Table 4 Descriptive statistics of survey on patient safety culture and benchmark scores

   a. People support one another between units

   b. When a lot of work needs to be done quickly, we work together as a team to get the work done

   c. In all units, people treat each other with respect

   d. When one area in this unit gets really busy, others help out

Management Expectations and Actions Promoting Patient Safety (Cronbach's α = 0.72)

   a. Management says a good word when he/she sees a job done according to established resident safety procedures

   b. Management seriously considers staff suggestions for improving resident safety

   c. Whenever pressure builds up, my manager wants us to work faster, even if it means taking shortcuts (R)

   d. My manager overlooks resident safety problems that happen over and over (R)

Teamwork across units and Management support for resident safety (Cronbach's α = 0.80)

   a. Management provides a work climate that promotes resident safety

   b. The actions of management show that resident safety is a top priority

   c. Management seems interested in resident safety only after an adverse event happens

   d. There is good cooperation among units that need to work together

   e. Units work well together to provide the best care for residents

   f. Units do not coordinate well with each other (R)

Organizational learning (Cronbach's α = 0.68)

   a. We are actively doing things to improve resident safety

   b. Staff in this facility work longer hours than is best for resident care

   c. After we make changes to improve resident safety, we evaluate their effectiveness

Overall perceptions of safety (Cronbach's α = 0,57)

   a. Resident safety is never sacrificed to get more work done

   b. Our procedures and systems are good at preventing errors from happening

   c. It is just by chance that more serious mistakes don't happen around here

   d. We have patient safety problems in this facility (R)

Feedback and communication openness about error (Cronbach's α = 0.81)

   a. We are given feedback about changes put into place based on event reports

   b. We are informed about errors that happen in the units

   c. In this facility, we discuss ways to prevent errors from happening again

   a. Staff will freely speak up if they see something that may negatively affect resident care

   b. Staff feel free to question the decisions or actions of those with more authority

   c. Staff are afraid to ask questions when something does not seem right (R)

Frequency of events reported (Cronbach's α = 0.86)

   a. When a mistake is made, but is caught and corrected before affecting the resident, how often is this reported?

   b. When a mistake is made, but has no potential to harm the resident, how often is this reported?

   c. When a mistake is made that could harm the resident, but does not, how often is this reported?

Staffing (Cronbach's α = 0.63)

   a. We have enough staff to handle the workload

   c. We use more agency/temporary staff than is best for resident care

   d. We work in "crisis mode" trying to do too much, too quickly (R)

Handoffs and transitions (Cronbach's α = 0.72)

   a. Things "fall between the cracks" when transferring residents from one unit to another (R)

   b. Important resident care information is often lost during shift changes (R)

   c. Problems often occur in the exchange of information across units (R)

   d. It is often unpleasant to work with staff from other units (R)

   e. Shift changes are problematic for residents in this facility (R)

Non-punitive response to error (Cronbach's α = 0.71)

   a. Staff feel like their mistakes are held against them (R)

   b. When an event is reported, it feels like the person is being written up, not the problem (R)

   c. Mistakes have led to positive changes here

   d. Staff worry that mistakes they make are kept in their personnel file (R)

Overall (Cronbach's α = 0.86)