The safety attitudes questionnaire \u2013 ambulatory version: psychometric properties of the Slovenian version for the out-of-hours primary care setting

Zalika Klemenc-Ketis,Gunnar Tschudi Bondevik,Matjaz Maletic,Ellen Tveter Deilkås,Dag Hofoss,Vesna Stropnik

doi:10.1186/s12913-016-1972-7

Abstract

BackgroundSeveral tools have been developed to measure safety attitudes of health care providers, out of which the Safety Attitudes Questionnaire (SAQ) is regarded as one of the most appropriate ones. In 2007, it was adapted to outpatient (primary health care) settings and in 2014 it was tested in out-of-hours health care settings in Norway. The purpose of this study was to translate the English version of the SAQ-Ambulatory Version (SAQ-AV) to Slovenian language; to test its reliability; and to explore its factor structure.MethodsThis was a cross-sectional study that took place in Slovenian out-of-hours primary care clinics in March-May 2015 as a part of an international study entitled Patient Safety Culture in European Out-of-hours services. The questionnaire consisted of the Slovenian version of the SAQ-AV. The link to the questionnaire was emailed to health care workers in the out-of-hours clinics. A total of 438 participants were invited. We performed exploratory factor analysis.ResultsOut of 438 invited participants, 250 answered the questionnaire (response rate 57.1%). Exploratory factor analysis put forward five factors: 1) Perceptions of management, 2) Job satisfaction, 3) Safety climate, 4) Teamwork climate, and 5) Communication. Cronbach’s alpha of the whole SAQ-AV was 0.922. Cronbach’s alpha of the five factors ranged from 0.587 to 0.791. Mean total score of the SAQ-AV was 56.6 ± 16.0 points. The factor with the highest average score was Teamwork climate and the factor with the lowest average was Job satisfaction.ConclusionsBased on the results in our study, we cannot state that the SAQ-AV is a reliable tool for measuring safety culture in the Slovenian out-of-hours care setting. Our study also showed that there might be other safety culture factors in out-of-hours care not recognised before. We therefore recommend larger studies aiming to identify an alternative factor structure.

Highlights

Several tools have been developed to measure safety attitudes of health care providers, out of which the Safety Attitudes Questionnaire (SAQ) is regarded as one of the most appropriate ones
Patient safety is an important aspect of quality assurance and improvement in health care
The study was a part of an international study entitled Patient Safety Culture in European Out-of-hours services (SAFE-EUR-OOH), which was led by a coordinating research group from Norway

Summary

Introduction

Several tools have been developed to measure safety attitudes of health care providers, out of which the Safety Attitudes Questionnaire (SAQ) is regarded as one of the most appropriate ones. A concept of patient safety culture has been developed It describes leader and staff interaction, attitudes, routines, awareness, and practices, which impinge on the risk of patient adverse events [1]. Quantitative surveys have concentrated on measuring staff perceptions, which are referred to as organizational climates. Organizational climates are mathematical expressions of how members in natural social units perceive that cultural norms are enacted by leadership and members in the unit. These climates are measured both according to level of mean and the degree to which staff share the perceptions, which is the organizational climate strength [4]. Organizational climates with diverging perceptions amongst staff are regarded as weak with limited power to predict staff practices [5]

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