Objective. To compare
safety climate between diverse U.S. hospitals and Veterans Health
Administration (VA) hospitals, and to explore the factors influencing
climate in each setting.
Data Sources. Primary
data from surveys of hospital personnel; secondary data from the
American Hospital Association's 2004 Annual Survey of Hospitals.
Study Design. Cross-sectional study of 69 U.S. and 30 VA hospitals.
Data Collection. For
each sample, hierarchical linear models used safety-climate scores as
the dependent variable and respondent and facility characteristics as
independent variables. Regression-based Oaxaca–Blinder decomposition
examined differences in effects of model characteristics on safety
climate between the U.S. and VA samples.
Principal Findings. The
range in safety climate among U.S. and VA hospitals overlapped
substantially. Characteristics of individuals influenced safety climate
consistently across settings. Working in southern and urban facilities
corresponded with worse safety climate among VA employees and better
safety climate in the U.S. sample. Decomposition results predicted 1.4
percentage points better safety climate in U.S. than in VA hospitals:
−0.77 attributable to sample-characteristic differences and 2.2 due to
differential effects of sample characteristics.
suggest that safety climate is linked more to efforts of individual
hospitals than to participation in a nationally integrated system or
measured characteristics of workers and facilities.