scholarly journals Examination of the relationship between management and clinician agreement on communication openness, teamwork, and patient satisfaction in the US hospitals

2016 ◽  
Vol 5 (4) ◽  
pp. 20
Author(s):  
Olena Mazurenko ◽  
Jason Richter ◽  
Abby Swanson-Kazley ◽  
Eric Ford
Keyword(s):  
Patient Safety ◽  
Patient Satisfaction ◽  
Safety Culture ◽  
Healthcare Providers ◽  
Patient Safety Culture ◽  
Data Sets ◽  
Cross Sectional ◽  
Communication Openness ◽  
Cross Sectional Design ◽  
Willingness To Recommend

Background: Patient satisfaction has always been an area of focus for hospitals, but gained particular importance due to the changes in the Centers for Medicare and Medicaid reimbursement policies. Hospital managers and clinicians interact with patients in different ways and have different perspectives on safety culture, yet little is known about how that impacts patient satisfaction.Objective: To examine how the agreement between clinicians and management perspectives on patient safety culture is related to patient satisfaction by employing cross-sectional design with linear regressions.Methods: Two data sets were used: 2012 Hospital Survey on Patient Safety Culture and 2012 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The dependent variables were: overall rating of the hospital experience and willingness to recommend a hospital. The independent variables were four safety culture domains: communication openness, feedback, and communication about errors, teamwork within units, and teamwork between units.Results: The results suggest that manager and clinician agreement on high levels of communication openness, feedback and communication about errors, teamwork between units, and teamwork across units were positively and significantly associated with overall patient satisfaction and willingness to recommend. Additionally, more favorable perceptions about patient safety culture by only clinicians yielded similar findings.Conclusions: For policymakers, measuring managers and clinicians’ perceptions on patient safety culture may provide a valuable indicator of patient satisfaction throughout the country. While managers are more likely to have the power to devote resources to patient safety initiatives, they may not adequately judge culture in their unit and should take into account the perspectives of clinicians who have a more frontline perspective.

scholarly journals PENERAPAN BUDAYA KESELAMATAN PASIEN OLEH PERAWAT DI RUMAH SAKIT BANDAR LAMPUNG

2020 ◽  
Vol 6 (1) ◽  
pp. 62-71
Author(s):  
Ernawaty Siagian
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Head Nurse ◽  
Cross Sectional ◽  
Cross Sectional Design

Pemberi layanan kesehatan harus mengutamakan keamanan pasien sebagai perioritas. Sebagai tenagakesehatan dengan jumlah terbesar, perawat mempunyai andil besar dalam meningkatkan budayakeselamatan pasien di rumah sakit. Penting untuk mengkaji penerapan budaya keselamatan pasien padaperawat, sehingga hasilnya dapat dijadikan acuan dalam melakukan perbaikan.Penelitian descriptivecomparative cross sectional design dilakukan kepada 50 responden perawat dari instalasi gawat darurat,Hemodialisa, Instalasi pasien rawat jalan dan ruang operasi dengan menggunakan instrument HospitalSurvey of Patient safety Culture (HSOPCS) yang terdiri dari 12 dimensi. Uji statistic Mann Whitneydigunakan untuk mengetahui apakah terdapat perbedaan penerapan antara staff pelaksana dan incharge,antara head nurse dan kepala ruangan.Hasil penelitian menunjukkan nilai rata-rata respon positif dari 12dimensi yang diberikan oleh staf pelaksana (74,6%). Ada 5 dimensi yang perlu di tingkatkan yaitupersepsi tentang keselamatan pasien secara menyeluruh (70,5%), harapan dan tindakan manajer dalammeningkatkan keselamatan pasien (65,7%), respon tidak menghukum terhadap kesalahan (48,6%),staffing (70,5%) serta overan dan transisi (65,7%). Sementara incharge mempunyai nilai rata-rata (79,4%). Ada 4 dimensi yang perlu ditingkatkan yaitu frekuensi pelaporan insiden(66,7%), persepsi tentangkeselamatan pasien secara menyeluruh (55,6%), harapan dan tindakan manajer dalam meningkatkankeselamatan pasien (41,7%),dan staffing (66,7%). Pada head nurse nilai rata-rata respon positif dari 12dimensi (76,7%). Ada 5 dimensi yang perlu ditingkatkan yaitu persepsi tentang keselamatan pasien secaramenyeluruh (62,5%), harapan dan tindakan manajer dalam meningkatkan keselamatan pasien (65,6%),respon tidak menghukum terhadap kesalahan (50%), kerjasama tim antar unit (68,8%) serta overran dantransisi (56,3%). Pada kepala ruangan nilai rata-rata respon positif dalam 12 dimensi (88,6%). Ada 1dimensi yang perlu ditingkatkan yaitu respon tidak menghukum terhadap kesalahan (66,7%). Terdapatperbedaan yang signifikan antara staf pelaksana dengan incharge, antara head nurse dengan kepalaruangan dalam penerapan budaya keselamatan pasien. Dengan meningkatkan penerapan budayakeselamatan pasien diharapkan perawat dapat memberikan perawatan yang komprehensif, berbasisevidence dan berpusat pada kebutuhan pasien sehingga keselamatan pasien dirumah sakit dapat tercapai.Kata Kunci: Budaya keselamatan pasien, Perawat, HSOPSC

