Agreement between patient safety culture and employee safety culture in a healthcare environment

William John Pate, The University of Texas School of Public Health


The measurement of safety culture is useful in identifying potential systemic causes for patient and employee safety incident trends. Organizations often assume a relationship between patient safety culture and employee safety culture. However, historically these two concepts have been considered separate and distinct areas of interest with organizations independently measuring and developing interventions for each. This separation has resulted in disparity in the attention and resources allocated towards improving both areas of safety culture. The purpose of this project was to evaluate agreement between the two measures and the potential to use one survey tool as a surrogate for the other. To this end, we concurrently administered an electronic patient safety culture survey and an employee safety culture survey to a sample of healthcare workers in hospital settings at two public healthcare organizations in Texas. The two survey tools used in this study were the Hospital Survey on Patient Safety Culture, from the Agency for Healthcare Research and Quality, and the Organizational Performance Metric, from the Institute for Work and Health. Statistical measures of agreement between the two safety culture surveys, including Cohen’s kappa-statistic and Lin’s Concordance Correlation Coefficient, were calculated. The data collected from these surveys accomplished the study’s primary objective to estimate the level of agreement between these two measures. Overall, there was weak agreement between measures of patient safety culture and employee safety culture. Thus, tools used to assess one component of safety culture in a healthcare organization cannot be used as a surrogate for the other component of safety culture. Organizations wanting to measure and improve both employee safety culture and patient safety culture will need to do so separately.

Subject Area

Occupational health|Environmental Health

Recommended Citation

Pate, William John, "Agreement between patient safety culture and employee safety culture in a healthcare environment" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10248303.