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MedStar Washington Hospital Center, a 926-bed teaching and research hospital in Washington, D.C., has used AHRQ's Hospital Survey on Patient Safety Culture since 2010 to help the tertiary medical center work toward its goal of being a high-reliability organization. AHRQ's tool helps hospitals assess their patient safety culture, track changes in patient safety over time, and evaluate the effect of patient safety interventions.

"The results of our survey were a huge help for us to guide our improvement," says Barbara Mitchell, M.S.N., R.N., Washington Hospital Center's vice president of outcomes management. "The survey is an integral part in moving toward our goal of being a high-reliability organization. It laid the groundwork for us. If we didn't have that, it would be much more difficult."

The first survey in 2010 established a baseline for the hospital's quality improvement efforts. It also helped the hospital raise staff awareness about patient safety, diagnose and assess the status of its patient safety culture, and identify strengths and areas for improvement. "It helped us internally," Ms. Mitchell says, adding, "The key is maintaining a patient safety culture. This survey helps keep patient safety in the forefront."

"Overall, our 2012 [survey] results were better," she reports, adding that the staff's overall perception of patient safety has increased since the 2010 baseline. Other areas that improved included frequency of events reported, teamwork within the units, openness of communication, non-punitive response to errors, and handoffs and transitions. Two-thirds of respondents rated their unit or work area in the hospital as excellent or very good.

Washington Hospital Center first initiated the survey during the same year the facility implemented a culture of safety education program, which increased awareness among staff. As part of that education program, the Hospital Center determined that its "serious safety event" rate had increased by 58 percent. When the second survey was conducted in 2012, the serious safety event rate decreased by 44 percent.

Although the hospital's overall survey response rate fell between 2010 and 2102 (64 percent of staff members completed the survey in 2010 vs. 42 percent in 2012), the response rate among clinicians—registered nurses, physicians, medical residents—and administrative/management staff increased. A total of 2,889 employees took the survey in 2012.

"The dimensions of the survey are part of the work we are doing," Ms. Mitchell notes. "We feel like we are on the right path."

For more information on MedStar Washington Hospital Center, visit

To learn more about AHRQ's Hospital Survey on Patient Safety Culture, visit: http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/index.html