title: Assessment of patient safety culture in clinical laboratories in the Spanish National Health System.
abstract: BACKGROUND
  There is increasing awareness of the importance of transforming organisational culture in order to raise safety standards. This paper describes the results obtained from an evaluation of patient safety culture in a sample of clinical laboratories in public hospitals in the Spanish National Health System.
  
  
  METHODS
  A descriptive cross-sectional study was conducted among health workers employed in the clinical laboratories of 27 public hospitals in 2012. The participants were recruited by the heads of service at each of the participating centers. Stratified analyses were performed to assess the mean score, standardized to a base of 100, of the six survey factors, together with the overall patient safety score.
  
  
  RESULTS
  740 completed questionnaires were received (88% of the 840 issued). The highest standardized scores were obtained in Area 1 (individual, social and cultural) with a mean value of 77 (95%CI: 76-78), and the lowest ones, in Area 3 (equipment and resources), with a mean value of 58 (95%CI: 57-59). In all areas, a greater perception of patient safety was reported by the heads of service than by other staff.
  
  
  CONCLUSIONS
  We present the first multicentre study to evaluate the culture of clinical safety in public hospital laboratories in Spain. The results obtained evidence a culture in which high regard is paid to safety, probably due to the pattern of continuous quality improvement. Nevertheless, much remains to be done, as reflected by the weaknesses detected, which identify areas and strategies for improvement.
authors.affiliation: CMU of Clinical Laboratory, Antequera Hospital, Antequera, Spain.
authors.forename: Angeles
authors.initials: A
authors.lastname: Giménez-Marín
authors.affiliation: Hospital Research Unit, Costa del Sol Hospital, Málaga, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rivas-Ruiz
authors.affiliation: Clinical Laboratory, University Hospital Son Espases, Palma de Mallorca, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: García-Raja
authors.affiliation: CMU of Clinical Biochemistry, San Agustín Hospital, Avilés, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Venta-Obaya
authors.affiliation: Area Laboratory, Catalan Institute of Health, Barcelona, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Fusté-Ventosa
authors.affiliation: Clinical Laboratory, CatLab, Viladecavalls, Barcelona, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Caballé-Martín
authors.affiliation: Clinical Analysis Service, Integrated Management Santiago, Santiago de Compostela, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Benítez-Estevez
authors.affiliation: CMU of the University Hospital Laboratories Araba, Osakidetza, Vitoria, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Quinteiro-García
authors.affiliation: Core Laboratory, Clinical Hospital, Barcelona, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Bedini
authors.affiliation: CMU Clinical Analysis, Hospital Complex Huelva, Huelva, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: León-Justel
authors.affiliation: UDIAT Centre Diagnostic, Sanitary Corporation Parc Tauli, Sabadell, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Torra-Puig
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D059232:Laboratory Personnel; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D015279:Organizational Culture; D061214:Patient Safety / Q000331:legislation & jurisprudence / Q000592:standards*; D010564:Personnel, Hospital / Q000193:education; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D013030:Spain; D011795:Surveys and Questionnaires; D017749:Total Quality Management
keywords: clinical laboratory services; cross-sectional studies; patient safety; public hospital; questionnaires; total quality management; universal safety measures