Westat, Rockville, Maryland, USA.
J Patient Saf. 2012 Sep;8(3):131-9. doi: 10.1097/PTS.0b013e318258ca46.
The purpose of this study was to examine relationships among 2 Agency for Healthcare Research and Quality measures of hospital patient safety and quality, which reflect different perspectives on hospital performance: the Hospital Survey on Patient Safety Culture (Hospital SOPS)-a hospital employee patient safety culture survey-and the Consumer Assessment of Healthcare Providers and Systems Hospital Survey (CAHPS Hospital Survey)-a survey of the experiences of adult inpatients with hospital care and services. Our hypothesis was that these 2 measures would be positively related.
We performed multiple regressions to examine the relationships between the Hospital SOPS measures and CAHPS Hospital Survey measures, controlling for hospital bed size and ownership. Analyses were conducted at the hospital level with each survey's measures using data from 73 hospitals that administered both surveys during similar periods.
Higher overall Hospital SOPS composite average scores were associated with higher overall CAHPS Hospital Survey composite average scores (r = 0.41, P < 0.01). Twelve of 15 Hospital SOPS measures were positively related to the CAHPS Hospital Survey composite average score after controlling for bed size and ownership, with significant standardized regression coefficients ranging from 0.25 to 0.38. None of the Hospital SOPS measures were significantly correlated with either of the two single-item CAHPS Hospital Survey measures (hospital rating and willingness to recommend).
This study found that hospitals where staff have more positive perceptions of patient safety culture tend to have more positive assessments of care from patients. This finding helps validate both surveys and suggests that improvements in patient safety culture may lead to improved patient experience with care. Further research is needed to determine the generalizability of these results to larger sets of hospitals, to hospital units, and to other settings of care.
本研究旨在检验美国医疗保健研究与质量署(Agency for Healthcare Research and Quality)的两项医院患者安全与质量衡量标准之间的关系,这两项衡量标准反映了医院绩效的不同视角:医院患者安全文化调查(Hospital Survey on Patient Safety Culture,Hospital SOPS)——一项针对医院员工患者安全文化的调查,以及医疗保健提供者和系统患者评估调查(Consumer Assessment of Healthcare Providers and Systems Hospital Survey,CAHPS Hospital Survey)——一项针对成年住院患者医院护理和服务体验的调查。我们的假设是,这两项衡量标准之间存在正相关关系。
我们进行了多元回归分析,以检验 Hospital SOPS 衡量标准与 CAHPS Hospital Survey 衡量标准之间的关系,同时控制了医院床位数和所有权。分析在医院层面进行,使用了在相似时期同时进行这两项调查的 73 家医院的数据,对每个调查的衡量标准进行分析。
总体 Hospital SOPS 综合平均得分较高的医院与总体 CAHPS Hospital Survey 综合平均得分较高的医院相关(r = 0.41,P < 0.01)。在控制床位数和所有权后,15 项 Hospital SOPS 衡量标准中有 12 项与 CAHPS Hospital Survey 综合平均得分呈正相关,标准化回归系数的范围为 0.25 至 0.38。Hospital SOPS 衡量标准中没有任何一项与 CAHPS Hospital Survey 的两项单项衡量标准(医院评分和推荐意愿)显著相关。
本研究发现,员工对患者安全文化的看法更为积极的医院往往对患者的护理评估更为积极。这一发现有助于验证这两项调查的有效性,并表明患者安全文化的改善可能会导致患者对护理的体验得到改善。需要进一步研究以确定这些结果在更大规模的医院、医院科室和其他护理环境中的普遍性。