Patient safety culture in burn care units from the perspectives of healthcare providers: across-sectional study

2021 ◽  
Author(s):  
Maryam Moghimian ◽  
Sedigheh Farzi ◽  
Kolsoum Farzi ◽  
Mohammad Javad Tarrahi ◽  
Hossein Ghasemi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Care Delivery ◽  
Quality Care ◽  
Healthcare Providers ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Burn Care ◽  
Healthcare Settings ◽  
Collection Data

Abstract Creating a positive patient safety culture is a key step in the improvement of patient safety in healthcare settings. PSC is a set of shared attitudes, beliefs, and perceptions about PS among healthcare providers. This study aimed to assess PSC in burn care units from the perspectives of healthcare providers. This cross-sectional descriptive study was conducted in 2020 in the units of a specialty burn center. Participants were 213 healthcare providers recruited to the study through a census. A demographic questionnaire and the Hospital Survey on Patient Safety Culture were used for data collection. Data were managed using the SPSS16 software and were summarized using the measures of descriptive statistics. The mean of positive responses to PSC items was 51.22%, denoting a moderate-level PSC. The lowest and the highest dimensional mean scores were related to the no punitive response to error dimension (mean: 12.36%) and the teamwork within departments dimension (mean: 73.25%), respectively. Almost half of the participants (49.3%) reported acceptable PS level in their workplace and 69.5% of them had not reported any error during the past twelve months before the study. Given the great vulnerability of patients with burn injuries in clinical settings, improving PSC, particularly in the no punitive response to error dimension, is essential to encourage healthcare providers for reporting their errors and thereby, to enhance PS. For quality care delivery, healthcare providers in burn care units need a safe workplace, adequate managerial support, a blame-free PSC, and an incentive error reporting system to readily report their errors.

PERSEPSI PERAWAT DAN DOKTER TERHADAP PENERAPAN BUDAYA KESELAMATAN PASIEN DI RUMAH SAKIT ADVENT BANDUNG

2019 ◽  
Vol 4 (1) ◽  
pp. 46-55
Author(s):  
Mori Peranginangin
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Cross Sectional Design

