Nursing home administrators perceive a better safety culture in their facility than clinical staff, according to a new report.

Researchers at University of Michigan, using nursing homes participating in the Agency for Healthcare Research and Quality’s Safety Program in Long-Term Care, found that nursing assistants gave the domains of teamwork, training and skills, communication openness, supervisor expectations and organizational learning worse ratings than administrators.

The largest gaps were found in communication openness, teamwork and supervisor expectations. 

More than 14,000 nursing home staff members from 170 facilities responded to the Nursing Home Survey on Patient Safety Culture.  

Ratings of safety culture tended to be highest for employees with minimal tenure and lowest for those who were not new employees, the researchers, led by Jane Banaszak-Holl, Ph.D., found. Nonprofit and chain ownership also skewed toward worse supervisor expectations and poorer organizational learning. Facility ownership in general had the strongest effect on the perception of safety culture.

Administrators should spend more time at the bedside with clinicians to understand resident safety, they wrote. 

Results appeared in the Journal of the American Geriatrics Society in late August.