A Mixed Methods Study Exploring Patient Safety Culture at Four VHA Hospitals.

Area of Science:

• Healthcare Management
• Organizational Psychology
• Patient Safety Research

Background:

• Patient safety culture (PSC) is crucial for psychological safety and information sharing.
• The Veteran's Health Administration (VHA) utilizes a 20-item PSC survey across four scales.
• Understanding PSC manifestation and convergence is key for high reliability organization (HRO) implementation.

Purpose of the Study:

• To compare VHA PSC survey data with qualitative HRO implementation data.
• To assess the convergence and manifestation of PSC scales across four VHA hospitals.
• To evaluate the alignment between quantitative PSC survey results and qualitative insights.

Main Methods:

• Collected qualitative data from key informants at four VHA hospitals (2019-2020).
• Utilized a joint display to combine qualitative data with VHA PSC survey data.
• Analyzed survey responses and qualitative themes for each of the four PSC scales.

Main Results:

• Significant differences in PSC survey responses were observed across the four hospitals for all scales.
• Twelve out of twenty (60%) PSC survey items showed significant cross-hospital variation.
• Qualitative data supported the manifestation of 80% of individual PSC survey items.

Conclusions:

• Qualitative data generally aligned with VHA PSC scales, indicating good convergence.
• Inconsistencies between quantitative and qualitative data sources were noted.
• Further research is needed to fully understand the complex relationships between PSC data sources.