A culture of safety may not be the key to keeping patients safe, study finds

New research suggests that hospitals with a strong patient safety culture may not actually keep patients more safe.

The study, published in BMJ Quality & Safety, examined hundreds of hospitals and found that high scores on patient safety culture did not match up with how well the facilities did at reducing two risky hospital-acquired infections. The team, made up mostly of researchers from the University of Michigan (UM) and the VA Ann Arbor Health System,compared hospital units' results on the Hospital Survey on Patient Safety Culture and rates for two infections, central line-associated blood stream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI).

Though the rates of CLABSI and CAUTI dropped by 47 percent and 23 percent, respectively, over the course of the study, the team found no association between the infection reductions and the survey results. "In the data from both collaboratives, there was no connection between the safety culture scores derived from the surveys, and the actual decline in infection rates on the units," Jennifer Meddings, M.D., assistant professor of internal medicine at UM and the study's lead author, said in an announcement of the findings. "We think this indicates it's much more difficult to detect and measure safety culture than has been thought."

Hospital leaders are working to determine the best strategies for promoting a culture of safety in their facilities, especially in light of findings that suggest medical errors are the third-leading cause of death in the U.S.

Meddings said in the announcement that the team hopes the findings encourage hospitals to evaluate the use and effectiveness of surveys in promotion of patient safety. "We hope these analyses inform future collaboratives to be designed in way to better assess which components of multi-component interventions are most important to reduce infection and to reduce the routine use of culture surveys for busy clinicians until there are clearer links between the surveyed measures and culture observed on the units," she said.

To learn more:
- read the study
- here's the announcement