‘Not another safety culture survey’: using the Canadian patient safety climate survey (Can-PSCS) to measure provider perceptions of PSC across health settings

Abstract

BackgroundThe importance of a strong safety culture for enhancing patient safety has been stated for over a decade in healthcare. However, this complex construct continues to face definitional and measurement challenges. Continuing improvements in the measurement of this construct are necessary for enhancing the utility of patient safety climate surveys (PSCS) in research and in practice. This study examines the revised Canadian PSCS (Can-PSCS) for use across a range of care settings.MethodsConfirmatory factor analytical approaches are used to extensively test the Can-PSCS. Initial and cross-validation samples include 13 126 and 6324 direct care providers from 119 and 35 health settings across Canada, respectively.ResultsResults support a parsimonious model of direct care provider perceptions of patient safety climate (PSC) with 19 items in six dimensions: (1) organisational leadership support for safety; (2) incident follow-up; (3) supervisory leadership for safety; (4) unit learning culture; (5) enabling open communication I: judgement-free environment; (6) enabling open communication II: job repercussions of error. Results also support the validity of the Can-PSCS across a range of care settings.ConclusionsThe Can-PSCS has several advantages: (1) it is a theory-based instrument with a small number of actionable dimensions central to the construct of PSC; (2) it has robust psychometric properties; (3) it is validated for use across a range of care settings, therefore suitable for use in regionalised health delivery systems and can help to raise expectations about acceptable levels of PSC across the system; (4) it has been tested in a publicly funded universal health insurance system and may be suitable for similar international systems.

Patient safety climate strength: a concept that requires more attention

“…Details of the survey process have been reported previously. 20 In the present study, we used data from 442 direct providers working in 24 emergency departments (EDs) across Canada that had ≥10 respondents (reporting by unit was available to organisations that had set up this variable in their online Accreditation Canada portal). We included EDs with a minimum of 10 respondents so we would have a sufficient number to examine within-group agreement 12 -the emphasis of this paper.…”

An exploratory study of safety culture, biological risk management and hand hygiene of healthcare professionals

“…A questionnaire, the Canadian Patient Safety Climate Survey (Can‐PSCS) from Ginsburg, Tregunno, Norton, Mitchell, and Howley () was used to collect data about the safety culture perception at each site. This survey is often filled out by workers at Canadian healthcare facilities due to it being part of an accreditation package, but it is almost unknown in Europe.…”

“…The Can‐PSCS is valid and reliable according to Ginsburg et al. () both in French and English. Participants at the three sites were offered the CAN‐PSCS in both languages and were able to answer according to their personal linguistic strength.…”

“…This instrument is used across Canada and was developed in collaboration with Accreditation Canada, as part of the accreditation process. The Cronbach's alphas exceed 0.70 for each dimension of the Can‐PSCS (Ginsburg et al., ).…”

Results from the Implementation of a Surgical Safety Checklist (SSC) at an Interventional Radiology Unit

“…The awareness of the necessity of a strong safety culture is of utmost importance to enhance patient's safety and has been reiterated for years in the healthcare system [1,2].…”