American Journal of Medical Quality 28(5) 434–442 © 2013 by the American College of Medical Quality Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1062860613475867 ajmq.sagepub.com Article Following publication of the Harvard Medical Practice Study 1 and To Err is Human, 2 health care workers and society as a whole realized that medical care frequently caused severe negative consequences for patients, known as adverse events (AEs). Subsequently, research was con- ducted to estimate the magnitude of these AEs while strategies for their prevention were designed. Among health care workers, residents training in hos- pitals are a population greatly affected by this subject. During this period of their medical practice, while they progressively acquire experience and achieve competen- cies, they deliver a great deal of direct patient care. All too often, they do so in undesirable conditions—suffering from fatigue or sleep deprivation, lacking effective super- vision, and taking over assignments that are beyond their capabilities, to name but a few examples. All these factors are related to an increased incidence of AEs. 3-14 As a result, residents in particular can be involved in AEs and suffer from their negative consequences. Despite monitoring health care safety over time, col- lecting and analyzing all facts leading to the high inci- dence of AEs, and implementing evidence-based safety practices, the impact on reducing patient harm has been quite modest. 15 Health care workers learning from their mistakes has become a goal that cannot be ignored. This objective will be achieved only when a safety climate—a set of norms, values, perceptions, and beliefs that govern performance and, ultimately, outcomes—is well established within health care organizations. 16 An essential component of a safety culture is to know health care workers’ perceptions of these risks, their atti- tudes regarding prevention strategies, and the level of engagement their organizations have in safety and pre- vention initiatives. This knowledge will enable the development of action plans to correct attitudes that hin- der patient safety. The Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture 17 867AJM XX X 10.1177/1062860613475867Ameri de la Tassa et al 1 Hospital de Cabueñes, Gijón, Spain 2 Universidad de Oviedo, Oviedo, Spain 3 Hospital Universitario Central de Asturias, Oviedo, Spain 4 Servicio de Salud del Principado de Asturias, Oviedo, Spain Corresponding Author: Joaquín Morís de la Tassa, MD, PhD, Servicio de Medicina Interna, Hospital de Cabueñes, Calle de los Prados, 395-33203 Gijón-Asturias, Spain. Email: joaquin.moris@sespa.princast.es Survey on the Culture of Patient Safety Among Spanish Health Care Residents Joaquín Morís de la Tassa, MD, PhD, 1,2 Diana Galiana Martín, MD, 1 Elisa Luño Fernández, MD, PhD, 2,3 Mª José Gómez Castro, MD, PhD, 4 and Gonzalo Solís Sánchez, MD, PhD 2,3 Abstract To improve patient safety, it is essential to have knowledge of the attitudes of all those involved in health care. The Thomas Jefferson Survey on Inpatient Adverse Events was translated and validated; all residents in Asturias, Spain, were invited to complete the survey. A total of 359 residents (60%) completed the survey; 50% of those surveyed agreed that adverse events (AEs) can be prevented. A greater percentage of responses attributed more responsibility to patients (54.4%) than to physician errors (28.7%). A total of 72% of respondents had observed AEs over the past 2 months, and 37% would be willing to take part in a work group to improve patient safety. It is necessary to increase residents’ involvement in efforts to improve patient safety, so that they will learn how to deal with health care risks and AEs and will share their knowledge and experiences. Keywords patient safety, attitudes of health care residents, medical education, medical errors, adverse events