Use of the Safety Attitudes Questionnaire as a measure in patient safety improvement

There is widespread interest in improving safety for patients receiving medical care, yet direct measurement of harm has been elusive. The Safety Attitudes Questionnaire is a validated measure of patient safety culture that has been associated with improved patient outcomes. We report on an attempt to use the Safety Attitude Questionnaire as an outcome measure for a patient safety implementation project.

Operating room staffs at 63 Veterans Affairs Medical Centers were surveyed using the Safety Attitude Questionnaire before and after a medical team training (MTT) program focused on improving staff communication. Survey results before and after MTT within medical centers were compared using nonparametric statistical testing.

Of the 63 VA hospitals that received medical team training, 26 showed changes in the staff's attitude as measured by the Safety Attitudes Questionnaire. Improvement was most common in the "perceptions of management" domain. There was no correlation between survey response rate and measured improvement.

The Safety Attitudes Questionnaire demonstrated good utility as a possible proxy measure of patient safety in the implementation study of MTT. Health care organizations may consider using it to measure effectiveness of safety improvement activities.