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.

Highlights

  • A 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

  • Lowest values were 74% and 78% for item G6 (“In this unit, patients and families who have suffered an adverse event, are informed about the possibility to apply for economic compensation from the Patient Insurance”) and 60% for item F11 (“Shift changes are problematic for patients in this unit”)

  • Results of exploratory factor (EFA) by using principal axis factoring (PAF) as extraction method and Promax as rotation method are presented in Additional file 1: Appendix 1

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Summary

Introduction

A 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. Researchers have noted the need for more standardized use of terms and a greater understanding of how safety culture as measured is related to other features of healthcare as well as the need to develop theoretical models to explain the influence of culture on patient safety outcomes [8,9]

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