The Hospital Patient Safety Culture Survey: Reform of Analysis and Visualization Methods

Understanding the topography of hospital safety culture is vital for developing, implementing, and monitoring the effectiveness of tailored safety programs. Since 2009, the Chinese version of the Safety Attitudes Questionnaire (SAQ-C) has been introduced and administered to providers in many Taiwanese hospitals. The percentage of SAQ respondents who demonstrate attitudinal agreement within each of the SAQ domains, the percent agreement (PA) score, is used worldwide as the main parameter of safety culture surveys. However, several limitations within PA scoring have been identified. Our study sought to improve scoring methodology and develop a new graph layout for cultural topography presentation. A total of 37,163 responses to a national SAQ-C administration involving 200 Taiwan hospitals were retrospectively analyzed. To understand the central tendency and spread of safety culture scores across all participating hospitals, the median and interquartile range (IQR) of individual respondent’s SAQ-C scores by its domain were calculated, plotted, and named “Jeong & Lee plot”. Because of space limitation, we showed teamwork domain only. Study results denote limitations in the current PA scoring scheme, suggest SAQ analysis modification, and introduce a visualization graph layout that can provide richer information about safety culture dissemination than that available from currently utilized tools.