BackgroundStudying safety attitudes of front-line workers can help hospital managers take initiatives to improve patient safety. The Safety Attitudes Questionnaire, a psychometric tool that measures safety attitudes in health facilities, has been used and validated in several languages worldwide but there is no Italian version available. Hence, the study is aimed at cross-culturally validating the questionnaire (short form 2006) in Italian at two hospitals in the Veneto region (northeastern Italy).MethodsThe translation and linguistic adaptation process of the questionnaire followed the World Health Organization guidelines. The questionnaire was delivered to staff working in four departments in two hospitals. Confirmatory factor analysis was used to assess the content validity of a pre-specified factor model that recognizes seven safety factors of the SAQ. Retest was performed to assess reliability. Internal consistency of items and safety factors was evaluated via Cronbach’s alpha.ResultsResponse rate was 60 % (n = 261/433). Test-retest correlation between items and factors showed a high degree of agreement. Goodness-of-fit indices demonstrated an acceptable hypothesis model with seven safety factors. Cronbach’s alpha of a whole questionnaire was 0.85, demonstrating a good internal consistency. Polychoric correlations showed that the factors are well correlated with each other. Stress recognition was found to have negative correlation with other safety factors.ConclusionsThe Safety Attitudes Questionnaire in Italian language has satisfactory psychometric characteristics and is a valid instrument to measure safety culture in Italian hospitals.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0951-8) contains supplementary material, which is available to authorized users.

ObjectiveTo study the psychometric characteristics of German version of the Hospital Survey on Patient Safety Culture and to compare its dimensionality to other language versions in order to understand the instrument’s potential for cross-national studies.DesignCross-sectional multicentre study to establish psychometric properties of German version of the survey instrument.Setting73 units from 37 departments of two German university hospitals.ParticipantsClinical personnel (n=995 responses, response rate 39.6%).Primary and secondary outcome measuresPsychometric properties (eg, model fit, internal consistency, construct validity) of the instrument and comparison of dimensionality across different language translations.ResultsThe instrument demonstrated acceptable to good internal consistency (Cronbach’s alpha 0.64–0.88). Confirmatory factor analysis of the original 12-factor model resulted in marginally satisfactory model fit (root mean square error of approximation (RMSEA)=0.05; standardised root mean residual (SRMR)=0.05; comparative fit index (CFI)=0.90; goodness of fit index (GFI)=0.88; Tucker-Lewis Index (TLI)=0.88). Exploratory factor analysis resulted in an alternative eight-factor model with good model fit (RMSEA=0.05; SRMR=0.05; CFI=0.95; GFI=0.91; TLI=0.94) and good internal consistency (Cronbach’s alpha 0.73–0.87) and construct validity. Analysis of the dimensionality compared with models from 10 other language versions revealed eight dimensions with relatively stable composition and appearance across different versions and four dimensions requiring further improvement.ConclusionsThe German version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties for use in German hospitals. However, our comparison of instrument dimensionality across different language versions indicates limitations concerning cross-national studies. Results of this study can be considered in interpreting findings across national contexts, in further refinement of the instrument for cross-national studies and in better understanding the various facets and dimensions of patient safety culture.

Objectives In recent years, several instruments for measuring patient safety culture (PSC) have been developed and implemented. Correct interpretation of survey findings is crucial for understanding PSC locally, for comparisons across settings or time, as well as for planning effective interventions. We aimed to evaluate the influence of gender, profession, and managerial function on perceptions of PSC and on the interplay between various dimensions and perceptions of PSC. Methods We used German and Swiss survey data of frontline physicians and nurses (n = 1786). Data analysis was performed for the two samples separately using multivariate analysis of variance, comparisons of adjusted means, and series of multiple regressions. Results Participants’ profession and managerial function had significant direct effect on perceptions of PSC. Although there was no significant direct effect of gender for most of the PSC dimensions, it had an indirect effect on PSC dimensions through statistically significant direct effects on profession and managerial function. We identified similarities and differences across participant groups concerning the impact of various PSC dimensions on Overall Perception of Patient Safety . Staffing and Organizational Learning had positive influence in most groups without managerial function, whereas Teamwork Within Unit , Feedback & Communication About Error , and Communication Openness had no significant effect. For female participants without managerial functions, Management Support for Patient Safety had a significant positive effect. Conclusions Participant characteristics have significant effects on perceptions of PSC and thus should be accounted for in reporting, interpreting, and comparing results from different samples.

Background Many hospitals seek to increase patient safety through interprofessional team-trainings. Accordingly, these trainings aim to strengthen important key aspects such as safety culture and communication. This study was designed to investigate if an interprofessional team-training, administered to a relatively small group of nurses and physicians would promote a change in healthcare professionals’ perceptions on safety culture and communication practices throughout the hospital. We further sought to understand which safety culture aspects foster the transfer of trained communication practices into clinical practice. Methods We conducted a pre-post survey study using six scales to measure participants’ perceptions of safety culture and communication practices. Mean values were compared according to profession and participation in training. Using multiple regression models, the relationship between safety culture and communication practices was determined. Results Before and after the training, we found high mean values for all scales. A significant, positive effect was found for the communication practices of the physicians. Participation in the training sessions played a variably relevant role in the communication practices. In addition, the multiple regression analyses showed that specific safety culture aspects have a cross-professional influence on communication practices in the hospital. Conclusions This study suggest that interprofessional team-trainings of a small group of professionals can successfully be transferred into clinical practice and indicates the importance of safety culture aspects for such transfer processes. Thus, we recommend the consideration of safety culture aspects before starting a training intervention.

