Abstract
BackgroundA supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS).MethodsThe survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' patient safety grade of their practices correlated with their scores on the questionnaire.ResultsOf 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety and expectations and actions of managers. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not.ConclusionsThe SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.
Highlights
A supportive patient safety culture is considered to be an essential condition for improving patient safety
As at the time of the start of this study (2006) all available surveys originated from hospital care [26,27,28], the aim of this study was to adapt the Dutch translation of the Hospital Survey on Patient Safety Culture (HSOPS) of the Agency for Healthcare Research and Quality (AHRQ) for use in Dutch general practice, and to investigate the internal consistency and construct validity
Three items from Dutch HSOPS were deleted based on discussion about face validity with the expert-professionals from general practice (’Patient safety is never sacrificed to get more work done’, ‘There is good cooperation between hospital units that need to work together’ and ‘ It is often unpleasant to work with staff from other hospital units’), and seven new items were added to safety culture questionnaire for general practice (SCOPE)
Summary
A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. We studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS). A major challenge in addressing the safety issues in general practice is to create a culture for safety which has not been established yet [13]. A constructive patient safety culture is recognised as a key condition for improving patient safety [14,15]. An additional reason for aspiring to a positive safety culture is that it could stimulate incident reporting and analysis by professionals which is a fruitful tool for safety improvement [24,25]
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