Surgical culture safety survey

Surgical culture safety survey (pdf)
01 Dec 2015

The Health Quality & Safety Commission's Surgical Culture Safety Survey provides baseline data on attitudes and perceptions of surgical team members at New Zealand district health boards. Nearly 850 survey responses were received.

The Commission is rolling out a package of programmes aimed at helping improve teamwork and communication in the operating theatre. The Surgical Culture Safety Survey was conducted to provide baseline data on attitudes and the quality of teamwork in operating theatres. It closely replicates analysis developed by the Harvard School of Public Health.


Since 2012, the Health Quality & Safety Commission (the Commission) has had a goal of reducing peri-operative harm caused by adverse events and other errors that take place during the peri-operative period. To date the focus of this programme has been largely to support implementation of the WHO Surgical Safety Checklist (the checklist) and measuring its uptake through the Commission’s Quality and Safety Markers.

Research suggests that teamwork and communication failure are at the core of nearly half of all medical errors and adverse events. The Commission also recognises that ‘the checklist’ has not reached its full potential as a tool to improve teamwork and communication within surgical teams. Therefore, over the next two years the Commission is rolling out a package/suite of evidence-based teamwork and communications interventions to District Health Boards (DHBs).

As part of the overall monitoring and evaluation of the programme, the Commission wanted to conduct a Surgical Safety Culture Survey (SSCS) in order to provide baseline data on the perceptions and experiences of surgical team members across New Zealand DHBs regarding patient safety and the quality of teamwork in operating theatres. This report presents the results of this work.


This research was conducted as an online survey with surgical team members in New Zealand DHBs. The survey was a modified version of a SSCS developed by the Harvard School of Public Health, with amendments around language differences only. Permission was given by the Harvard School of Public Health for the Commission to use the survey.

Contact was made directly with nominated Safe Surgery Champions across New Zealand DHBs detailing the background to this research and requesting their assistance in this work. All DHBs (aside from Lakes) agreed to take part and all DHBs except South Canterbury sent the survey out. Note however that three surgical team members at another DHB identified Lakes DHB as their main place of work and some other surgical team members identified more than one DHB. Responses from up to N=843 surgical team members have been included in the analysis (but note that not all participants answered every question). A total of N=756 fully completed the survey.

Page last modified: 15 Mar 2018