Pendahuluan: Budaya keselamatan pasien masih menjadi permasalahan secara global. Hal ini tercermin dari masih tingginya angka insiden keselamatan pasien yang terjadi. Perawat dan dokter mempunyai andil besar dalam meningkatkan budaya keselamatan pasien di rumah sakit, sehingga penting untuk mengkaji bagaimana persepsi mereka. Tujuan: Meningkatkan budaya keselamatan perawat dan dokter. Metode: Penelitian descriptive comparative cross sectional design dilakukan kepada 185 responden dengan menggunakan instrumen Hospital Survey of Patient Safety Culture (HSOPSC) Pengukuran persepsi terhadap masing masing dimensi dilakukan untuk mengetahui dimensi mana yang masih perlu ditingkatkan. Uji statistik Mann Whitney digunakan untuk mengetahui apakah terdapat perbedaan persepsi antara perawat dan dokter. Hasil: Hasilnya menunjukkan bahwa rata rata persepsi perawat adalah 69.7%. Dimensi yang perlu ditingkatkan adalah Respon Tidak Menghukum Terhadap Kesalahan (24.8%); Staffing (56%); Harapan Dan Tindakan Manajer Dalam Meningkatkan Keselamatan Pasien (65%); Persepsi Tentang Keselamatan Pasien Secara Keseluruhan (66.5%); Dukungan Manajemen Rumah Sakit Terhadap Program Keselamatan Pasien; Overan Dan Transisi; Kerjasama Tim Antar Unit (74.8%). Sementara pada profesi dokter mempunyai nilai rata rata 65.4% dimana 10 dimensi masih perlu ditingkatkan , yaitu:  Respon Tidak Menghukum Terhadap Kesalahan (43.3%); Staffing (55%); Frekuensi Pelaporan Insiden (55%); Umpan Balik dan Komunikasi Tentang Kesalahan (55%), Komunikasi Terbuka (61.7%); Harapan Dan Tindakan Manajer Dalam Meningkatkan Keselamatan Pasien (62.5%); Dukungan Manajemen Rumah Sakit Terhadap Program Keselamatan Pasien (66.7%); Persepsi  Tentang Keselamatan Pasien Secara Keseluruhan (68.3%); Overan dan Transisi (72.5%); Kerjasama Tim Antar Unit (73.8%). Diskusi: Kesimpulan dari penelitian ini adalah bahwa tidak terdapat perbedaan yang signifikan antara persepsi perawat dengan dokter.   Kata Kunci: Budaya keselamatan pasien, dokter, HSOPSC, perawat, persepsi

scholarly journals PERSEPSI PERAWAT DAN DOKTER TERHADAP PENERAPAN BUDAYA KESELAMATAN PASIEN DI RUMAH SAKIT ADVENT BANDAR LAMPUNG

2019 ◽  
Vol 4 (1) ◽  
pp. 82-94
Author(s):  
Ernawaty Siagian
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Cross Sectional Design

Pendahuluan: Budaya keselamatan pasien dalam pelayanan rumah sakit adalah hal yang sangat mendasar. Permasalahan dalam budaya keselamatan pasien tercermin dari masih tingginya angka insiden keselamatan pasien baik secara global maupun nasional. Jumlah insiden keselamatan pasien di Rumah Sakit Advent Bandar Lampung yang dilaporkan tidak terlalu banyak. Namun berdasarkan hasil wawancara diketahui bahwa masih banyak insiden yang tidak dilaporkan oleh karena pekerja merasa enggan dan takut mendapat konsekuensi. Tujuan:  Penelitian ini bertujuan untuk meningkatkan penerapan budaya keselamatan. Metode: Penelitian descriptive comparative cross sectional design tentang persepsi perawat dan dokter dilakukan kepada 130 responden dengan menggunakan instrument Hospital Survey of Patient Safety Culture (HSOPSC) yang terdiri dari 12 dimensi. Pengukuran persepsi terhadap masing-masing dimensi dilakukan untuk mengetahui dimensi mana yang masih perlu ditingkatkan. Uji statistic mann Whitney digunakan untuk mengetahui apakah terdapat perbedaan persepsi antara perawat dan dokter, antara staf pelaksana dan supervisor. Hasil: Hasil penelitian ini menunjukkan bahwa persepsi perawat terhadap 12 dimensi mempunyai nilai rata-rata 62.3%.  Ada 9 dimensi yang perlu ditingkatkan yaitu harapan dan tindakan manajer dalam meningkatkan keselamatan pasien (28.9%); Respon tidak menghukum (39.0%); Komunikasi terbuka (52.3%); Kerjasama tim antar unit (55.0%); Umpan balik dan komunikasi tentang kesalahan (60.9%); Staffing (63.5%); Dukungan manajemen rumah sakit terhadap program keselamatan pasien (63.6%); Persepsi tentang keselamatan pasien secara menyeluruh (65.0%) dan frekuensi pelaporan insiden (73.9%). Sementara pada profesi dokter mempunyai nilai rata-rata 60.1% dimana 11 dimensi masih perlu ditingkatkan, yaitu: harapan dan tindakan manajer dalam meningkatkan keselamatan pasien (27.8%); respon tidak menghukum (44.4%);  frekuensi pelaporan insiden (48.2%); persepsi tentang keselamatan pasien secara menyeluruh (59.0%); komunikasi terbuka (59.2%); overran dan transisi (61.1%); kerjasama tim antar unit (61.1%); staffing (63.0%); umpan balik dan komunikasi (66.7%); pembelajaran organisasi serta perbaikan secara berkelanjutan (70.4%) dan dukungan manajemen rumah sakit terhadap program keselamatan pasien (70.4%). Diskusi: Kesimpulan dari penelotian ini adalah bahwa tidak terdapat perbedaan yang signifikan antara persepsi perawat dengan dokter, antara staf pelaksana dengan supervisor.   Kata Kunci: Budaya keselamatan pasien, perawat, dokter, persepsi, HSOPSC

