Hospitals are urged to measure their safety culture through the use of one of several validated surveys that assess teamwork and organizational attitudes toward safety. Although several such surveys exist, evidence linking survey responses to improved patient outcomes is lacking. This AHRQ-funded study assessed the relationship between safety culture (as measured by the Safety Attitudes Questionnaire) and clinical outcomes in surgical patients, and found no clear relationship between perceived safety culture and risk-adjusted morbidity and mortality. However, reduced morbidity correlated with higher ratings of communication within surgical teams. This finding supports prior research that implicated communication failures as a cause of safety problems in surgery.