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Table 6 HSOPSC dimensions and items

From: Psychometric properties of the Norwegian version of the hospital survey on patient safety culture in a prehospital environment

Dimension / Item Factor loadings
Manager expectations & actions promoting patient safety
 C1 My manager says a good word when he/she sees a job done according to established patient safety procedures. .80
 C2 My manager seriously considers staff suggestions for improving patient safety. .87
 C3 Whenever pressure builds up, my manager wants us to work faster, even if it means taking shortcuts*. (*Do not follow all procedures, for example, not implement the dual control of drugs prior to administration.) .57
 C4 My local manager overlooks patient safety problems that happen over and over. .73
Organizational learning - continuous improvement
 A6 We are actively doing things to improve patient safety. .68
 A9 Mistakes have led to positive changes here. .59
 A13 After we make changes to improve patient safety, we evaluate their effectiveness. .70
Teamwork within units
 A1 People support one another in this local unit. .82
 A3 When a lot of work needs to be done quickly, we work together as a team to get the work done. .73
 A4 In this local unit, people treat each other with respect. .81
 A11 When one area in this unit gets really busy, others help out. .47
Communication openness
 D2 Staff will freely speak up if they see something that may negatively affect patient care. .65
 D4 Staff feel free to question the decisions or actions of those with more authority. .78
 D6 Staff are afraid to ask questions when something does not seem right. .72
Feedback and communication about error
 D1 We are given feedback about changes put into place based on event reports. .66
 D3 We are informed about errors that happen in this local unit. .76
 D5 In this local unit, we discuss ways to prevent errors from happening again. .79
Nonpunitive response to error
 A8 Staff feel like their mistakes are held against them. .80
 A12 When an event is reported, it feels like the person is being written up, not the problem. .77
 A16 Staff worry that mistakes they make are kept in their personnel file. .71
Staffing
 A2 We have enough staff to handle the workload. .59
 A5 Staff in this local unit work longer hours than is best for patient care. .43
 A7 We use more agency/temporary staff than is best for patient care. .61
 A14 We work in "crisis mode"* trying to do too much, too quickly. (*The experience of workload beyond what should be normal.) .65
Hospital management support for patient safety
 H1 Hospital management provides a work climate that promotes patient safety. .78
 H8 The actions of hospital management show that patient safety is a top priority. .84
 H9 Hospital management seems interested in patient safety only after an adverse event happens. .63
Teamwork across units
 H2 Units in the prehospital chain do not coordinate well with each other. .41
 H4 There is good cooperation among units that need to work together. .64
 H6 It is often unpleasant to work with staff from other units in the prehospital chain. .64
 H10 Units in the prehospital chain work well together to provide the best care for patients. .59
Handoffs and transitions
 H3 Things “fall between the cracks”* when transferring patients from one unit to another. (*For example, patient information is not transmitted, unclear responsibility for tasks and procedures in patient handover.) .64
 H5 Important patient care information is often lost during shift changes. .71
 H7 Problems often occur in the exchange of information across units in the prehospital chain. .73
 H11 Patient handovers are problematic for patients in the prehospital chain. .65
Overall perception of safety
 A10 It is just by chance that more serious mistakes don’t happen in this local unit. .72
 A15 Patient safety is never sacrificed to get more work done. .56
 A17 We have patient safety problems in this local unit. .73
 A18 Our procedures and systems are good at preventing errors from happening. .70
Frequency of error reporting
 F1 When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported? .76
 F2 When a mistake is made, but has no potential to harm the patient, how often is this reported? .75
 F3 When a mistake is made that could harm the patient, but does not, how often is this reported? .75
Stop working in dangerous situations
 A19 I ask my colleagues to stop work when I think the job is being done in a risky manner. .63
 A20 I report dangerous situations when I see them. .69
 B1 My colleagues stop me if I'm working in a dangerous manner. .79
 B2 I stop working if I think it can be dangerous for me or others to continue. .57
  1. Note: Dimensions and items based on the original HSOPSC [44], except for the dimension “Stop working in dangerous situations”, which is based on the Norwegian HSOPSC extension [36] *Idioms expressed by a minor explanation/example in the bracket text following the statements C3, A14 and H3