Features | Name of instrument | ||||
---|---|---|---|---|---|
HSOPSC (1) | SAQ (2) | PSCHO (3) | SOS (4) | Can-PSC (5) | |
Safety Climate Dimensions: • Number of Dimensions Safety Climate Dimensions: • Scope of Dimensions | 12 | 6 | 9 | 1 | 6 |
Communication openness, Feedback and communication about error, Frequency of event reporting, Handoffs and transitions, Management support for patient safety, Non-punitive response to error, Organisational learning –Continuous improvement, Overall perceptions of patient safety, Staffing, Supervisor/manager expectations & actions promoting safety, Teamwork across units, Teamwork within units. | Teamwork, Safety climate, Job satisfaction, Stress recognition, Perception of management, Working conditions. | Senior manager’s engagement, Organisational resources for safety, Overall emphasis on safety, Unit safety norms, Unit recognition and support for safety efforts, Fear of shame, Provision of safe care, Learning, Fear of blame | Self-reported “behaviours enabling safety culture” through collective mindfulness. | Organisational leadership support for safety, Incident follow-up, Supervisory leadership for safety, Unit learning culture, Enabling open communication I: judgment-free environment, Enabling open communication II: job repercussions of error. | |
Theoretical basis | Literature review in areas of safety management; organizational & safety climate & culture; medical error & error reporting; patient safety. Existing safety climate and culture instruments. | Based on Vincent’s framework for analyzing risk & safety, Donabedian’s conceptual model for assessing quality Derived from an aviation safety culture questionnaire | High reliability organizations Derived from a naval aviation safety culture questionnaire | High Reliability organizations | Based on Zohar & Hofmann &Mark’s work on safety climate & error literature Adapted from work by Singer and colleagues |
Key features | Tested on a large sample of hospitals Ability to benchmark data Self-report outcome measures | Tested on a large sample of hospitals Cross-industry comparisons Ability to benchmark data Favourable scores were associated with shorter lengths of stay& fewer medication errors in other studies | Measures safety climate among all hospital personnel and across multiple hospitals of different types Cross-industry comparisons | SOS is negatively associated with reported medication errors and patient falls | Validated for use across a range of care settings |
Limitations | Supervisor/ Manager Expectations & Actions Promoting Patient Safety CFI =0.88 at unit & hospital levels Item A7 in the Staffing composite had a low within- unit & within hospital factor loading (0.36). Staffing had Cronbach’s alpha =0.62 | (SRMR) model fit statistic at the clinical area level was larger than desirable, indicating further scale refinement Modest Response Rate | Three individual dimensions demonstrate low internal consistency. Selection Bias | Validated using a sample composed exclusively of registered nurses | Questions about generalizability Further research and cross- validation of will be required with international samples More appropriate for improvement and research Data was not suitable for multilevel CFA |