The Psychometric Properties of the Farsi Version of "Hospital Survey on Patient Safety Culture" in Iran's Hospitals

By Moghri, J.; Arab, M. et al. | Iranian Journal of Public Health, October 1, 2012 | Go to article overview

The Psychometric Properties of the Farsi Version of "Hospital Survey on Patient Safety Culture" in Iran's Hospitals


Moghri, J., Arab, M., Saari, A. Akbari, Nateqi, E., Forooshani, A. Rahimi, Ghiasvand, H., Sohrabi, R., Goudarzi, R., Iranian Journal of Public Health


Abstract

Background: If you want to start a long journey towards patient safety, you should create a good culture of patient safety among employees alongside structural interventions. The first step in doing so is the assessment of current culture in the organization using different tools. One of the most commonly used instruments of measuring patient safety culture is Hospital Survey of Patient Safety culture (HSOPS). The aim of this study was to assess the validity and reliability of Farsi version of this questionnaire for the first time in Iran's hospitals.

Methods: We purposefully selected four hospitals out of seven general Tehran University of Medical Sciences affiliated hospitals. Then a 420 sample of staff of these hospitals were taken randomly. Staff was asked to complete the questionnaire. Confirmative factor analysis, correlation coefficient, Cronbach's alpha were employed in statistical analyses.

Results: Factor loadings for almost all questions were acceptable. Factors jointly explained 77.8% of the variance in the responses. The Cronbach's alpha coefficient was between 0.57 and 0.8. The study revealed that over 70% of employees were working at their hospitals more than 40 hours a week and also more than half of the employees were not reporting errors.

Conclusion: Farsi version of HSOPS with 12 dimensions and 42 questions is a valid and reliable questionnaire to measure patient safety culture for the first time in Iran hospitals. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Iran.

Keywords: Patient, Hospitals, Validity, Reliability, Questionnaire, Iran

Introduction

Quality of care is one of the most important issues in health sector. It consists of several elements that patient safety is one of the main (1). Efforts in improving patient safety should be address quality and try to identify and eliminate unsafe processes and inappropriate procedures (2).

Considering the prevalence of medical errors and the huge burden of their costs that imposed to the health system (3, 4), it is vital to be aware of patient safety culture in the health sector in order to change this culture and making it consistent with the recent advances in quality of care; because improving patient safety is not only a clinical issue, but it is also related to the organizational aspects (5). Experts believe that hospitals should be establishing patient safety culture among their staff along with structural intervention (1). It could be claimed that patient safety culture is one of the essential elements in promoting safety and improving quality of patient care (6, 7).

Safety culture is a culture where safety is the main concern for individuals (8). In this case we can consider patient safety culture as adoption and application of patient safety as the first priority in the organization (9).

Institute of Medicine (IOM) stated that if there is a culture in an organization which employees report adverse events freely and without any fear, they could learn from their mistakes and thus prevent systemic and human made errors in future (10). IOM consider changing patient safety culture as the greatest challenge in approaching toward a safer care and recommends that healthcare organizations assess their patient safety culture, establish comprehensive PS programs to increase detection of adverse events, and redesign systems to reduce opportunities for error (11).

Assessing the level of safety culture is the start point in creating such a culture in an organization, because moving toward a safer care without knowledge of the status quo may lead to increased costs and risks (12).

Safety culture surveys are now being used to assess this culture in healthcare organizations, and a comprehensive report of scale development was provided (13-16). Hospital Survey On Patient Safety culture which is a commonly used instrument to measure multiple dimensions of patient safety culture developed by Agency for Healthcare Research and Quality (AHRQ) is applied increasingly in the United States and England (11, 17). …

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