# Unraveling Patient Safety Culture Trends in U.S. Hospital Settings: A Yearly Retrospective Analysis
## 3 Results
### Hospital and Respondent Characteristics
The West had the smallest representation (11.4%, 183 hospitals, 108,556 participants). Hospitals in the 400+ bed category represented the largest proportion (14.2%), while hospitals in the 6-49 bed category had the smallest representation (20.5%, 328 hospitals, 43,007 respondents). Data collection spanned 2013-2020, peaking in 2015 (23.9%, 372 hospitals, 237,135 respondents), with the lowest participation in 2013 (<1%) and 2020 (2.5%). Web-based surveys were the primary mode of administration (81.8%, 1310 hospitals, 844,469 respondents), followed by mixed-mode and paper-based surveys (71 hospitals, 18,757 respondents). The sample included both non-teaching (1015 hospitals, 420,819 respondents) and teaching hospitals (586 hospitals, 572,426 respondents). Regarding participants' characteristics, 13% had less than 1 year of hospital experience, 34% had 1-5 years, and 19% had 6-10 years. In terms of specialty/profession experience, 27% had 1-5 years, and 24% had 21+ years. Registered Nurses comprised the largest group (35%), followed by patient care assistants/hospital aides/care partners (6%). In their work area/unit, 40% had 1-5 years of experience, 16% had less than 1 year, and 19% had 6-10 years. Most participants worked 40-59 h per week (48%), followed by 20-39 h (41%) and less than 20 h (5%). Direct patient interaction was reported by 78% of participants. As shown in Figure 1, the number of distributed surveys peaked at 514,839 in 2015 and reached a low of 15,583 in 2013. However, these fluctuations were not statistically significant (\(p=0.134\)). Valid responses also peaked in 2015 (237,135) and reached a low in \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**Hospital Characteristics** & **Hospital Frequency (\%)** & **Participant Frequency (\%)** & **Respondent Characteristics** & **Participant Frequency (\%)** \\ \hline Selected staff positions & 2 (\textless{1}\%) & 3716 (\textless{1}\%) & & \\ \hline Selected depts/units and selected staff positions & 61 (4\%) & 44,047 (4\%) & & Worked in Current Speciality or Profession (N = 897,411) \\ \hline \hline \end{tabular}
\begin{tabular}{p{113.8 pt} p{113.8 pt} p{113.8 pt} p{113.8 pt}} \hline \hline
**Respondent Characteristics** & **Participant Frequency (\%)** & Less than 1 year & 65,760 (7\%) \\ \hline \hline Worked in a Hospital & (* N = 899,076) & 6 to 10 years & 163,133 (18\%) \\ \hline Less than 1 year & 114,366 (13\%) & 11 to 15 years & 118,060 (13\%) \\ \hline
1 to 5 years & 302,106 (34\%) & 16 to 20 years & 97,249 (11\%) \\ \hline
6 to 10 years & 171,946 (19\%) & 21 years or more & 212,385 (24\%) \\ \hline
11 to 15 years & 115,538 (13\%) & & \\ \hline
16 to 20 years & 73,194 (8\%) & & \\ \hline
21 years or more & 121,926 (14\%) & & \\ \hline \hline \end{tabular}  
* N is the total valid number of respondents out of the total survey participants.  
\end{table} 
Table 1: _Cont._2013 (9094), with no significant difference between these years (\(p\) = 0.598). However, the average response rate significantly increased from 0.59 in 2013 to 0.63 in 2020 (\(p\) = 0.002), suggesting improved engagement or survey processes. The surveys were rigorously cleaned by [PERSON](r) ([PERSON], 2013), with incomplete surveys excluded before the response rate was calculated. Hospitals with missing values in PSC domains were also excluded. While the yearly total of surveys distributed and valid responses showed no significant differences, the response rate varied significantly.