Assessing the culture of safety in cardiovascular perfusion: attitudes and perceptions

Introduction: The Hospital Survey on Patient Safety Culture was developed by the Agency for Healthcare Research and Quality (AHRQ) to assess the culture of safety in hospitals. The purpose of this study was to identify specific domains of perfusion that are indicators of a high quality culture of safety. Methods: Perfusionists were recruited to participate in the survey through email invitation through Perflist, Perfmail and LinkedIn. The survey consisted of 37 questions across six safety domains. Questions were developed using the AHRQ Hospital Survey on Patient Safety Culture. ‘Positive scores’ were defined as a response that either agreed or strongly agreed with a safety standard. Survey responses that resulted in a 75 percent or higher positive response rate were identified as vital components of a high culture of safety. Logistic regression analysis was used to determine importance components of perceived safety. Results: Four responses were found to have a significant predictive level of a positive safety environment in the work unit: (1) in this unit, we discuss ways to prevent errors from happening again; OR=3.09, (2) in this unit, we treat others with respect; OR=1.09 (3) my supervisor/manager seriously considers staff suggestions for improving patient safety; OR=1.89 and (4) there is good cooperation among hospital units that need to work together; OR=1.77. There were two predictors of a negative work unit safety environment: (1) staff are afraid to ask questions when something does not seem right; OR=0.62 and (2) it is just by chance that more serious mistakes don’t happen around here; OR=0.55. Conclusions: The results from this survey indicate that effective communication secondary to both incident and near-miss reporting is associated with a higher perceived culture of safety. A positive safety environment is associated with being able to speak up regarding safety issues without fear of negative repercussions.