TY - JOUR
T1 - Association of Safety Culture with Surgical Site Infection Outcomes
AU - Fan, Caleb J.
AU - Pawlik, Timothy M.
AU - Daniels, Tania
AU - Vernon, Nora
AU - Banks, Katie
AU - Westby, Peggy
AU - Wick, Elizabeth C.
AU - Sexton, J. Bryan
AU - Makary, Martin A.
N1 - Funding Information:
Disclosure Information: This research study at Johns Hopkins was supported by Mr and Mrs John Rodda and The Rodda Family Partnership, LTD. The authors have nothing else to disclose.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background Hospital workplace culture may have an impact on surgical outcomes; however, this association has not been established. We designed a study to evaluate the association between safety culture and surgical site infection (SSI). Study Design Using the Hospital Survey on Patient Safety Culture and National Healthcare Safety Network definitions, we measured 12 dimensions of safety culture and colon SSI rates, respectively, in the surgical units of Minnesota community hospitals. A Pearson's r correlation was calculated for each of 12 dimensions of surgical unit safety culture and SSI rate and then adjusted for surgical volume and American Society of Anesthesiologists (ASA) classification. Results Seven hospitals participated in the study, with a mean survey response rate of 43%. The SSI rates ranged from 0% to 30%, and surgical unit safety culture scores ranged from 16 to 92 on a scale of 0 to 100. Ten dimensions of surgical unit safety culture were associated with colon SSI rates: teamwork across units (r = -0.96; 95% CI [-0.76, -0.99]), organizational learning (r = -0.95; 95% CI [-0.71, -0.99]), feedback and communication about error (r = -0.92; 95% CI [-0.56, -0.99]), overall perceptions of safety (r = -0.90; 95% CI [-0.45, -0.99]), management support for patient safety (r = -0.90; 95% CI [-0.44, -0.98]), teamwork within units (r = -0.88; 95% CI [-0.38, -0.98]), communication openness (r = -0.85; 95% CI [-0.26, -0.98]), supervisor/manager expectations and actions promoting safety (r = -0.85; 95% CI [-0.25, -0.98]), non-punitive response to error (r = -0.78; 95% CI [-0.07, -0.97]), and frequency of events reported (r = -0.76; 95% CI [-0.01, -0.96]). After adjusting for surgical volume and ASA classification, 9 of 12 dimensions of surgical unit safety culture were significantly associated with lower colon SSI rates. Conclusions These data suggest an important role for positive safety and teamwork culture and engaged hospital management in producing high-quality surgical outcomes.
AB - Background Hospital workplace culture may have an impact on surgical outcomes; however, this association has not been established. We designed a study to evaluate the association between safety culture and surgical site infection (SSI). Study Design Using the Hospital Survey on Patient Safety Culture and National Healthcare Safety Network definitions, we measured 12 dimensions of safety culture and colon SSI rates, respectively, in the surgical units of Minnesota community hospitals. A Pearson's r correlation was calculated for each of 12 dimensions of surgical unit safety culture and SSI rate and then adjusted for surgical volume and American Society of Anesthesiologists (ASA) classification. Results Seven hospitals participated in the study, with a mean survey response rate of 43%. The SSI rates ranged from 0% to 30%, and surgical unit safety culture scores ranged from 16 to 92 on a scale of 0 to 100. Ten dimensions of surgical unit safety culture were associated with colon SSI rates: teamwork across units (r = -0.96; 95% CI [-0.76, -0.99]), organizational learning (r = -0.95; 95% CI [-0.71, -0.99]), feedback and communication about error (r = -0.92; 95% CI [-0.56, -0.99]), overall perceptions of safety (r = -0.90; 95% CI [-0.45, -0.99]), management support for patient safety (r = -0.90; 95% CI [-0.44, -0.98]), teamwork within units (r = -0.88; 95% CI [-0.38, -0.98]), communication openness (r = -0.85; 95% CI [-0.26, -0.98]), supervisor/manager expectations and actions promoting safety (r = -0.85; 95% CI [-0.25, -0.98]), non-punitive response to error (r = -0.78; 95% CI [-0.07, -0.97]), and frequency of events reported (r = -0.76; 95% CI [-0.01, -0.96]). After adjusting for surgical volume and ASA classification, 9 of 12 dimensions of surgical unit safety culture were significantly associated with lower colon SSI rates. Conclusions These data suggest an important role for positive safety and teamwork culture and engaged hospital management in producing high-quality surgical outcomes.
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U2 - 10.1016/j.jamcollsurg.2015.11.008
DO - 10.1016/j.jamcollsurg.2015.11.008
M3 - Article
C2 - 26712245
AN - SCOPUS:84959518016
SN - 1072-7515
VL - 222
SP - 122
EP - 128
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 2
ER -