Measuring Patient Safety Climate: A Review of Surveys

Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03755, USA.
Quality and Safety in Health Care (Impact Factor: 2.16). 11/2005; 14(5):364-6. DOI: 10.1136/qshc.2005.014217
Source: PubMed


Five years ago the Institute of Medicine recommended improving patient safety by addressing organizational cultural issues. Since then, surveys measuring a patient safety climate considered predictive of health outcomes have begun to emerge. This paper compares the general characteristics, dimensions covered, psychometrics performed, and uses in studies of patient safety climate surveys.
Systematic literature review.
Nine surveys were found that measured the patient safety climate of an organization. All used Likert scales, mostly to measure attitudes of individuals. Nearly all covered five common dimensions of patient safety climate: leadership, policies and procedures, staffing, communication, and reporting. The strength of psychometric testing varied. While all had been used to compare units within or between hospitals, only one had explored the association between organizational climate and patient outcomes.
Patient safety climate surveys vary considerably. Achievement of a culture conducive to patient safety may be an admirable goal in its own right, but more effort should be expended on understanding the relationship between measures of patient safety climate and patient outcomes.

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    • "Other authors have reviewed specific PSC tools in order to distil its main dimensions. For instance, Colla et al. (2005) reviewed nine such tools, identifying that nearly all of them had leadership, policies and procedures, staffing, communication, and reporting as common dimensions. Singla et al. (2006) reviewed 13 PSC tools representing 23 dimensions of PSC, which they grouped into the broad categories of management/supervision, risk, work pressure, competence, procedures/rules, and miscellaneous. "
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    • "All items with responses of 'most of the time/always' or 'agree/strongly agree' were considered as positive responses. The HSOPSC has very well-established psychometric properties including factor analysis, reliability and item analysis (Colla et al. 2005; Fleming 2005; Flin 2007; Hellings et al. 2007). The Cronbach's α reliability for the HSOPSC dimensions has been reported to range from 0.63 to 0.84 (Fleming 2005). "
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