Chapter 33. Promoting a Culture of Safety

How Important Is the Problem? A culture of safety has been suggested as a core mechanism underlying safe, effective, and timely patient care. It has been implicated as a critical factor underlying continuous learning and effective teamwork, as well as a key driver of safety behaviors such as error reporting, and safety outcomes such as reduced adverse events. A number of studies have found associations between culture and safe care practices, such as error reporting Other studies have found associations between patient safety culture and patient outcomes, including reduced adverse event indicies and mortality. For example, several studies have found relationships between safety culture and the AHRQ Patient Safety Indicators. In one study that utilized a composite of 12 AHRQ patient safety indicators results suggested that a 1 standard deviation increase in patient safety culture scores was associated with a 10% decrease in the composite PSI risk. Other work has indicated that culture can account for up to 6% of the variance in adverse events and 18% of the variance in patient willingness to recommend a hospital to family and friends.