Table 1

Questionnaire scale items

Dimension

Item


Safety Culture Dimensions


Hospital management support

F1

Hospital management provides a work climate that promotes patient safety.

for patient safety

F8

The actions of hospital management show that patient safety is a top priority.

F9r

Hospital management seem to be interested in patient safety only after an adverse event happens.


Supervisor/manager expectations/actions

B1

Supervisors/managers say a good word when they see that a job has been done according to established procedures (standards and guidelines).*

B2

Supervisors/managers seriously consider staff suggestions for improving patient safety.

B3r

Whenever pressure builds up, supervisors/managers want staff to work faster, even if it means taking shortcuts or skipping steps.

B4r

Supervisors/managers overlook patient safety problems that happen over and over.


Teamwork across hospital

F2r

Hospital units do not coordinate well with each other.

units

F4

There is good cooperation among hospital units that need to work together.

F6r

It is often unpleasant for staff from one hospital unit to work with staff from other hospital units.

F10

Hospital units work well together to provide the best care for patients.


Teamwork within units

A1

Staff support one another within the units.

A3

When a lot of work needs to be done quickly, staff within the units work together as a team to get the work done.

A4

Staff within the units treat each other with respect.

A11

When one area within a unit gets really busy, others help out.


Communication openness

C2

Staff within units will freely speak up if they see something that may negatively affect patient care.

C4

Staff within units feel free to question the decisions or actions of those with more authority.

C6r

Staff within units are afraid to ask questions when something does not seem right.


Hospital handoffs and

F3r

Things "fall between the cracks" when transferring patients from one unit to another.

transitions

F5r

Important patient care information is often lost during shift changes within the hospital units.

F7r

Problems often occur during the exchange of information across hospital units.

F11r

Shift changes are problematic for patients within the hospital units.


Nonpunitive response to error

A8r

Staff within the individual units feel like their mistakes are held against them.

A12r

When an event (e.g., mistake) is reported, it feels like the person is being written up, not the problem.*

A16r

Staff worry that mistakes they make are kept in their personnel file.


Feedback and communication about errors

C1

Staff within units are given feedback about changes put into place based on events reported (e.g., mistakes).*

C3

Staff within units are informed about events (e.g., errors) that happen in their units.*

C5

Staff within units discuss ways to prevent an event (e.g., error) from happening again.*


Staffing

A2

Units within this hospital have enough staff to handle the workload.

A5r

Unit staff work longer hours than is best for patient care.

A7r

The units use more agency/temporary staff than is best for patient care.

A14r

Staff within units work in "crisis mode" trying to do too much, too quickly.


Organizational learning

A6

Staff within the units are actively doing things to improve patient safety.

A9

Mistakes have led to positive changes within the hospital units.

A13

After changes have been made to improve patient safety within the units, their effectiveness is evaluated by the staff.


Outcome Dimensions


Overall perceptions of safety

A10r

It is just by chance that more serious mistakes don't happen within the units.


A15

Patient safety is never sacrificed to get more work done.

A17r

We have patient safety problems within the units.

A18

Unit procedures and systems are good at preventing errors from happening.


Frequency of event reporting

D1r

When an event (e.g., error) occurs that is caught and corrected before affecting the patient, how often is this reported?*

D2r

When an event (e.g., error) occurs that poses no potential harm to the patient, how often is this reported?*

D3r

When an event (e.g., error) occurs that could harm the patient, but does not, how often is this reported?*


NOTE: Items marked with * include very special adoptions for a survey in Germany. For these items, additional translations closer to the original HSOPS version are available.

Hammer et al. BMC Health Services Research 2011 11:165   doi:10.1186/1472-6963-11-165

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