Psychometric properties of the Georgian version of Hospital Survey on Patient Safety Culture: a cross-sectional study.
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ABSTRACT: Objectives
To study the psychometric properties of the Georgian version of the Hospital Survey on Patient Safety Culture (HSPSC-GE).Design
Cross-sectional study.Setting
Three Georgian hospitals.Participants
Staff of participating hospitals (n=579 responses, response rate 41.6%).Primary and secondary outcome measures
Psychometric properties (Model fit, internal consistency, construct validity) of the instrument, factor structure derived from the data.Results
HSPSC-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).Conclusions
The 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.
SUBMITTER: Gambashidze N
PROVIDER: S-EPMC6677969 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture was designed to assess staff views on patient safety culture in hospital settings. The purpose of this study was to examine the multilevel psychometric properties of the survey.MethodsSurvey data from 331 U.S. hospitals with 2,267 hospital units and 50,513 respondents were analyzed to examine the psychometric properties of the survey's items and composites. Item factor loadings, intraclass correlations (ICCs), design effects, internal consistency reliabilities, and multilevel confirmatory factor analyses (MCFA) were examined as well as intercorrelations among the survey's composites.ResultsPsychometric analyses confirmed the multilevel nature of the data at the individual, unit and hospital levels of analysis. Results provided overall evidence supporting the 12 dimensions and 42 items included in the AHRQ Hospital Survey on Patient Safety Culture as having acceptable psychometric properties at all levels of analysis, with a few exceptions. The Staffing composite fell slightly below cutoffs in a number of areas, but is conceptually important given its impact on patient safety. In addition, one hospital-level model fit indicator for the Supervisor/Manager Expectations & Actions Promoting Patient Safety composite was low (CFI = .82), but all other psychometrics for this scale were good. Average dimension intercorrelations were moderate at .42 at the individual level, .50 at the unit level, and .56 at the hospital level.ConclusionsPsychometric analyses conducted on a very large database of hospitals provided overall support for the patient safety culture dimensions and items included in the AHRQ Hospital Survey on Patient Safety Culture. The survey's items and dimensions overall are psychometrically sound at the individual, unit, and hospital levels of analysis and can be used by researchers and hospitals interested in assessing patient safety culture. Further research is needed to study the criterion-related validity of the survey by analysing the relationship between patient safety culture and patient outcomes and studying how to improve patient safety culture.
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Project description:ObjectiveThe Hospital Survey on Patient Safety Culture (HSPSC) was designed to assess staff views on patient safety and has been translated and validated into several languages and settings. This study developed a Latin American Spanish version of the HSPSC for use in perioperative settings and examines its psychometric properties.MethodsAfter translation and adjustments, a web-based questionnaire was administered to all health care personnel at operating room in a public university-affiliated hospital in Popayán, Colombia. Descriptive statistics, internal reliability, confirmatory and exploratory factor analysis, and intercorrelations among survey composites were calculated.ResultsConfirmatory factor analysis showed inadequate model fit for the original 12-factor structure of the HSPSC. Rather, a 9-factor, 36-item instrument showed acceptable factor loadings, internal consistency, and psychometric properties. Five factors were formed with minor changes. Adjusted factors emerged, like "staffing and work pressure" and "supervisor/manager expectations and actions promoting patient safety," "organizational learning-continuous improvement," and "hospital management support for safety," as well as "repeated errors and perception of safety." Internal consistency for each remaining composite met or exceeded a Cronbach α value of 0.60.ConclusionsPsychometric analyses provided overall support for 9 of the 12 initial factors of patient safety culture. Our findings suggest that more validation studies need to be conducted before applying safety dimensions from the original HSPSC to perioperative settings only. By providing this initial tool, we hope to stimulate further studies and the patient safety research agenda in this part of the world.
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Project description:OBJECTIVE:To carry out a systematic review of the psychometric properties of international studies that have used the Hospital Survey on Patient Safety Culture (HSPSC). DESIGN:Literature review and an analysis framework to review studies. SETTING:Hospitals and other healthcare settings in North and South America, Europe, the Near East, the Middle East and the Far East. DATA SOURCES:A total of 62 studies and 67 datasets made up of journal papers, book chapters and PhD theses were included in the review. PRIMARY AND SECONDARY OUTCOME MEASURES:Psychometric properties (eg, internal consistency) and sample characteristics (eg, country of use, participant job roles and changes made to the original version of the HSPSC). RESULTS:Just over half (52%) of the studies in our sample reported internal reliabilities lower than 0.7 for at least six HSPSC dimensions. The dimensions 'staffing', 'communication openness', 'non-punitive response to error', 'organisational learning' and 'overall perceptions of safety' resulted in low internal consistencies in a majority of studies. The outcomes from assessing construct validity were reported in 60% of the studies. Most studies took place in a hospital setting (84%); the majority of survey participants (62%) were drawn from nursing and technical staff. Forty-two per cent of the studies did not state what modifications, if any, were made to the original US version of the instrument. CONCLUSIONS:While there is evidence of a growing worldwide trend in the use of the HSPSC, particularly within Europe and the Near/Middle East, our review underlines the need for caution in using the instrument. Future use of the HSPSC needs to be sensitive to the demands of care settings, the target population and other aspects of the national and local healthcare contexts. There is a need to develop guidelines covering procedures for using, adapting and translating the HSPSC, as well as reporting findings based on its use.
