Table 2

 Descriptive statistics of survey on patient safety culture and benchmark scores

Subscales and survey itemsNursing home score† (SD)Benchmark score†
n = 2717.
R =  item was reverse coded, so for all questions higher scores are more favourable.
*Significantly different t test at p<0.05 (using same standard for both primary data and benchmark scores).
†The scales used for the questions were (1) strongly disagree, disagree, neither, agree and strongly agree; and (2) never, rarely, sometimes, most of the time and always. For each positively worded item, the percentage of positive responses was calculated—that is, the percentage of respondents answering the question as strongly agree and agree, or always or most of the time. In a similar way, for each negatively worded item, the percentage of negative responses was calculated.
1. Overall perceptions of safety (Cronbach’s α  = 0.78) 39 (12) 56*
    a. Resident safety is never sacrificed to get more work done42 (11)50*
    b. Our procedures and systems are good at preventing errors from happening41 (12)67*
    c. It is just by chance that more serious mistakes don’t happen around here36 (15)56*
    d. We have patient safety problems in this facility (R)38 (14)53*
2. Frequency of events reported (Cronbach’s α  = 0.71) 31 (12) 52*
    a. When a mistake is made, but is caught and corrected before affecting the resident, how often is this reported?40 (11)43
    b. When a mistake is made, but has no potential to harm the resident, how often is this reported?13 (16)42*
    c. When a mistake is made that could harm the resident, but does not, how often is this reported?28 (14)71*
3. Management Expectations and Actions Promoting Patient Safety (Cronbach’s α  = 0.62) 50 (11) 71*
    a. Management says a good word when he/she sees a job done according to established resident safety procedures37 (14)63*
    b. Management seriously considers staff suggestions for improving resident safety66 (9)68
    c. Whenever pressure builds up, my manager wants us to work faster, even if it means taking shortcuts (R)55 (8)72*
    d. My manager overlooks resident safety problems that happen over and over (R)46 (12)77*
4. Organizational learning (Cronbach’s α  = 0.77) 24 (14) 71*
    a. We are actively doing things to improve resident safety21 (16)78*
    b. Mistakes have led to positive changes here27 (14)68*
    c. After we make changes to improve resident safety, we evaluate their effectiveness23 (11)68*
5. Teamwork within units (Cronbach’s α  = 0.80) 27 (12) 74*
    a. People support one another between units37 (13)84*
    b. When a lot of work needs to be done quickly, we work together as a team to get the work done33 (12)81*
    c. In all units, people treat each other with respect24 (10)72*
    d. When one area in this unit gets really busy, others help out21 (9)59*
6. Communication openness (Cronbach’s α  = 0.71) 27 (12) 61*
    a. Staff will freely speak up if they see something that may negatively affect resident care46 (12)72*
    b. Staff feel free to question the decisions or actions of those with more authority15 (14)43*
    c. Staff are afraid to ask questions when something does not seem right (R)23 (12)65*
7. Feedback and communication about error (Cronbach’s α  = 0.70) 38 (13) 52*
    a. We are given feedback about changes put into place based on event reports35 (11)48*
    b. We are informed about errors that happen in the units45 (9)52*
    c. In this facility, we discuss ways to prevent errors from happening again15 (16)58*
8. Non-punitive response to error (Cronbach’s α  = 0.72) 34 (12) 43*
    a. Staff feel like their mistakes are held against them (R)28 (14)47*
    b. When an event is reported, it feels like the person is being written up, not the problem (R)21 (12)47*
    c. Staff worry that mistakes they make are kept in their personnel file (R)42 (10)33*
9. Staffing (Cronbach’s α  = 0.81) 21 (12) 50*
    a. We have enough staff to handle the workload22 (11)40*
    b. Staff in this facility work longer hours than is best for resident care23 (15)54*
    c. We use more agency/temporary staff than is best for resident care17 (13)67*
    d. We work in “crisis mode” trying to do too much, too quickly (R)21 (10)37*
10. Management support for resident safety (Cronbach’s α  = 0.66) 40 (12) 60*
    a. Management provides a work climate that promotes resident safety42 (11)72*
    b. The actions of management show that resident safety is a top priority39 (12)60*
    c. Management seems interested in resident safety only after an adverse event happens38 (14)49*
11. Teamwork across units (Cronbach’s α  = 0.74) 55 (11) 53
    a. There is good cooperation among units that need to work together62 (10)54*
    b. Units work well together to provide the best care for residents57 (9)59
    c. Units do not coordinate well with each other (R)48 (12)41*
    d. It is often unpleasant to work with staff from other units (R)55 (10)57
12. Handoffs and transitions (Cronbach’s α  = 0.75) 27 (14) 45*
    a. Things “fall between the cracks” when transferring residents from one unit to another (R)36 (12)42*
    b. Important resident care information is often lost during shift changes (R)15 (15)58*
    c. Problems often occur in the exchange of information across units (R)32 (14)38*
    d. Shift changes are problematic for residents in this facility (R)16 (17)42*