Patient safety culture – how can it be assessed?

Abstract

Patient safety culture is an important indicator of the healthcare quality. It is a complex concept that comprises common values, attitudes, beliefs and behaviors of personnel in health care facilities. In this review paper, the most prevalent research topics in the scientific literature on patient safety, the most commonly used measurement instruments and methods of their validation are analyzed. The analysis of 387 abstracts of papers on measurement of patient safety, indexed in the Core Collection Web of Science databases, identified ten topics. The most prevalent topics were psychometric characteristics of measurement instruments, education on patient safety and dimensions of patient safety culture. Content analysis of a narrower selection of 35 papers identified as many as 17 different measurement instruments for measuring patient safety culture. The most commonly used instrument is the Hospital Survey on Patient Safety Culture – HSOPSC developed in the United States by the Agency for Healthcare Research and Quality. This instrument is intended for use in hospitals, and has been trans-lated, adapted, and validated in various countries. Although there is no systematic study of patient safety culture in Croatia, two measurement instruments – HSOPSC and Safety Attitudes Questionnaire – Ambulatory version (SAQ-A) have been translated into Croatian and used in several studies. According to the authors’ experience, the most common mistake in practice is using a measurement instrument from foreign literature, without method-ologically correct cultural adaptation. There is a lack of national guidelines for the development and application of measurement instruments for patient safety culture, which would allow for systematic and comparative monitoring of the development of patient safety culture in Croatian health care facilities.