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Published on: February 16, 2011
Understanding the Concept of Patient Safety Culture: Constitutive and Operational Definitions for Health Care
Rhanna Emanuela Fontenele Lima de Carvalho1, David W Bates
1Author Affiliations: School of Nursing (Dr Fontenele Lima de Carvalho), Ceara State University, Fortaleza, Ceará, Brazil; Division of General Internal Medicine (Drs Fontenele Lima de Carvalho and Bates), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.; and Department of Health Policy and Management (Dr Bates), Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Background:
Patient safety culture is crucial for improving health care quality, however, there is no consensus on its definition.
Purpose:
This study aimed to clarify and update the concept of patient safety culture.
Methods:
We employed Norris' 6-step concept clarification method. The content was organized through a scoping review of 4 databases. Twelve health professionals participated in focus groups and 10 experts participated in content validation. The content validity coefficient (CVC) was calculated for agreement between experts.
Results:
Three patient safety culture domains were identified: organizational, professional, and patient and family participation. The experts rated the definitions favorably, with high CVC scores (>0.87), indicating good agreement. The operational definitions were reduced from 76 to 54 items after expert evaluation.
Conclusion:
An updated definition of patient safety culture is provided, which can inform development of assessment instruments by managers and health care professionals.
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