Becker's Clinical Quality & Infection Control

9 PATIENT SAFETY & OUTCOMES Hospitals' safety culture gap By Mackenzie Bean H ealthcare workers' perceptions of safety at their organizations is improving, though a gap still remains between senior leaders and front-line workers, according to an April 2 Press Ganey report. Press Ganey surveyed more than 1 million employees from 200 health systems in 2023. e poll included 19 questions related to safety culture across three domains: prevention and reporting, pride and reputation, and resources and teamwork. ree takeaways: 1. Staff safety culture scores have risen from an all-time low of 3.96 (out of 5) in 2021 to 4.01 in 2023. is increase was largely driven by improvements around staff members' perceptions of resources and teamwork, including views on adequate unit staffing. "While these improvements are encouraging, there's still a lot of work to do," Press Ganey said. "Pre-pandemic rates were never the desired end state, and it's important to note that nearly half (48.5%) of employees still have a low perception of safety culture." 2. Senior management reported the highest perceptions of safety culture at 4.53, while registered nurses and advanced practice providers reported the second- and third-lowest at 3.95 and 3.92, respectively. Security team members had the lowest perceptions of safety at 3.91. 3. A large gap was also seen between senior leaders and registered nurses regarding perceptions of workplace violence protections. Senior management gave their organizations a 4.30 out of 5 for having strong security measures in place to prevent violence, compared to just 3.36 for nurses. "is gap is particularly concerning given that nearly a third (29%) of RNs report experiencing violence 'occasionally' or 'frequently' from patients or patients' family members," Press Ganey said. n Female physicians have lower patient mortality, readmission rates: Study By Mariah Taylor P atients treated by female physicians have lower mortality and readmission rates, a recent study found. The study, published April 23 in Annals of Internal Medicine, used a 20% random sample of Medicare fee-for-service beneficiaries hospitalized with medical conditions between 2016 and 2019 and treated by hospitalists. Of 458,108 female patients and 318,819 male patients, 31.1% and 30.6%, respectively, were treated by a female physician. Both female and male patients had lower patient mortality when treated by a female physician, but female patients had greater results from being treated by female physicians. The difference in patient mortality between female and male physicians was 8.15% and 8.38% respectively. The pattern was similar for readmission rates. For male patients, there was no significant difference in outcomes based on the gender of their physician. "Studies have shown that treatment by female physicians leads to improved communication effectiveness, better rapport and greater agreement about advice provided in female patients," the researchers wrote. "Some (prior) studies also suggest that seeing a female physician is associated with higher quality-of-care processes, especially in female patients." n Inside HCA's safety work By Mackenzie Bean N ashville, Tenn.-based HCA Healthcare has taken numerous steps to embed safety work into daily operations across its 186 hospitals, Karla Miller, PharmD, the system's chief patient safety officer, wrote in a March 15 blog post. Four ways HCA infuses patient safety into the organization's culture: Patient safety organization. HCA launched a federally chartered patient safety organization 10 years ago that is overseen by its patient safety and care experience teams. This group oversees event reporting, patient experience and various medication safety efforts, according to Dr. Miller. "Safe Table" discussions. These open forums allow team members to share concerns and ideas related to patient safety. Every year, the organization holds an enterprisewide "Safe Table" campaign where thousands of team members share insights that lead to local and systemwide changes across the organization. These sessions may occur in formal group settings or as impromptu discussions when leaders round on patient care units, according to Jessica Kirby, assistant vice president of quality at HCA Healthcare's Central and West Texas Division. Culture of Caring initiative. This new initiative, launching in early 2024, will spotlight team members of HCA's Physician Services Group who go the extra mile to care for patients and colleagues. The goal is to recognize colleagues for compassionate care and empower others to do the same, Dr. Miller said. Culture of Safety surveys. To measure progress on safety work, HCA uses the Agency for Healthcare Research and Quality's Surveys on Patient Safety Culture. These surveys ensure team members' voices are heard and help inform the organization's safety agenda, according to Dr. Miller. n

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