Medical Staff Pulse Newsletter

Results: 2019 Culture of Safety Survey


Staff from Cedars-Sinai Medical Center and the Cedars-Sinai Medical Network participated in the 2019 "I am the voice of patient safety" survey, which ran Nov. 4-18.

The survey, adapted from the Agency for Health Care Quality (AHRQ) Survey on Patient Safety Culture, was confidential, with results grouped by department or unit. Survey participants at the medical center included managers and staff who provide direct and indirect patient care in areas such as admissions, case management, clinical operations, clinical care services, as well as faculty and other physicians and house staff. In the medical network, physicians and both clinical and nonclinical staff were surveyed.

The survey is designed to help leadership better appreciate the degree to which employees and affiliated physicians understand their role in patient safety and feel management supports their efforts. Of those asked to take the survey, 82% of Medical Network employees and physicians completed it, as did 64% of medical center staff. Medical Network participation increased by 15% and medical center participation was nearly 20% higher than the 2017 survey. Results were available to be shared on Nov. 20.

One key survey result indicated that engaged employees score higher on all elements of patient safety.

"Understanding staff perceptions of safety is critical to enhance our safety culture," said Edward Seferian, MD, chief patient safety officer. "The information will be used to identify opportunities to maintain and enhance a culture of safety that supports staff in achieving our mission of providing the highest-quality, patient-centered, safe, efficient and effective care possible."

Key Findings

Cedars-Sinai Medical Network

  • Medical Network results improved in all surveyed domains, including leadership support for patient safety, communication openness and communication about error.
  • The best-scoring item was the safety culture index score based on the statement, "I would recommend this organization to family and friends as a safe place to seek care."
  • Leadership support for patient safety was the second-highest category, based on four questions including statements like "Leadership takes patient care mistakes seriously so repeat mistakes are not made."
  • Communication openness received a "very high" impact on safety culture, based on four questions including statements like, "Staff are encouraged to ask questions when something does not seem right."
  • Ease of voicing disagreement, as well as providers and staff speaking openly about office problems, were the lowest-rated areas.

Cedars-Sinai Medical Center

  • The organization scored better than the AHRQ benchmark in multiple areas, including management support for patient safety, organizational learning and continuous improvement, communication openness, feedback and communication about error and frequency of events reported.
  • Non-punitive response to error, while still an opportunity and a focus for improvement over the last several years, was also higher than benchmark and showed a significant improvement from the 2017 survey.
  • While still scoring high, areas that were slightly below benchmark included teamwork within units and manager expectations and actions for promoting patient safety.

Similar to benchmark, staffing was noted as an opportunity and one of the lowest-rated areas for the Medical Network and the medical center.

Area leaders have shared results with their staff and have been asked to take one step to promote a culture of safety—particularly one that ensures staff will feel safe to speak up and bring safety concerns forward.

"By asking leaders to focus their efforts on tangible, positive next steps, we hope to improve feedback, communication and engagement across Cedars-Sinai," said Caroline Goldzweig, MD, MSHS, chief medical officer of the Cedars-Sinai Medical Network. "Everyone has a voice in patient safety, and all of their feedback is invaluable."