Objectives: This study aims to examine the difference of patient safety culture between 2013 and 2019 at 16 hospitals in Japan.

Methods: Questionnaire surveys were conducted at 16 hospitals (average number of beds:238 [50 to 600 beds]; average number of staff:377 [49 to 1,700 staff]) in 2013 and 2019 with using a Hospital Survey on Patient Safety Culture (HSOPSC) sheet developed by the United States Agency for Healthcare Research and Quality (AHRQ). It consists of 12 factors (42 items) based on four categories (communication, organizational activity and understanding, education/ learning and number of reports).

Results: The numbers of valid respondents were 2931 (doctors:199, nurses:1570, clinical staff:460, office workers:330) in 2013 and 2988 (doctors:217, nurses:1590, clinical staff:561, office workers:383) in 2019, respectively. The average positive response rates (PRRs) of 12 factors in 2019 was 53.6 and increased by 0.8%, compared with that in 2013. Additionally, PRRs of 9 factors increased and three factors including Factor 1: Communication openness, Factor 6: Non-punitive response to error, and Factor 10: Supervisor/manager expectations and actions promoting safety extremely changed. On the contrary, Factor 3: Frequency of events reported, Factor 4: Hands-off and transitions, and Factor 12: Teamwork within units declined. The mean PRR of 12 factors increased at 11 of 16 hospitals. PRRs of Factor 1, Factor 5 (Management support for patient safety), Factor 8 (Overall perceptions of patient safety), and Factor 10 in 2019 were higher than in 2013 at most hospitals.

Conclusion: As the average PRRs for many factors related with “Organization” increased but the PRRs of many factors related with “Communication” decreased at each hospital. Therefore, it is suggested that improving the working environment will make patient safety culture.