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Project description:BackgroundHow hospital health care personnel perceive safety climate has been assessed in several countries by using the Hospital Survey on Patient Safety (HSOPS). Few studies have examined safety climate factors in surgical departments per se. This study examined the psychometric properties of a Norwegian translation of the HSOPS and also compared safety climate factors from a surgical setting to hospitals in the United States, the Netherlands and Norway.MethodsThis survey included 575 surgical personnel in Haukeland University Hospital in Bergen, an 1100-bed tertiary hospital in western Norway: surgeons, operating theatre nurses, anaesthesiologists, nurse anaesthetists and ancillary personnel. Of these, 358 returned the HSOPS, resulting in a 62% response rate. We used factor analysis to examine the applicability of the HSOPS factor structure in operating theatre settings. We also performed psychometric analysis for internal consistency and construct validity. In addition, we compared the percent of average positive responds of the patient safety climate factors with results of the US HSOPS 2010 comparative data base report.ResultsThe professions differed in their perception of patient safety climate, with anaesthesia personnel having the highest mean scores. Factor analysis using the original 12-factor model of the HSOPS resulted in low reliability scores (r = 0.6) for two factors: "adequate staffing" and "organizational learning and continuous improvement". For the remaining factors, reliability was ? 0.7. Reliability scores improved to r = 0.8 by combining the factors "organizational learning and continuous improvement" and "feedback and communication about error" into one six-item factor, supporting an 11-factor model. The inter-item correlations were found satisfactory.ConclusionsThe psychometric properties of the questionnaire need further investigations to be regarded as reliable in surgical environments. The operating theatre personnel perceived their hospital's patient safety climate far more negatively than the health care personnel in hospitals in the United States and with perceptions more comparable to those of health care personnel in hospitals in the Netherlands. In fact, the surgical personnel in our hospital may perceive that patient safety climate is less focused in our hospital, at least compared with the results from hospitals in the United States.
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Project description:ObjectiveAs healthcare organisations endeavour to improve the quality and safety of their services, there is increasing recognition of the importance of building a culture of safety to promote patient safety and improve the outcomes of patient care. Surveys of safety culture/climate have not knowingly been conducted in Kuwait public hospitals, nor are valid or reliable survey instruments available for this context. This study aims to investigate the psychometric properties of the HSOPSC (Hospital Survey on Patient Safety Culture) tool in Kuwaiti public hospitals in addition to constructing an optimal model to assess the level of safety climate in this setting.DesignCross-sectional study.SettingThree public hospitals in Kuwait.ParticipantsAbout 1317 healthcare professionals.Main outcome measureAn adapted and contextualised version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis, confirmatory factor analysis reliability and correlation analysis.Results1317 questionnaires (87%) were returned. Psychometric evaluation, showed an optimal model of eight factors and 22 safety climate items. All items have strong factor loadings (0.42-0.86) and are theoretically related. Reliability analysis showed satisfactory results (α >0.60).ConclusionsThis is the first validation study of a standardised safety climate measure in a Kuwaiti healthcare setting. An optimal model for assessing patient safety climate was produced that mirrors other international studies and which can be used for measuring the prevailing safety climate. More importance should be attached to the psychometric fidelity of safety climate questionnaires before extending their use in other healthcare culture and contexts internationally.
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Project description:OBJECTIVE:To 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. DESIGN:Cross-sectional multicentre study to establish psychometric properties of German version of the survey instrument. SETTING:73 units from 37 departments of two German university hospitals. PARTICIPANTS:Clinical personnel (n=995 responses, response rate 39.6%). PRIMARY AND SECONDARY OUTCOME MEASURES:Psychometric properties (eg, model fit, internal consistency, construct validity) of the instrument and comparison of dimensionality across different language translations. RESULTS:The 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. CONCLUSIONS:The 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.
| S-EPMC5695411 | biostudies-other
Project description: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 ?.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 ? 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.
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