Abstract
BackgroundHigh performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety. The 10-item HPWS questionnaire is a validated instrument developed to assess existing HPWS structures in hospitals. The objectives of this cross-sectional study were to translate the English HPWS questionnaire into German (HPWS-G), to rate its content validity, and to examine its psychometric properties.MethodsContent validity was examined by a panel of 12 physicians and nurses, and I-CVI and S-CVI calculated. For internal consistency, Cronbach’s α and item-scale correlations were determined. Construct validity was measured via confirmatory factor analysis.A convenience sample of 782 nurses and physicians in a University hospital setting in Switzerland’s German-speaking region was surveyed. Four inclusion criteria were applied: working in intensive care, emergency department or operating room; having daily patient contact; having worked in the current clinical area for more than three months; and more than 40% employment.ResultsA total of 281 questionnaires were completed (response rate: 35.9%). Overall, the 10-item HPWS-G questionnaire showed good content validity (I-CVI = .83–1; S-CVI = .86) and internal consistency (Cronbach’s α = .853). HPWS-G scores correlated significantly with safety climate (rs = .657, p < .01) and teamwork climate (rs = .615, p < .01). The proposed 1-factor model was accepted considering results of applied minimum rank factor analysis; a confirmatory factor analysis indicated an acceptable to good model fit (GFI = .968; CFI = .902; RMSEA = .043).ConclusionsThe HPWS-G showed good psychometric properties. In clinical practice it can be used to assess HPWS practices and for intra- and inter-hospital benchmarking. Some minor adaptions to the wording could be made as well as reassessing the psychometric properties at other clinical sites.
Highlights
High performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety
Under pressure to find ways to keep patients safe, health care researchers, institutions, and policymakers the world over are focusing on safety culture and teamwork in other sectors; and increasingly, they are recognizing, adapting and implementing HPWSs used in high-risk industries such as aviation and nuclear power [8,9,10,11]
Unlike Etchegaray et al.’s findings [5], our analyses indicated that HPWS was a stronger predictor of safety climate than of patient safety grade
Summary
High performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety. The 10-item HPWS questionnaire is a validated instrument developed to assess existing HPWS structures in hospitals The objectives of this cross-sectional study were to translate the English HPWS questionnaire into German (HPWS-G), to rate its content validity, and to examine its psychometric properties. High performance work systems (HPWSs) are successful in the context of patient safety [1, 2]. Chuang et al (2012) identified three HPWS practices; supervisor support, team-based work practices and flexible work arrangements positively associated with job satisfaction and, when complemented with performance-based incentives, positively associated with frontline health care worker’s perceived quality of care [7]. While it is not possible to measure safety culture directly, it can be evaluated in relation to safety climate [9, 10, 17, 19], the surface features of which indicate the characteristics of the underlying safety culture [9]
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