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Patient Safety Climate: A Study of Southern California Healthcare Organizations

Avramchuk, Andre, S., PhD; McGuire, Stephen, J.J., PhD

Journal of Healthcare Management: May-June 2018 - Volume 63 - Issue 3 - p 175–192
doi: 10.1097/JHM-D-16-00004

EXECUTIVE SUMMARY Human error remains the most important factor in unnecessary deaths and suffering in U.S. hospitals. Human error results from healthcare providers' attitudes and behaviors toward patients in different settings. Therefore, taking periodic snapshots of the attitudes and behaviors prevalent in an organization and manifested in its patient safety climate (PSC) is essential.

We developed and tested a short survey instrument intended as an organization-level measure of PSC with good psychometric properties that can be used in hospitals, clinics, or other healthcare provider settings. Analysis of data from 61 Southern California healthcare organizations resulted in a PSC model with four distinct, reliable factors: (1) Assistance From Others and the Organization, (2) Leadership Messages of Support in Policy and Behavior, (3) Resources and Work Environment, and (4) Error Reporting Behavior. A PSC score, ranging from 0 to 100, was generated for each organization.

For a subsample of hospitals in our study, preliminary results indicate a predictive quality of the model. The higher the PSC score, the lower the number of violations detected by the Centers for Medicare & Medicaid Services in complaint inspections, and the fewer the safety problems reported by The Leapfrog Group.

Given the association between PSC and health outcomes, we urge healthcare leaders to use various means, such as our survey, to monitor the degree to which their organizations maintain a climate that fosters patient safety and use such data to pinpoint areas for improvement.

assistant professor and coordinator, Graduate Healthcare Management Program, Department of Management, College of Business & Economics, California State University, Los Angeles

professor, Department of Management, and director of graduate programs, College of Business & Economics, California State University, Los Angeles

For more information regarding the concepts in this article, contact Dr. Avramchuk at

The authors declare no conflicts of interest. The authors contributed equally to this article.

© 2018 Foundation of the American College of Healthcare Executives
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