Measuring and benchmarking safety culture: application of the safety attitudes questionnaire to an acute medical admissions unit.

Abstract

Objectives: To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results against international data and guide a unit-based, integrated, risk management strategy. Methods: The Safety Attitudes Questionnaire (SAQ), a validated instrument for the measurement of safety culture, was applied to an AMAU. All AMAU healthcare staff (n = 92) were surveyed: doctors, nurses, healthcare assistants (HCAs) and allied healthcare professionals (AHPs). Safety attitude scores for the overall unit and individual caregiver types were assessed across six domains of safety culture. Results: When compared against an international benchmark, the AMAU scored significantly higher for four of the six safety domains: p<0.01 for ‘teamwork climate’, ‘safety climate’ and ‘stress recognition’, and p<0.05 for ‘job satisfaction’. The difference between nurse manager scores and the overall mean for the study group was statistically significant for the domains of ‘teamwork climate’ (p<0.05) and ‘safety climate’ (p<0.01). HCAs scored significantly lower relative to staff overall with regard to ‘working conditions’ (p<0.05) and ‘perceptions of management’ (p<0.01). Conclusions: The SAQ was successfully applied to an AMAU setting giving a valuable insight into staff issues of concern across the safety spectrum: employee and environmental safety, clinical risk management and medication safety.