliation: 1 Patient Safety Work Group of the Spanish Society of Family and Community Medicine, Spain 4 Integrated Care Management of Talavera de la Reina, Health Service of Castilla-La Macha, Toledo, Spain.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Torijano-Casalengua
authors.affiliation: 1 Patient Safety Work Group of the Spanish Society of Family and Community Medicine, Spain 5 Technical Direction of Quality and Process, Quality Management and Planning Department, Health Service of Madrid (SERMAS), Madrid, Spain.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Olivera-Cañadas
authors.affiliation: 6 Quality Unit Health Service of Basque Country, Guipuzcoa, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Silvestre-Busto
authors.affiliation: 7 General Direction of Public Health, Quality and Innovation, Ministry of Health, Madrid, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Agra-Varela
authors.affiliation: 1 Patient Safety Work Group of the Spanish Society of Family and Community Medicine, Spain 8 Primary Care Management of Salamanca, Health Service of Castilla y León (SACYL), REDIAPP, IBSAL, Salamanca, Spain 9 Primary Care Research Unit, the Alamedilla Health Center, Salamanca, Spain.
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: Maderuelo-Fernández
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D058007:Physicians, Primary Care / Q000706:statistics & numerical data; D059017:Primary Care Nursing / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D013030:Spain; D011795:Surveys and Questionnaires