Development of the Austrian version of the Hospital Survey on Patient Safety Culture

Abstract

Abstract Background Patient safety culture in hospitals (PSC), as well as its measurement and development, have received plenty of attention in Europe in recent years. Several instruments have been developed for its measurement in European countries. As Austria does not have empirically reviewed questionnaires to measure PSC jet, the research question of this study was: Is the globally admitted American questionnaire “Hospital Survey on Patient Safety Culture (HSOPSC)” (Sorra & Nieva, 2004) suitable for the healthcare system in Austria? Methods The HSOPSC contains 42 questions, which constituted twelve factors altogether. The pre-test was done with 101 health professionals. The online survey was conducted in ten public hospitals in 2017. Overall 1525 health professionals participated, which corresponded to a response rate of 23%. A new instrument, namely “Hospital Survey on Patient Safety Culture in Austria (HSPSC-AUT)”, was developed using the Exploratory Factor Analysis (EFA) and the Confirmatory Analysis (CFA). Results The factor structure of HSOPSC was not identical to the factor structure of HSPSC-AUT, developed in our study. The study showcased a new tool, HSPSC-AUT, with 30 items altogether, consisting of seven departmental factors, two hospital factors and one outcome factor. This new tool (HSPSC-AUT) showed pleasant results on the model, indicator, and construct level. The results of CFA for HSPSC-AUT (χ2 [360] = 1408.245, p = 0.0001) showed a better model compared to HSOPSC. The absolute and relative fit-indices showed excellent model adjustment (RMSEA = 0.049, SRMR = 0.041, GFI = 0.927, CFI = 0.941, TLI = 0.929). Conclusions The study presents a new instrument, HSPSC-AUT, for the measurement of PSC. According to the results, HSPSC-AUT (10-factor structure) has a better model fit than the original HSOPSC. This was confirmed by chi-square test, absolute and relative fit-indices, informational criteria, reliability, and construct validity. Key messages The development of an instrument for measuring safety culture is the first step leading to a better PSC. For this reason, HSPSC-AUT is recommended as an instrument to measure the PSC in Austria. Finally, it can be said that the development of a new questionnaire as well as the related measurements of validity and reliability have added value to science and practice.