Taking the Temperature of Your Patient Safety

Errors, accidents, injuries, infections, and even death – certainly nothing you would ever want to experience at any healthcare facility – yet, they happen. 

Hospitals, compounded by the volume of services as well as the large numbers of patients they treat, have had their publicized share of adverse and unfortunate occurrences. Ambulatory surgery centers (ASCs) aren’t exempt either.

Medical errors also lead to denied, downward-adjusted, or retracted reimbursement. Sub-par patient satisfaction scores related to safety issues can likewise contribute to reimbursement penalties. And if prospective patients see those lower scores, they’re likely to look elsewhere for treatment, if not forego treatment entirely. 

Even the slight possibility that these conditions exist somewhere in-house should be enough to compel any healthcare organization to prioritize their efforts to improve their own delivery of quality and safe healthcare.

There are two main types of risk mitigation: detection and prevention. And that starts out with a comprehensive overview of how those on the front line – the caregiving staff – perceive the patient safety conditions at your facilities. 

Surveys on Patient Safety Culture™(SOPS™)

Developed by the Agency for Healthcare Research and Quality (AHRQ), and administered and managed by SPH, Surveys on Patient Safety Culture, are expressly designed to gauge the awareness of patient safety among the staff at hospitals and ASCs, as well as ambulatory outpatient medical offices, community pharmacies, and nursing homes. 

The information gleaned from the completed surveys reveals the beliefs, values, and norms present that your staff experience every day – an illuminating insight that you wouldn’t normally be able to capture under other circumstances.

More pointedly, the results from SOPS will give you the means to:

  • raise staff awareness about patient safety
  • diagnose and assess the present status of patient safety culture
  • identify strengths and areas for patient safety culture improvement
  • examine trends in patient safety culture change over time
  • evaluate the cultural impact of patient safety initiatives and interventions
  • conduct internal and external comparisons

What SOPS covers

There are quite a few patient safety initiatives on which SOPS focuses. 

For hospitals:

Communication Openness– Can staff freely speak up if they see something that may negatively affect a patient? And do they feel free to question those with more authority? 
Feedback and Communication About Error– Is staff informed about errors that happen? Are they given feedback about changes implemented? And are they encouraged to discuss ways to prevent errors? 
Frequency of Events Reported– How often are mistakes of the following types being reported: (1) mistakes caught and corrected before affecting the patient, (2) mistakes with no potential to harm the patient, and (3) mistakes that could harm the patient but do not. 
Handoffs and Transitions– How often does important patient care information get transferred across hospital units and during shift changes?
Management Support for Patient Safety– Does hospital management provide a work climate that promotes patient safety and shows that patient safety is a top priority? 
Nonpunitive Response to Error– Does the staff feel that their mistakes and event reports are not held against them and that mistakes are not kept in their personnel file? 
Organizational Learning / Continuous Improvement– Have past mistakes led to positive changes? And have those changes been evaluated for effectiveness? 
Overall Perceptions of Patient Safety– Are the procedures and systems in place good at preventing errors? Has there been a questionable lack of reported patient safety problems? 
Staffing– Is there enough staff to handle the workload? And are work hours appropriate to provide the best care for patients?
Supervisor/Manager Expectations and Actions Promoting Patient Safety– Do supervisors / managers consider staff suggestions for improving patient safety, praise staff for following patient safety procedures, and do not overlook patient safety problems?
Teamwork Across Units– Are hospital units cooperating and coordinating with one another to provide the best care for patients?
Teamwork Within Units– Do the staff support each other, treat each other with respect, and work together as a team?

For ASCs:

Communication About Patient Information– Is key information about patients available and communicated well within the center?
Communication Openness– Can the staff speak up when they see something unsafe? Do they feel comfortable asking questions? And do they feel their suggestions are valued?
Management Support for Patient Safety– Have managers scrutinized recent near-miss events, provided adequate resources, and encouraged everyone to suggest ways to improve patient safety?
Organizational Learning / Continuous Improvement– Does the facility actively look for ways to improve patient safety and make changes to ensure that problems do not recur?
Response to Mistakes– Are staff told about patient safety problems? Is ‘learning’ rather than ‘blame’ emphasized? And are staff treated fairly when they do make mistakes? 
Staff Training– Have newer staff members received adequate orientation? Did they get the refresher and on-the-job training they need? And do they not feel pressured to do tasks they are not trained to do?
Staffing, Work Pressure, and Pace– Does the staff have enough time to properly prepare for procedures, and is there enough staff to handle the workload? 
Teamwork– Are staff respectful and helpful of each other? Do they work together as an effective team and understand each other’s roles and responsibilities?

What your patient safety culture can tell you

After summarizing your completed and tabulated SOPS survey results, you can develop a deeper understanding of your safety conditions and the perspectives of those in a position to affect them. And with that insight, you can adjust and guide the policies, procedures, priorities, and, in turn, the culture that promotes and maintains patient safety levels befitting those of a top-tier healthcare institution. 

One company’s “SOPS story”

One SPH client, already a long-time patient-safety-centric organization with more than 200 surgical centers and tens of thousands of team members, has had SPH implement SOPS to its caregiving teams on successive years. Annually, as each center’s patient safety landscape widened just a bit more, the corporate office, because of the SOPS results, became increasingly aware of potential vulnerabilities that could perhaps escalate into something more. Taking the preventive tack rather than a reactive one, procedures and policies were quickly amended, communicated, and implemented to head off any incident from occurring. 

Even after subsequent survey years, a majority of centers continued to record higher scores over the previous year’s already impressive tallies. Participation among the survey-takers was also high – approaching an astounding 85% in some facilities. Clearly an indicator of how serious caregivers also treat patient safety – “caregivers” in every sense of the word!

The goal of increased patient safety

Value-based care is expected to account for 59% of all healthcare payments by 2020 (up 25% from 2017). As more providers transform to fee-for-value risk-sharing arrangement, the more significant reducing risk to the patients and maximizing their safety becomes. Results from the SOPS survey can enlighten the organization as to the true state of patient safety in place at your facilities. 

With that awareness, you’re now on the road to setting measurable and attainable goals in your transformed patient safety culture. And that yields better care experiences, fewer readmissions, boosted staff morale, improved population health, higher ratings, and – better still – saved lives.

Ready to take the temperature of your patient safety? Contact SPH for Survey on Patient Safety Culture (SOPS) administration and reporting availability today.


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