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Psychometric properties of the Safety Climate Survey (SCS) in Austrian acute care: factor structure, reliability and usability
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  • Manela Glarcher,
  • Karin Kaiser,
  • Nadja Nestler,
  • Patrick Kutschar
Manela Glarcher
Paracelsus Medical Private University
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Karin Kaiser
Paracelsus Medical Private University
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Nadja Nestler
Paracelsus Medical Private University
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Patrick Kutschar
Paracelsus Medical Private University
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Abstract

Rationale, Aims and Objectives Hospitals are complex organizations with a high potential for medical errors that can be influenced by safety culture, a central aspect in research and practice to increase patient safety. Safety climate as a measurable element of safety culture, illustrates the perception of safety-relevant aspects of health care staff at a certain time. The Safety Climate Survey (SCS) is applied internationally to measure safety climate. However, psychometrics for the German SCS have yet not been evaluated. Aim of this study is to explore the factor structure, reliability, and potential usefulness of the German SCS in Austrian acute care. Methods Cross-sectional online-surveys of physicians, therapists and nurses/midwives from eight hospitals from one hospital operator were implemented. An exploratory factor analysis (EFA) was carried out, both, for the total sample and also split by two select professions (physicians, nurses/midwives). After deriving a factor structure for both professions, internal consistency and scale means were calculated for the subscales. Finally, mean subscale differences between physicians and nurses/midwives were tested. Results In summary, 933 respondents out of 5,160 eligible staff participated, reaching a response rate of 18.1%. A six-factor solution explaining 59.1% of total variance was identified in the total sample. Comparison by profession illustrated that the factor structures and item loading patterns differ between physicians (n=124) and nurses/midwives (n=713). To achieve an overarching solution, five items were excluded from consecutive subscale measures due to cross-loadings and contradictory factor loadings. Subscales demonstrated good to low internal consistency (α=0.794 to 0.535). Significant mean differences between subscales of professions were found relating to three factors. Conclusions The German SCS measures safety climate multi- rather than unidimensional, demonstrated limitations in factor structures and item loadings but overall satisfactory reliability of the subscales. When assessing safety climate, a multi-dimensional and profession-related approach must be explicitly considered.

Peer review status:POSTED

08 Sep 2020Submitted to Journal of Evaluation in Clinical Practice
12 Sep 2020Assigned to Editor
12 Sep 2020Submission Checks Completed