Psychometric properties of the hospital survey on patient safety culture, HSOPSC,applied on a large Swedish health care sample

Abstract

BackgroundA Swedish version of the USA Agency for Healthcare Research and Quality “Hospital Survey on Patient Safety Culture” (S-HSOPSC) was developed to be used in both hospitals and primary care. Two new dimensions with two and four questions each were added as well as one outcome measure. This paper describes this Swedish version and an assessment of its psychometric properties which were tested on a large sample of responses from personnel in both hospital and primary care.MethodsThe questionnaire was mainly administered in web form and 84215 forms were returned (response rate 60%) between 2009 and 2011. Eleven per cent of the responses came from primary care workers and 46% from hospital care workers. The psychometric properties were analyzed using both the total sample and the hospital and primary care subsamples by assessment of construct validity and internal consistency. Construct validity was assessed by confirmatory (CFA) and exploratory factor (EFA) analyses and internal consistency was established by Cronbachs’s α.ResultsCFA of the total, hospital and primary care samples generally showed a good fit while the EFA pointed towards a 9-factor model in all samples instead of the 14-dimension S-HSOPSC instrument. Internal consistency was acceptable with Cronbach’s α values above 0.7 in a major part of the dimensions.ConclusionsThe S-HSOPSC, consisting of 14 dimensions, 48 items and 3 single-item outcome measures, is used both in hospitals and in primary care settings in Sweden for different purposes. This version of the original American instrument has acceptable construct validity and internal consistency when tested on large datasets of first-time responders from both hospitals and primary care centres. One common instrument for measurements of patient safety culture in both hospitals and primary care settings is an advantage since it enables comparisons between sectors and assessments of national patient safety improvement programs. Future research into this version of the instrument includes comparing results from patient safety culture measurements with other outcomes in relation to safety improvement strategies.

Psychometric Properties of the Hospital Survey on Patient Safety Culture (HSOPSC): Findings from Greece

“…The internal consistency of G-HSOPSC ranged between 0.60 and 0.88 with lowest Cronbach´s alpha values for 'Organizational learning' and 'Sufficient staffing' (both α = 0.60). These findings have also been presented in other studies [25,26,29,30]. As far as the present study is concerned, our belief is that these composites and items should be kept since they signify important aspects of patient safety and as such shape a useful foundation for improvement work.…”

Suffering in silence: a qualitative study of second victims of adverse events

“…The Swedish version includes two new dimensions: ‘Information and support to patients and family who have suffered an adverse event’ and ‘Information and support to staff who have been involved in an adverse event’. Both questions address the relationship between the patient safety culture and how the first and second victims of adverse events are taken care of 25. This information can be used to develop support structures which can help counter unnecessary distress for many professionals involved in adverse events.…”

Patient safety culture within a university hospital: feasibility trial

“…In the past, questions about the applicability of the US HSOPSC arose [10] as significant differences between healthcare systems exist and suggest careful testing in other countries. Recently, the HSOPSC was translated into German and was tested within a University Hospital in Switzerland [11].…”

“…The survey consists of 12 dimensions of culture pertaining safety. The HSOPSC is widely distributed in the USA and in the meantime also within Europe [3,[9][10][11]. Whereas in some European countries the assessment of the patient safety culture became mandatory and was linked to reimbursement as well as to issue reports on improvement strategies [10].…”