Volume 44 | Number 5p1 | October 2009

Abstract List

Sara J. Singer M.B.A, Ph.D., Christine W. Hartmann, Amresh Hanchate Ph.D., Shibei Zhao, Mark Meterko, Priti Shokeen, Shoutzu Lin, David M. Gaba, Amy K. Rosen Ph.D.


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 of sample characteristics.


Results 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.