Safety Culture in Cardiac Surgical Teams: Data From Five Programs and National Surgical Comparison.
BACKGROUND
Little is known about safety culture in the area of cardiac surgery as compared with other types of surgery. The unique features of cardiac surgical teams may result in different perceptions of patient safety and patient safety culture.


METHODS
We measured and described safety culture in five cardiovascular surgical centers using the Hospital Survey on Patient Safety Culture, and compared the data with the Agency for Healthcare Research and Quality (AHRQ) 2010 comparative database in surgery and anesthesiology (all types). We reported mean scores, standard deviations, and percent positive responses for the two single-item measures and 12 patient safety climate dimensions in the Hospital Survey on Patient Safety Culture.


RESULTS
In the five cardiac surgical programs, the dimension of teamwork within hospital units had the highest positive score (74% positive responses), and the dimension of nonpunitive response to error had the lowest score (38% positive responses). Surgeons and support staff perceived better safety climate than nurses, perfusionists, and anesthesia practitioners. The cardiac surgery cohort reported more positive safety climate than the AHRQ all-type surgery cohort in four dimensions but lower frequency of reporting mistakes. The cardiac anesthesiology cohort scored lower on two dimensions compared with the AHRQ all-type anesthesiology cohort.


CONCLUSIONS
This study identifies patient safety areas for improvement in cardiac surgical teams in comparison with all-type surgical teams. We also found that different professional disciplines in cardiac surgical teams perceive patient safety differently.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address: jmarste2@jhu.edu.
Jill A
JA
Marsteller
Department of Health Sciences, College of Education and Human Services, Western Illinois University, Macomb, Illinois.
Mei
M
Wen
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Yea-Jen
YJ
Hsu
Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, Maryland.
Laura C
LC
Bauer
Department of Anesthesiology, Lehigh Valley Health Network, University of South Florida Morsani College of Medicine, Tampa, Florida.
Nanette M
NM
Schwann
University of Missouri-Kansas City, Kansas City, Missouri.
Christopher J
CJ
Young
Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
Juan A
JA
Sanchez
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Nicole A
NA
Errett
Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, Maryland.
Ayse P
AP
Gurses
Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, Maryland.
David A
DA
Thompson
Society of Cardiovascular Anesthesiologists Foundation, Richmond, Virginia.
Joyce A
JA
Wahr
Department of Anesthesia, Massachusetts General Hospital, Boston, Massachusetts.
Elizabeth A
EA
Martinez
D001291:Attitude of Health Personnel; D002300:Cardiac Care Facilities; D006348:Cardiac Surgical Procedures; D006801:Humans; D010348:Patient Care Team; D061214:Patient Safety; D015397:Program Evaluation; D017751:Safety Management; D011795:Surveys and Questionnaires; D014481:United States