Evaluation of a survey tool to measure safety climate in Australian hospital pharmacy staff.

Abstract

Safety climate evaluation is increasingly used by hospitals as part of quality improvement initiatives. Consequently, it is necessary to have validated tools to measure changes. To evaluate the construct validity and internal consistency of a survey tool to measure Australian hospital pharmacy patient safety climate. A 42 item cross-sectional survey was used to evaluate the patient safety climate of 607 Australian hospital pharmacy staff. Survey responses were initially mapped to the factor structure previously identified in European community pharmacy. However, as the data did not adequately fit the community pharmacy model, participants were randomly split into two groups with exploratory factor analysis performed on the first group (n=302) and confirmatory factor analyses performed on the second group (n=305). Following exploratory factor analysis (59.3% variance explained) and confirmatory factor analysis, a 6-factor model containing 28 items was obtained with satisfactory model fit (χ2 (335)=664.61 p<0.001, RMSEA=0.06, CFI=0.93, TLI=0.92), internal reliability (α>0.643) and model nesting between the groups (Δχ2 (22)=30.87, p=0.10). Three factors (blame culture, organisational learning and working conditions) were similar to those identified in European community pharmacy and labelled identically. Three additional factors (preoccupation with improvement; comfort to question authority; and safety issues being swept under the carpet) highlight hierarchical issues present in hospital settings. This study has demonstrated the validity of a survey to evaluate patient safety climate of Australian hospital pharmacy staff. Importantly, this validated factor structure may be used to evaluate changes in safety climate over time.