Objective This study aimed to survey patient safety culture in a county hospital and to provide evidence for strategies to improve patient safety culture.

Methods Nine hundred and thirty-two medical staff in a county hospital were surveyed with use of the Hospital Survey on Patient Safety Culture. Information was analyzed by one-way ANOVA and multiple linear regression analysis.

Results Nine hundred and thirty-two questionnaires were distributed, of which 661 of those returned were valid. The subscale-level results showed that the positive response rate for “teamwork across units” was higher than 75.0%, indicating it was an area of strength. Five areas – “nonpunitive response to error,” “staffing,” “communication openness,” “overall perceptions of patient safety,” and “frequency of event reporting” – had potential for improvement, with a positive responsive rate lower than 50%. Twenty-nine percent of respondents gave their work area a patient safety grade of “excellent” or “very good.” Further, 60.1% of respondents had reported no event in the previous 12 months. Multiple linear regression analysis indicated that position and number of years working in this hospital were the factors influencing patient safety culture.

Conclusion Patient safety culture in the county hospital has potential for improvement, especially in the areas of “nonpunitive response to error,” “staffing,” “overall perceptions of patient safety,” “communication openness,” and “frequency of event reporting.”

Statement of Significance It has been recognized for almost 20 years that safety culture is important in ensuring high-quality and safe care. This article describes the results of a patient safety culture survey undertaken in one Chinese county hospital, which distributed the Hospital Survey on Patient Safety Culture to 932 health care staff. It reaffirms that there is still a long way to go until hospitals have successfully established positive safety cultures. In terms of relevance, we believe the findings will be most useful to the hospital where the study was undertaken. Many of the recommendations in the discussion should be useful for the hospital.