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Am J Surg. 2009 Jul;198(1):70-5. doi: 10.1016/j.amjsurg.2008.09.017. Epub 2009 Mar 6.

How does patient safety culture in the operating room and post-anesthesia care unit compare to the rest of the hospital?

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Department of Surgery, Boston, VA Healthcare System, West Roxbury, MA, USA.



A strong patient safety culture in the operating room (OR) and post-anesthesia care unit (PACU) is essential to promote safe care.


The Patient Safety Climate in Healthcare Organizations (PSCHO) survey was administered to employees at 30 Veterans Affairs (VA) hospitals. The survey consisted of 42 close-ended items representing 12 different dimensions of safety. We measured percent problematic response (PPR); higher PPR values reflect weaker safety culture. The "OR/PACU" and the "Other Work Areas" groups' item-specific, dimension-specific, and overall problematic responses were compared.


The overall and dimension-specific PPRs were similar between the OR/PACU and the Other Work Areas group (overall: 20.2% and 18.1%, respectively; P = .41). When the 2 groups were compared on an item-by-item level, the OR/PACU staff reported more frequent witnessing of unsafe patient care (PPR 55.1% vs 43.2%; P = .01), and perceived less understanding by senior leadership of clinical care (PPR 28.3% vs 17.1%; P = .01) and less hospital interest in quality of care (PPR 20.4% vs 12.5%; P = .03).


Specific areas of safety culture in the OR/PACU were found that should be targeted for improvement.

[Indexed for MEDLINE]

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