Factor Structure and Construct Validity of a Hospital Survey on Patient Safety Culture Using Exploratory Factor...

Area of Science:

• Healthcare Management
• Patient Safety Research
• Organizational Psychology

Background:

• Nurses' voluntary reporting of adverse events is crucial for enhancing patient safety.
• The concept of patient safety culture requires further investigation for effective implementation.
• Existing instruments for measuring patient safety culture need validation and refinement.

Purpose of the Study:

• To explore the underlying factor structure of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture.
• To examine the correlational relationships between survey items.
• To assess the construct validity of the patient safety culture survey.

Main Methods:

• Exploratory factor analysis was performed on secondary data from the survey's database.
• Pattern matching was used to compare extracted factors with a 6-component theoretical framework of patient safety culture.
• The theoretical framework included psychological safety, organizational culture, safety culture quality, high reliability organization, deference to expertise, and resilience.

Main Results:

• Six exploratory factors were identified, accounting for 51% of the total variance.
• These factors included communication, organizational culture, psychological safety (two components), patient safety, and reporting.
• While overall construct validity was good, few factors aligned with the theoretical components of deference to expertise and resilience.

Conclusions:

• Transparent and voluntary error reporting requires specific attention to deference to expertise and resilience.
• Items focusing on empowering experienced staff and coping with errors are needed.
• A supplemental survey incorporating these elements may enhance future patient safety culture assessments.