Comparative Results from the AHRQ Nursing Home Survey on Patient Safety Culture
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Comparative Results from the AHRQ Nursing Home Survey on Patient Safety Culture Track A, Session 108 Deborah Carpenter RN MSN PMP CPHQ Theresa Famolaro, MPS AHRQ 2011 Annual Conference Leading Through Innovation & Collaboration September 19, 2011 Bethesda, MD Westat 1600 Research Blvd.

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Comparative Results from the AHRQ Nursing Home Survey on Patient Safety Culture

Track A, Session 108

Deborah Carpenter RN MSN PMP CPHQ

Theresa Famolaro, MPS

AHRQ 2011 Annual Conference

Leading Through Innovation & Collaboration

September 19, 2011

Bethesda, MD

Westat

1600 Research Blvd.

Rockville, MD 20850


Objectives

Describe survey domains and development process. Patient Safety Culture

Present comparative data from 200+ nursing homes.

Objectives


Background

Nursing Home Survey on Patient Safety Culture (NH-SOPS)

Sponsored by AHRQ; developed by Westat

Survey development process:

Reviewed literature & existing surveys

Interviewed nursing home staff

Identified key areas of safety culture

Developed & pretested survey items

Obtained input from researchers & stakeholders

Pilot tested in 40 nursing homes with 3,698 respondents

Background


Background1
Background (NH-SOPS)

  • AHRQ Nursing Home Survey on Patient Safety Culture released in fall 2008

  • Survey and support tools available at:

  • http://www.ahrq.gov/qual/patientsafetyculture/nhsurvindex.htm


Nhsops patient safety culture dimensions

42 items assess 12 dimensions of patient safety culture (NH-SOPS)

1. Communication openness

2. Compliance with procedures

3. Feedback & communication about incidents

4. Handoffs

5. Management support for resident safety

6. Nonpunitive response to mistakes

7. Organizational learning

8. Overall perceptions of resident safety

9. Staffing

10. Supv/mgr expectations & actions promoting resident safety

11. Teamwork

12. Training and skills

Resident safety “grade” (Excellent to Poor)

Overall recommendation of nursing home to friends

NHSOPS Patient Safety Culture Dimensions


Nhsops comparative database

AHRQ funded a NHSOPS comparative database (NH-SOPS)

Reports (2008 preliminary & 2011)

http://www.ahrq.gov/qual/nhsurvey11/

Purposes:

Comparison—of survey results in efforts to establish, improve and maintain a culture of resident safety

Assessment and Learning—insafety improvement process (rather than basis for determining punitive actions or external judgment of nursing home performance)

Supplemental Information—to help nursing homes identify strengths and areas with potential for safety culture improvement

NHSOPS Comparative Database


2011 nhsops comparative database

226 US nursing homes: 16,155 respondents (NH-SOPS)

Average # respondents per nursing home = 71

Survey administration

Paper 83%

Web 12%

Both 6%

Average nursing home response rate = 67%

Paper 70%

Web 49%

Both 56%

2011 NHSOPS Comparative Database


Job titles

Nursing Assistant/Aide 35% (5,154) (NH-SOPS)

Support Staff 18%

Licensed Nurse 17%

Administrator/Manager 10%

Direct Care Staff 9%

Administrative Support Staff 5%

Other 4%

Physician (MD, DO) 1%

Other Provider 1%

Job Titles


Work areas patient contact

Many different areas/no specific 46% (NH-SOPS)

Skilled nursing unit 21%

Other area or unit 20%

Alzheimer’s/Dementia unit 7%

Rehab unit 6%

71% had direct interaction with residents

Work Areas & Patient Contact






Results by nursing home characteristics
Results by Nursing Home Characteristics (NH-SOPS)

  • Smaller nursing homes (49 beds or fewer) scored highest on 10 out of 12 patient safety culture composites

  • Nonprofit/government nursing homes had higher average percent positive scores than for profit nursing homes on all 12 patient safety culture composites.

  • Both smaller and nonprofit/government nursing homes were willing to recommend their nursing home to friends

    • - 1-49 beds (88%) vs. 100-199 beds (74%)

    • - Nonprofit/gov (80%) vs. Profit (72%)


Results by job title
Results by Job Title (NH-SOPS)

  • Administrators/Managers and Physicians scored highest on all patient safety culture composites.

  • Nursing Assistants/Aides had the lowest scores

    • Overall Rating on Resident Safety (% “Excellent” or

    • “Very good”)

    • - Administrators/Managers and Physicians 81%

    • - Nursing Assistants/Aides 56%

  • Willingness to Recommend this Nursing Home to Friends

    • - Administrators/Managers and Physicians 93%

    • - Nursing Assistants/Aides 72%


Other respondent characteristics
Other Respondent Characteristics (NH-SOPS)

  • Higher scores on 11 of the 12 composites

  • reported for respondents that:

    • - Work day shifts

    • - Have no interaction with residents

  • There was a 14% difference on Overall Rating on

  • Resident Safety by shift

    • - Day shift (65%) vs. Nights (51%)


  • Future plans for surveys on safety culture
    Future Plans for Surveys on Safety Culture (NH-SOPS)

    • Medical Office Survey on Patient Safety Culture Data Submission is now open

      • (September 15 – October 15)

  • Pilot Test of Pharmacy Survey on Patient Safety Culture & release in Summer 2012

  • Free ongoing technical assistance


  • For assistance or questions

    [email protected] (NH-SOPS)

    [email protected]

    For Assistance or Questions


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