Measuring patient safety climate

Colla, J.B., Bracken, A.C., Kinney, L.M. and Weeks, W.B. 2005. Measuring patient safety climate A review of surveys. Quality and Safety in Health Care, 14(5), 364-6. 

Patient safety researchers have developed several surveys to assess patient safety climate, including the Safety Attitudes Questionnaire (SAQ), AHRQ s Hospital Survey on Patient Safety Culture (SOPS see Chapter 12 for more detailed information), and Patient Safety Climate in Healthcare Organizations. Our chapter provides an in-depth examination of the SAQ in terms of what it measures, key findings and limitations and future areas in need of research. 

Safety climate has also been measured using safety culture maturity matrixes (Ashcroft et al. 2005 Dingsdag et al. 2006, 2008 Hayes et al. 2007, 2008 Kirk et al. 2007). Safety culture maturity matrices display a set of key indicators on the y axis and an evolutionary measure of cultiual maturity on the x axis. Originally developed as part of the Hearts and Minds project for Shell pic, one such matrix, the Manchester Patient Safety Framework (MaPSaF) was adapted for use in primary care settings and has since been developed into versions for mental health, acute and ambulance trusts (Kirk et al. 2007). 

Zohar, D., Livne, Y, Teime-Gazit, O., Admi, H. and Donchin, Y. 2007. Healthcare climate A framework for measuring and improving patient safety. Critical Care Medicine, 35,1312-17. 

While the focus of almost all studies included in this chapter was the adaptation of a patient safety cUmate measure from the USAto their own national and healthcare contexts, maity of the questions we will have to answer in future might be better addressed at a cross-national level. At the level of the survey instmment this would require a certain amount of consistency regarding the use of terminology and the addition or removal of items - a minimal shared item set. Taking cross-national similarities and differences into account (especially with regard to internal consistencies of the various safety climate dimensions) might help to improve further the overall quality of the HSPSC and to further our understanding of factors at the level of healthcare systems that may have a considerable impact on safety climate. 

Certain other healthcare-related instruments fall between a true diagnostic instrument and an opinion survey. The Agency for Healthcare Research and Quality s (AHRQ s) Hospital Survey on Patient Safety Culture is an example, It measures some aspects of team functioning and safety climate it does not measure the dimensions of organizational culture known to predict performance, AHRQ maintains a database of other hospitals that have used the survey as a benchmark, but the survey has not been shown to have predictive validity,... 

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