Background Patient safety culture is measured using a range of survey tools. Many provide limited data on psychometric properties and few report findings outside of the US healthcare context. This study reports an assessment of the psychometric properties and suitability of the American Hospital Survey on Patient Safety Culture for use within the UK. Methods A questionnaire survey of three hospitals within a large UK Acute NHS Trust. 1437 questionnaires were completed (37% response rate). Exploratory factor analysis, confirmatory factor analysis and reliability analyses were carried out to assess the psychometric performance of this survey instrument and to explore potential improvements. Results Reliability analysis of the items within each proposed scale showed that more than half failed to achieve satisfactory internal consistency (Cronbach's a<0.7). Furthermore, a confirmatory factor analysis carried out on the UK data set achieved a poor fit when compared with the original American model. An optimal measurement model was then constructed via exploratory and confirmatory factor analyses with splithalf sample validation and consisted of nine dimensions compared with the original 12 in the American model. Conclusion This is one of the few studies to provide an evaluation of an American patient safety culture survey using data from the UK. The results indicate that there is need for caution in using the Hospital Survey on Patient Safety Culture survey in the UK and underline the importance of appropriate validation of safety culture surveys before extending their usage to populations outside of the specific geographical and healthcare contexts in which they were developed.

A hybrid organosilica monolith was synthesized containing an allyl functionality. This provided a viable platform for producing silica-based, chromatographic, monolithic columns with the stationary phase bonded through a surface silicon-carbon bond rather than a conventional siloxane bond.

BackgroundWhile unannounced standardized patients (USPs) have been used to assess physicians’ clinical skills in the ambulatory setting, they can also provide valuable information on patients’ experience of the health care setting beyond the physician encounter. This paper explores the use of USPs as a methodology for evaluating patient-centered care in the health care system.MethodsUSPs were trained to complete a behaviorally-anchored assessment of core dimensions of patient-centered care delivered within the clinical microsystem, including: 1) Medical assistants’ safe practices, quality of care, and responsiveness to patients; 2) ease of clinic navigation; and 3) the patient-centeredness of care provided by the physician. Descriptive data is provided on these three levels of patient-centeredness within the targeted clinical microsystem. Chi-square analyses were used to signal whether variations by teams within the clinical microsystem were likely to be due to chance or might reflect true differences in patient-centeredness of specific teams.ResultsSixty USP visits to 11 Primary Care teams were performed over an eight-month period (mean 5 visits/team; range 2–8). No medical assistants reported detecting an USP during the study period. USPs found the clinic easy to navigate and that teams were functioning well in 60% of visits. In 30% to 47% of visits, the physicians could have been more patient-centered. Medical assistants’ patient safety measures were poor: patient identity was confirmed in only 5% of visits and no USPs observed medical assistants wash their hands. Quality of care was relatively high for vital signs (e.g. blood pressure, weight and height), but low for depression screening, occurring in only 15% of visits. In most visits, medical assistants greeted the patient in a timely fashion but took time to fully explain matters in less than half of the visits and rarely introduced themselves. Physicians tried to help patients navigate the system in 62% of visits.ConclusionsUSP assessment captured actionable, critical, behaviorally-specific information on team and system performance in an urban community clinic. This methodology provides unique insight into the patient-centeredness and quality of care in medical settings.

No abstract

Articles you may be interested inEffect of growth temperature and post-growth annealing on luminescence properties of molecular beam epitaxy grown single layer Ge quantum dots SiGe quantum dot single-hole transistor fabricated by atomic force microscope nanolithography and silicon epitaxial-regrowthWe examine variations in the basic structure of quantum dot molecules ͑fourfold quantum dot nanostructures forming around a central facetted pit͒ in the Si x Ge 1−x / Si͑100͒ system. Arrays of quantum dot molecules are seeded by Ga + focused ion beam ͑FIB͒ prepatterning of the Si substrate prior to epitaxial Si buffer layer growth and Ge x Si 1−x film deposition. Five main variants to the regular quantum dot molecule structure are observed. The populations of these variant structures depend on the initial FIB processing conditions; their frequencies generally increase with increasing prepatterned pit depth and with increasing incident ion energy. This work suggests both routes to improving uniformity of regular quantum dot molecule arrays as well as routes to enabling synthesis of a wider range of nanostructure geometries.