Disconnect Between Infection Rates and Patient Safety Survey Scores
The staff at hospitals are all too familiar with those surveys designed to gauge patient safety, but do they touch on the right problems? Patient Safety Culture surveys are given and assessed by the Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services. According to the agency’s website, the goal is to support a culture built around patient safety and to improve the quality of health care in this country. With antibiotic resistance and healthcare-associated infections on the rise, how well does this survey address these concerns?
Research on the Effectiveness of the Surveys
Recently, a team of researchers with the University of Michigan Medical School and VA Ann Arbor Healthcare System studied the effectiveness of these surveys in relation to infection control. The study authors used data from hundreds of hospitals and published their findings in the journal BMJ: Quality & Safety.
During the study, researchers found that the patient safety scores didn’t always match the unit’s progress on key goals like reducing the risk of infections. There was a clear disconnect between the survey results and the actual environment patients faced at the hospital.
All units involved in the study were focused on reducing two specific types of healthcare-associated infections:
- Central line-associated bloodstream infections
- Catheter-associated urinary tract infections
All the hospitals gave their staff additional tools and training in these areas. They worked to improve teamwork and to get the employees to report problem areas. The researchers predicted that better survey measures would mean lower infection rates, especially given this extra effort by the hospitals.
What they found was different than what they expected, according to lead author Jennifer Meddings, MD. The data showed no connection between the survey scores and any decline in infection rates. The fact was hospitals were struggling to even get staff to take the rather long surveys, so this may have contributed to the unexpected results. The actual survey scores may be skewed due to the low numbers.
A previous study looked directly at baseline data from a central line-associated bloodstream infection reduction project and did find the numbers lined up with the actual reduction in infections.
These surveys should work to validate infection control efforts. Meddings suggests that future surveys be designed in a way to show a clearer link to patient safety culture and infection control. They want to be able to tell which interventions actually reduce hospital-acquired infections using data from these surveys. The agency that conducts the survey actually funded the study, so there is hope they will learn from the results.