Psychometric Properties of the Romanian Version of the Hospital Survey on Patient Safety Culture (HSOPS)

Abstract

To explore psychometrics of the Romanian version of the Hospital Survey on Patient Safety Culture (HSOPS) released by the US Agency for Healthcare Research and Quality in 2004. The original US survey with 12 composites and 42 items was translated (back translation method), pre-tested on a few staff and then minimally adjusted. A qualitative cross-sectional study was carried out in units from six hospitals in four Romanian regions, based on the census of medical and non-medical staff (n. 969). Participants completed a paper-based self-administered questionnaire. The main outcome measures were: descriptive statistics, confirmatory factor analysis (CFA), internal reliability and intercorrelations among survey composites. Nurses accounted for 67% of respondents, and doctors for 23%. Most work units were surgery (24%) and medical specialties (22%). After individual-level CFA on half of the sample, Staffing and Overall perceptions of patient safety composites were dropped and Feedback & communication about error and Communication openness composite items were aggregated to a single Communication composite. Subsequent CFA on the second half of the sample indicated that the novel composite structure adequately fitted the data: comparative fit index=0.90; root mean square error of approximation=0.06; standardized root mean square residual=0.06. Internal consistency was .0.70 for most composites. Spearman intercorrelations among the patient safety composites at the individual level averaged 0.28. Psychometrics of the Romanian version of the HSOPS tested in Romania was acceptable for nine composites with 31 items. Integration of this survey with items more pertinent for Romania is suggested.