Fakor Determinan yang Memengaruhi Budaya Keselamatan Pasien di RS Pemerintah Kabupaten Kuningan

1970 ◽  
Vol 4 (2) ◽  
Author(s):  
Lia Mulyati ◽  
Dedy Rachman ◽  
Yana Herdiana
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Work Satisfaction ◽  
Patient Safety Culture ◽  
Team Work ◽  
Chi Square ◽  
Cross Sectional ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress

Budaya keselamatan merupakan kunci untuk mendukung tercapainya peningkatan keselamatan dan kesehatan kerja dalam organisasi. Upaya membangun budaya keselamatan merupakan langkah pertama dalam mencapai keselamatan pasien. Terdapat beberapa faktor yang berkontribusi dalam perkembangan budaya keselamatan yaitu; sikap baik individu maupun organisasi, kepemimpinan, kerja tim, komunikasi dan beban kerja. Penelitian ini bertujuan mengetahui faktor determinan yang berhubungan dengan terciptanya budaya keselamatan pasien di RS Pemerintah Kabupaten Kuningan. Teknik pengambilan sampel yang digunakan incidental sampling 88 orang perawat pelaksana. Rancangan penelitian menggunakan survey analitik dengan pendekatan cross sectional, uji hipotesis digunakan Chi Square dan regresi logistik ganda. Hasil penelitian menunjukan terdapat pengaruh yang signifikan antara persepsi terhadap manajemen (p 0.0005, odd rasio 21.3), dukungan tim kerja (p 0.0005, odd rasio 13.34), stress kerja (p 0.006, odd rasio 3.94), kepuasan kerja (nilai p 0. 002) dengan budaya keselamatan pasien. Tidak terdapat pengaruh yang signifikan kondisi kerja dengan budaya keselamatan pasien dengan nilai p 0.507. Berdasarkan analisis multuvariat diperoleh persepsi terhadap manajemen menjadi factor determinan dengan nilai p 0.000 < α 0.05. Simpulan; unsur pimpinan memiliki pengaruh yang signifikan dalam menciptakan budaya keselamatan pasien. Pimpinan memiliki kewenangan dalam menerapkan system yang berlaku dalam organisasi, oleh karena itu gaya kepemimpinan, teknik komunikasi serta kemampuan manajerial merupakan suatu hal yang sangat perlu diperhatikan dalam menciptakan atmosfer kerja yang kondusif sebagai upaya terciptanya budaya keselamatan pasien. Berdasarkan hasil penelitian bahwa model kepemimpinan transformasional merupakan model yang sesuai diterapkan untuk meningkatkan budaya keselamatan pasien, pelatihan keterampilan komunikasi efektif serta pengembangan model pendidikan antar profesi sebagai upaya peningkatan kemampuan kolaborasi.Kata kunci:Budaya keselamatan pasien, stress kerja, kepuasan kerja.Determinant factors that are Influencing Patient Safety Culture in a Government-owned Hospitals in Kuningan Regency AbstractSafety culture is a key to support the achievement of occupational health and safety in an organization. An effort to build safety culture is the first step in ensuring patient safety. There are some factors that contribute in the development of safety culture, namely, individual and organizational attitude, leadership, team work, communication, and work load. This study aimed to identify the determinant factors that are related to achievement of patient safety culture in a government-owned hospital in Kuningan Regency. Eighty eight samples of nurses were recruited using incidental sampling technique. The research design was using cross sectional study, the hypothesis testing were using Chi Square and multiple logistic regression. The results showed that there were significant influenced between perception towards management (p= 0.0005, odd rasio 21.3), team work support (p= 0.0005, odd rasio 13.34), work-related stress (p= 0.006, odd rasio 3.94), work satisfaction (p= 0. 002) with patient safety culture. There was not significant influenced between work condition and patient safety (p= 0.507). The multivariate analysis showed that perception towards management was the determinant factor for patient safety culture (p 0.000 < α 0.05). In conclusion, leaders have significant influence in creating patient safety culture. Leaders have authority to implement systems in the organization. Therefore, leadership style, communication technique, and managerial ability are important in order to create a conducive atmosphere for developing patient safety culture. As recommendation, transformational leadership is a model that is appropriate to be applied in order to increase patient safety culture, trainings of effective communication and inter-professional education model are also needed to increase the collaboration skills among health professionals.Keywords:Patient safety culture, work-related stress, work satisfaction.

