(Bloomberg) — Patient safety at U.S. hospitals is hampered by inadequate teamwork and communication, as well as a negative culture, according to a study by insurer American International Group Inc.

More than half of hospital risk managers and 42% of executives surveyed by AIG say the top safety threat was tied to teamwork, communications or culture, according to a statement Friday from the New York-based insurer.

AIG, the insurer that repaid a U.S. bailout in December, provides coverage against risks such as medical liability and property damage to more than 2,000 hospitals and offers workers’ compensation insurance. AIG said it surveyed 250 U.S. hospital executives and 100 risk managers by phone as part of its effort to help improve patient safety and lower costs.

 “Improvements in patient safety will provide a quick return on investment,” says Emily Rhinehart, division manager for health care risk consulting at AIG.

Other impediments to patient safety include so-called handoffs of patients among hospital staff, burdens tied to documentation and the perception that nurses fear retribution if they discuss safety, according to the study. A majority of both risk managers and executives said patient safety was their No. 1 priority for 2013.

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