Measuring and benchmarking safety culture: application of the safety attitudes questionnaire to an acute medical admissions unit

Ir J Med Sci. 2009 Dec;178(4):433-9. doi: 10.1007/s11845-009-0352-2.


Objectives: To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results against international data and guide a unit-based, integrated, risk management strategy.

Methods: The safety attitudes questionnaire (SAQ), a validated instrument for the measurement of safety culture was applied to an AMAU. All AMAU healthcare staff (n = 92) were surveyed: doctors, nurses, healthcare assistants (HCAs) and allied healthcare professionals (AHPs). Safety attitude scores for the overall unit and individual caregiver types were assessed across six domains of safety culture.

Results: When compared against an international benchmark, the AMAU scored significantly higher for four of the six safety domains: p < 0.01 for 'teamwork climate', 'safety climate' and 'stress recognition' and p < 0.05 for 'job satisfaction'. The difference between nurse manager scores and the overall mean for the study group was statistically significant for the domains of 'teamwork climate' (p < 0.05) and 'safety climate' (p < 0.01). HCAs scored significantly lower relative to staff overall with regard to 'working conditions' (p < 0.05) and 'perceptions of management' (p < 0.01).

Conclusions: The SAQ was successfully applied to an AMAU setting giving a valuable insight into staff issues of concern across the safety spectrum: employee and environmental safety, clinical risk management and medication safety.

MeSH terms

  • Attitude of Health Personnel*
  • Benchmarking
  • Hospital Units / organization & administration*
  • Hospital Units / standards
  • Hospitals, Teaching
  • Humans
  • Organizational Culture*
  • Patient Admission* / standards
  • Personnel, Hospital / psychology*
  • Safety / standards*
  • Surveys and Questionnaires