Singer Sara, Meterko Mark, Baker Laurence, Gaba David, Falwell Alyson, Rosen Amy
Center for Health Policy, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019, USA.
Health Serv Res. 2007 Oct;42(5):1999-2021. doi: 10.1111/j.1475-6773.2007.00706.x.
To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity.
DATA SOURCES/STUDY SETTING: Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate.
Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers.
We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA).
We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's alpha coefficients ranged from 0.50 to 0.89.
It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes.
描述一种用于评估员工对医院安全文化认知的工具的开发过程，并评估其信度和效度。
数据来源/研究背景：2004年3月至2005年5月收集的原始数据。来自105家美国医院的人员完成了一份包含38个条目的纸笔调查。我们共收到21496份完整问卷，回复率为51%。
基于对现有安全氛围调查的回顾，我们列出了与在高可靠性组织中维持安全文化相关的关键主题清单。我们编制了一份问卷草稿以涵盖这些主题，并在四项针对医院人员的初步研究中进行了预测试。我们根据经验和受访者反馈对问卷进行了修改，并将修订版分发给42249名医院工作人员。
我们将受访者随机分为推导样本和验证样本。我们对推导样本的回答应用探索性因子分析。我们利用这些结果在验证样本中创建量表，并对其进行多特质分析（MTA）。
我们识别出九个结构，三个组织因素、两个科室因素、三个个体因素以及一个额外因素。这些结构在多特质分析中显示出显著的聚合效度和区分效度。克朗巴哈系数范围为0.50至0.89。
使用一份有效且可靠的包含38个条目的调查问卷以及合适的医院样本量来衡量医院安全氛围的关键显著特征是可行的。该工具可用于进一步研究，以更好地理解安全氛围对患者安全结果的影响。
