This paper compares results of safety climate survey questions from health care respondents with those from naval aviation, a high-reliability organization. Separate surveys containing a subset of 23 similar questions were conducted among employees of 15 hospitals and from naval aviators of 226 squadrons. For each question, a problematic response (PR) was defined that suggested an absence of a safety climate. Overall, the PR rate was 5.6% for naval aviators vs. 17.5% for hospital personnel. The PR was 20.9% in high-hazard hospital domains such as emergency departments and operating rooms. PR among hospital workers was up to 12 times greater than that among aviators on certain questions. Although further work is warranted on safety climate in health care, hospitals may need to make substantial changes to achieve a safety climate consistent with that of high-reliability organizations.
Abstract