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Table 2 Data extraction results of specialized features

From: Assessing safety climate in acute hospital settings: a systematic review of the adequacy of the psychometric properties of survey measurement tools

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
  1. HSOPSC Hospital Survey on Patient Safety Culture, SAQ Safety Attitudes Questionnaire, PSCHO Patient Safety Climate in Healthcare Organizations, Can-PSC Canadian Patient Safety Climate Scale, SOS Safety Organizing Scale