The effect of facility complexity on perceptions of safety climate in the operating room: size matters.

This study explores the effect of facility complexity on operating room (OR) caregiver perceptions of safety climate in the Veterans Health Administration (VHA). Facility complexity is a standardized score based on volume, risk, teaching, research, and intensive care unit capability. The Safety Attitudes Questionnaire was administered at 34 VHA hospitals. The authors performed analysis of variance on safety climate item scores by facility complexity and Bonferroni post hoc probes. Caregivers at high-complexity facilities were significantly less likely to agree that "Medical errors are handled appropriately in this hospital" than caregivers at medium-complexity facilities. Caregivers at high-complexity facilities were significantly more likely to agree that "I know the proper channels to direct questions regarding patient safety in the ORs here" than caregivers at medium-complexity facilities. Differences in caregiver perceptions of safety climate by facility complexity are present. Awareness of these differences can help when facilities implement surgical safety procedures.