scholarly journals Patient safety culture improves during an in situ simulation intervention: a repeated cross-sectional intervention study at two hospital sites

2021 ◽  
Vol 10 (1) ◽  
pp. e001183
Author(s):  
Anders Schram ◽  
Charlotte Paltved ◽  
Karl Bang Christensen ◽  
Gunhild Kjaergaard-Andersen ◽  
Hanne Irene Jensen ◽  
...  
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Intervention Study ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
In Situ Simulation ◽  
Culture Dimensions ◽  
Scale Scores ◽  
Safety Attitude

ObjectivesThis study aimed to investigate staff’s perceptions of patient safety culture (PSC) in two Danish hospitals before and after an in situ simulation intervention.DesignA repeated cross-sectional intervention study.SettingTwo Danish hospitals. Hospital 1 performs emergency functions, whereas hospital 2 performs elective functions.ParticipantsA total of 967 healthcare professionals were invited to participate in this study. 516 were employed in hospital 1 and 451 in hospital 2. Of these, 39 were trained as simulation instructors.InterventionA 4-day simulation instructor course was applied. Emphasis was put on team training, communication and leadership. After the course, instructors performed simulation in the hospital environment. No systematic simulation was performed prior to the intervention.Main outcome measuresThe Safety Attitude Questionnaire investigating PSC was applied prior to the intervention and again 4 and 8 weeks after intervention. The proportion of participants with a positive attitude and mean scale scores were measured as main outcomes.ResultsThe response rate varied from 63.6% to 72.0% across surveys and hospitals. Baseline scores were generally lower for hospital 1. The proportion of staff with positive attitudes in hospital 1 improved by ≥5% in five of six safety culture dimensions, whereas only two dimensions improved by ≥5% in hospital 2. The mean scale scores improved significantly in five of six safety culture dimensions in hospital 1, while only one dimension improved significantly in hospital 2.ConclusionsSafety attitude outcomes indicate an improvement in PSC from before to after the in situ simulation intervention period. However, it is possible that an effect is more profound in an acute care hospital versus an elective setting.

Assessment of patient safety culture during COVID-19: a cross-sectional study in a tertiary a-level hospital in China

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chih-Hsuan Huang ◽  
Ying Wang ◽  
Hsin-Hung Wu ◽  
Lee Yii-Ching
Keyword(s):  
Patient Safety ◽  
Working Conditions ◽  
Emotional Exhaustion ◽  
Safety Culture ◽  
Team Building ◽  
Reliability And Validity ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Content Type ◽  
Safety Attitudes

