Open Access

ARTICLE

Implementing a patient safety culture survey to identify and target process improvements in academic ambulatory urology practices: a multi-institutional collaborative

Alexander J. Skokan¹, Ryan W. Dobbs¹, Andrew M. Harris², Christopher D. Tessier³, Kamran P. Sajadi³, Ruchika Talwar¹, Ian Berger¹, Thomas J. Guzzo¹, Justin B. Ziemba¹

1 Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
2 Department of Urology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
3 Department of Urology, Oregon Health & Sciences University, Portland, Oregon, USA
Address correspondence to Dr. Justin B. Ziemba, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Perelman Center for Advanced Medicine, 3^rd Floor West, 3400 Civic Center Blvd., Philadelphia, PA 19104 USA

Canadian Journal of Urology 2020, 27(1), 10087-10092.

Abstract

Introduction: A shared professional culture focused on patient safety is critical to delivering high-quality care. There is a need for objective metrics to help identify target areas for improvement in patient safety culture. The Medical Office Survey on Patient Safety Culture (SOPS) was developed and validated by the United States Agency for Healthcare Research and Quality to measure patient safety culture in the ambulatory setting. In this study we report on safety culture and practices in six academic urology clinics utilizing this validated questionnaire.
Materials and methods: The SOPS was administered to all staff in ambulatory urology practices affiliated with participating centers. Percent positive responses were calculated for each of 10 validated composite domains and were compared between sites and respondent roles. Nonparametric statistical analyses were performed to identify differences between groups.
Results: The survey was administered to 185 staff members, with an overall response rate of 66%. Within each domain there was substantial variability between sites, with significant differences observed in staff training (p = 0.034), office processes/standardization (p = 0.008), patient care tracking (p = 0.047), communication about errors (p = 0.001), and organizational learning (p = 0.015). Similar variation was seen between respondent roles with significant differences for patient care tracking (p = 0.002) and communication about errors (p = 0.014).
Conclusions: The SOPS is a clinically useful tool to identify issues impacting a practice’s safety culture. Substantial variability was observed within each composite domain at the levels of practice site and respondent role. Comparing composite domain results between clinics will allow leadership to identify gaps and evaluate policies and resources of higher performing peer sites.

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