Organizational Role and Perception of Organizational Safety Culture: A Survey of Registered Nurses, Physicians, and Managers

Patient safety is a significant challenge to United States (U.S.) healthcare settings despite public and private efforts to reduce risk of medical error. Nurses function at the “sharp end” of error; they practice at the point in the clinical process where latent factors such as misaligned organizational process, poor communication, and lack of resources merge to actualize an error event. This article examines the impact of organizational role on perception of safety culture within a multi-state, multi-organization sample of healthcare professionals. The authors offer background information and describe study methods. Data were derived from a national sample of hospitals that administered the 2011 Agency for Healthcare Research and Quality (AHRQ) Safety Culture survey. The sample included registered nurses, physicians, and managers employed within 66 multi-state hospitals. Results demonstrated that managers reported significantly higher mean scores on the Safety Culture survey than registered nurses. Length of hospital employment predicted higher overall mean scores and number of reported adverse events predicted lower overall mean scores. Direct care providers reported significantly lower mean Safety Culture scores. The discussion and conclusion indicate that a primary implication of these findings is the importance of nursing input into patient safety policies.