OBJECTIVES

To study the psychometric properties of the Georgian version of the Hospital Survey on Patient Safety Culture (HSPSC-GE).

DESIGN

Cross-sectional study.

SETTING

Three Georgian hospitals.

PARTICIPANTS

Staff of participating hospitals (n=579 responses, response rate 41.6%).

PRIMARY AND SECONDARY OUTCOME MEASURES

Psychometric properties (Model fit, internal consistency, construct validity) of the instrument, factor structure derived from the data.

RESULTS

HSPSC-GE demonstrated acceptable construct validity but highly limited internal consistency (Cronbach's alpha 0.35-0.87). Confirmatory factor analysis with the original 12-factor model resulted in poor model fit (root mean square error of approximation (RMSEA)=0.06; standardised root mean square residuals (SRMR)=0.08; comparative fit index (CFI)=0.74; goodness of fit index (GFI)=0.81; Tucker-Lewis Index (TLI)=0.70). Accounting for reversed item bias resulted in improved fit indices. Exploratory factor analysis resulted in an alternative five-factor model including only 19 items, but with satisfactory model fit (RMSEA=0.07; SRMR=0.07; CFI=0.90; GFI=0.89; TLI=0.88).

CONCLUSIONS

The HSPSC-GE as a whole demonstrated poor psychometric properties. However, a number of dimensions demonstrated acceptable internal consistency and reliability. Our results indicated presence of reversed item bias, which may be inherent to the original instrument design of the HSPSC and should be taken into account while interpreting or comparing results, as well as in analyses of psychometric properties of the instrument. Nevertheless, the HSPSC-GE provides first insights in hospital patient safety culture (PSC) in Georgia and we recommend using it in its full form to facilitate deeper analysis and further development of PSC in Georgian healthcare.