Using the AHRQ Hospital Survey on Patient Safety Culture as an Intervention Tool for Regional Clinical Improvement Collaboratives

Objective: From 2005 to 2007, the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture was used as an assessment and intervention tool for hospitals participating in regional improvement collaboratives led by the Delmarva Foundation and Maryland Patient Safety Center. The collaboratives focused on specific hospital microsystems [emergency departments (EDs), intensive care units (ICUs), and operating rooms [ORs)] and measurable clinical outcomes. Methods: The survey was administered to staff during the collaborative’s pre-intervention period and end point. Teams implemented clinical interventions and selected culture goals. Collaborative support was provided through workshops, site visits, conference calls, and a virtual workspace. Results: 38 percent of ED teams, 57 percent of ICU teams, and 92 percent of OR teams improved in the Overall Perception of Safety. Teams improved in several culture dimensions, including Teamwork Within Units and Communication Openness. Conclusion: Improvements were most robust within each microsystem and less apparent between microsystems.