ObjectivesTo study the psychometric properties of the Georgian version of the Hospital Survey on Patient Safety Culture (HSPSC-GE).DesignCross-sectional study.SettingThree Georgian hospitals.ParticipantsStaff of participating hospitals (n=579 responses, response rate 41.6%).Primary and secondary outcome measuresPsychometric properties (Model fit, internal consistency, construct validity) of the instrument, factor structure derived from the data.ResultsHSPSC-GE demonstrated acceptable construct validity but highly limited internal consistency (Cronbach’s alpha 0.35–0.87). Confirmatory factor analysis with the original 12-factor model resulted in poor model fit (root mean square error of approximation (RMSEA)=0.06; standardised root mean square residuals (SRMR)=0.08; comparative fit index (CFI)=0.74; goodness of fit index (GFI)=0.81; Tucker-Lewis Index (TLI)=0.70). Accounting for reversed item bias resulted in improved fit indices. Exploratory factor analysis resulted in an alternative five-factor model including only 19 items, but with satisfactory model fit (RMSEA=0.07; SRMR=0.07; CFI=0.90; GFI=0.89; TLI=0.88).ConclusionsThe HSPSC-GE as a whole demonstrated poor psychometric properties. However, a number of dimensions demonstrated acceptable internal consistency and reliability. Our results indicated presence of reversed item bias, which may be inherent to the original instrument design of the HSPSC and should be taken into account while interpreting or comparing results, as well as in analyses of psychometric properties of the instrument. Nevertheless, the HSPSC-GE provides first insights in hospital patient safety culture (PSC) in Georgia and we recommend using it in its full form to facilitate deeper analysis and further development of PSC in Georgian healthcare.

ObjectiveTo study the psychometric properties of the Georgian version of the Safety Attitudes Questionnaire short version.DesignCross-sectional study.SettingThree Georgian hospitals.ParticipantsPersonnel of participating hospitals (n=305 responses, estimated response rate 30%).InterventionsNone.Primary and secondary outcome measuresPsychometric properties (model fit, internal consistency, construct validity, convergent and discriminant validity) of the instrument, factor structure derived from the data.ResultsThe Georgian version of Safety Attitudes Questionnaire demonstrated acceptable construct validity and internal consistency (Cronbach’s alpha 0.61–0.91). Three factors, Teamwork Climate, Safety Climate and Working Conditions, had limited convergent and discriminant validity. Confirmatory factor analysis with the original six-factor model resulted in limited model fit (χ2/df=2.14, root mean square error of approximation (RMSEA)=0.06, goodness of fit index (GFI)=0.83, CFI=0.88, TLI=0.86). Exploratory factor analysis resulted in a modified four-factor model with satisfactory model fit (χ2/df=2.09, RMSEA=0.06, GFI=0.88, CFI=0.93, TLI=0.91).ConclusionsThe Georgian version of the Safety Attitudes Questionnaire (short version) demonstrated acceptable psychometric properties, with acceptable to good internal consistency and construct validity. While the whole model had limited fit to the data, a modified factor model resulted in good model fit. Our findings suggest the dimension Working Conditions has questionable psychometric properties and should be interpreted with caution. Other two correlated dimensions Teamwork Climate and Safety Climate share considerable variance and may be merged. Overall, the instrument can provide valuable information relevant for advancement of patient safety culture in Georgian hospitals.

Improving patient safety and reducing occupational accidents are two of the main challenges in healthcare. Instruments to measure safety performance and occupational safety are rare. This study aimed to prepare and validate a German version of the adapted workplace health and safety instrument to assess the safety performance of healthcare professionals. Overall, 168 healthcare professionals participated in this explorative cross-sectional study. The instrument consists of 16 items related to safety performance in four dimensions. We calculated mean values and standard deviations for each individual item and those of the four dimensions of the instrument. We evaluated internal consistency and construct validity, explored the dimensionality of the instrument through exploratory factor analysis, and tested how our data fit with the original model with confirmatory factor analysis. Among the participants, 73.8% were nurses and nurses in training, with the majority of the sample being female (71.9%) and younger than 30 (52.5%). Cronbach’s alpha for all four dimensions was >0.7. All items were loaded on factors according to the original theoretical model. Confirmatory factor analysis showed good model fit (normed χ²/df = 1.43 (≤2.5), root mean square error of approximation = 0.06 (≤0.07), goodness of fit index = 0.90 (>0.90), comparative fit index = 0.95 (≥0.90), and Tucker–Lewis index = 0.93 (>0.90). The German version of the instrument demonstrated acceptable properties and was a good fit to the original theoretical model, allowing measurement of healthcare professionals’ safety knowledge, motivation, compliance, and participation.

Purpose Healthcare providers decide on recommendations for further treatment of patients with cancer in multidisciplinary tumor boards (MTBs). As such, communicative processes during MTBs are assumed to influence decision-making and, thereby, treatment planning. The aim of this exploratory study is to gain insights into decision-making during MTBs. Methods Case discussions from MTBs in breast cancer centers in North Rhine-Westphalia, Germany, were observed and audiotaped. The transcripts of the audio recordings were analyzed by procedures of conversation analysis. Results Based on 38 case discussions from 15 MTBs in four breast cancer centers, an action scheme for decision-making in MTBs in breast cancer care was developed. In addition, the conversational practices used by the participants during interactions were analyzed. Conclusion Analysis indicated that conventions in MTBs were observed during individual phases of decision-making but not for the entire process. Although exchanging multidisciplinary knowledge is an essential aspect of MTBs, this exchange does not always seem to occur in practice. The extent to which recommendations are derived from consensus during MTBs remains unclear. Thus, the study suggests developing standards for communication during MTBs to optimize decision-making and, thus, the quality of recommendation.