How to Assess Patient Safety Within the Emergency Department

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Establishing and maintaining a culture of patient safety within the emergency department is critical to the patient experience. However, assessing levels of safety and the overall culture of patient safety within the ED can prove difficult.

Hospital and ED leaders must understand that the role patient safety plays within the context of clinical operations is crucial to strengthening ED performance. And reaching out to staff, whether through regular meetings, surveys or group huddles, is one of the most effective ways to gauge how well patient safety initiatives are working and being received by staff and patients.

To assess the culture of patient safety, the Agency for Healthcare Research and Quality provides a handy tool that can be utilized by hospital and ED leaders. This short survey — AHRQ recommends allowing 10 to 15 minutes to complete — elicits responses to patient safety-related prompts, which ultimately provide compelling data to determine just how important of a role patient safety plays in your ED.

From “Strongly Disagree” to “Strongly Agree” staff can comment on how well they support one another in their unit and whether colleagues treat peers with respect. But some of the most telling prompts are related to how emergency departments respond to mistakes and errors. For example:

Mistakes have led to positive changes here.

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

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

While surveys, whether specifically tailored for your emergency department or adapted from AHRQ, are the most effective and efficient ways to assess the culture of patient safety within your ED, it’s important to utilize other measurement strategies to make an accurate assessment.

Observation is one of the simplest ways to determine the role patient safety plays within the ED. By devoting a specific amount of time each month to patient safety-related observation, ED leaders can gain a better understanding of how well patient safety initiatives are working in the ED. When you pair this strategy with regular meetings and an open-door policy staff members feel comfortable taking advantage of, hospital and ED leaders can expect to gain valuable feedback.

One important note: patient safety encompasses a vast array of possible data sets and areas of measurement and assessment. Surveys, observation and direct communication with staff won’t garner all of the information you need to make the most accurate determination of the role patient safety plays within the ED. It’s also crucial to dig deep into the data and numbers generated by your emergency department, such as length of stay, leaving without being seen rates, patient volume and return visits. Patterns often emerge within these data sets to signal issues related to patient safety; however, they can be misleading.  While an EDs may rank among, or better, than the state or national average, it’s not always a sign that a strong culture of patient safety prevails. Using data is a great starting point, but assessment can’t stop there. Multiple avenues of measurement must be employed.

Hospital and ED leaders: what strategies do you use to assess patient safety within your emergency department? Schedule your complimentary phone consultation with Connie Donovan to discuss how to possibly improve your strategies.


Agency for Healthcare Research and Quality: “Hospital Survey on Patient Safety Culture”