PurposeThe aims of this study are to (1) evaluate physicians and nurses' perspectives on patient safety culture amid the COVID-19 pandemic and (2) integrate the emotional exhaustion of physicians and nurses into an evaluation of patient safety culture to provide insights into appropriate implications for medical care.Design/methodology/approachPatient safety culture was assessed with the Chinese version of the Safety Attitudes Questionnaire. Confirmatory factor analysis was conducted to validate the structure of the data (i.e. reliability and validity), and Pearson's correlation analysis was performed to identify relationships between safety-related dimensions.FindingsSafety climate was strongly associated with working conditions and teamwork climate. In addition, working conditions was highly correlated with perceptions of management and job satisfaction, respectively. It is worth noting that the stress and emotional exhaustion of the physicians and nurses during this epidemic were high and needed attention.Practical implicationsFor healthcare managers and practitioners, team-building activities, power of public opinions, IoT-focused service, and Employee Assistance Programs are important implications for inspiring the patient safety-oriented culture during the period of the COVID-19 pandemic.Originality/valueThis paper considers the role of emotional state into patient safety instrument, a much less understood but equally important dimension in the field of patient safety.

scholarly journals Assessment of patient safety culture in intensive care units and factors affecting it

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M A Tlili ◽  
W Aouicha ◽  
H Lamine ◽  
E Taghouti ◽  
M B e n Dhiab ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Safety Culture ◽  
Improve Patient Safety ◽  
Healthcare Quality ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Learning From Errors

Abstract Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals participated in the study with a participation rate of 81.94%, spread over 10 hospitals and 18 units. All dimensions were to be improved. The overall perception of safety was 32.35%. The most developed dimension was teamwork within units with a score of 47.87% and the least developed dimension was the non-punitive response to error (18.6%). The patient safety culture was significantly more developed in private hospitals in seven of the 10 dimensions. Participants working in small units had a significantly higher patient safety culture. It has been shown that when workload is reduced the patient safety culture was significantly increased. Conclusions This study has shown that the patient safety culture still needs to be improved and allowed a clearer view of the safety aspects requiring special attention. Thus, improving patient safety culture. by implementing the quality management and error reporting systems could contribute to enhance the quality of healthcare provided to patients. Key messages The culture of culpability is the main weakness in the study. Encouraging event reporting and learning from errors s should be priorities in hospitals to enhance patient safety and healthcare quality.

scholarly journals Development of a patient safety culture scale for maternal and child health institutions in China: a cross-sectional validation study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e025607
Author(s):  
Yuanyuan Wang ◽  
Hui Han ◽  
Liqian Qiu ◽  
Chaojie Liu ◽  
Yan Wang ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Patient Safety ◽  
Safety Culture ◽  
Health Workers ◽  
Reliability And Validity ◽  
Patient Safety Culture ◽  
Cross Sectional ◽  
Retest Reliability ◽  
Confirmatory Factor ◽  
Test Retest Reliability

ObjectiveThis study aimed to develop a patient safety culture (PSC) scale for maternal and child healthcare (MCH) institutions in China.MethodsA theoretical framework of PSC for MCH institutions was proposed through in-depth interviews with MCH workers and patients and Delphi expert consultations. The reliability and validity of the PSC scale were tested in a cross-sectional survey of 1256 MCH workers from 14 MCH institutions in Zhejiang province of China. The study sample was randomly split into half for exploratory and confirmatory factor analyses, respectively. Test–retest reliability was assessed through a repeated survey of 63 voluntary participants 2 weeks apart.ResultsThe exploratory factor analysis extracted 10 components: patient engagement in patient safety (six items), managerial response to patient safety risks (four items), perceived management support (five items), staff empowerment (four items), staffing and workloads (four items), reporting of adverse events (three items), defensive medical practice (three items), work commitment (three items), training (two items) and transfer and handoff (three items). A good model fit was found in the confirmatory factor analysis: χ2/df=1.822, standardised root mean residual=0.048, root mean square error of approximation=0.038, comparative fit index=0.921, Tucker-Lewis index=0.907. The PSC scale had a Cronbach’s α coefficient of 0.89 (0.59–0.90 for dimensional scales) and a test–retest reliability of 0.81 (0.63–0.87 for dimensional reliability), respectively. The intracluster correlation coefficients confirmed a hierarchical nature of the data: individual health workers nested within MCH institutions.ConclusionThe PSC scale for MCH institutions has acceptable reliability and validity. Further studies are needed to establish benchmarking in a national representative sample through a multilevel modelling approach.

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