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BMC Health Services Research

, 11:165

Quality, performance, safety and outcomes


BackgroundFrom a management perspective, it is necessary to examine how a hospital-s top management assess the patient safety culture in their organisation. This study examines whether the Hospital Survey on Patient Safety Culture for hospital management HSOPS M has the same psychometric properties as the HSOPS for hospital employees does.

MethodsIn 2008, a questionnaire survey including the HSOPS M was conducted with 1,224 medical directors from German hospitals. When assessing the psychometric properties, we performed a confirmatory factor analysis CFA. Additionally, we proved construct validity and internal consistency.

ResultsA total of 551 medical directors returned the questionnaire. The results of the CFA suggested a satisfactory global data fit. The indices of local fit indicated a good, but not satisfactory convergent validity. Analyses of construct validity indicated that not all safety culture dimensions were readily distinguishable. However, Cronbach-s alpha indicated that the dimensions had an acceptable level of reliability.

ConclusionThe analyses of the psychometric properties of the HSOPS M resulted in reasonably good levels of property values. Although the set of dimensions within the HSOPS M needs further scale refinement, the questionnaire covers a broad range of sub-dimensions and supplies important information on safety culture. The HSOPS M, therefore, is eligible to measure safety culture from the hospital management-s points of view and could be used in nationwide hospital surveys to make inter-organisational comparisons.

List of abbreviations usedAVEAverage Variance Extracted

Chi-dfChi-squared value

CFIComparative Fit Index

CFAConfirmatory factor analysis

HOSQuaEffects of Hospital Ownership Structures on Quality of Health Care

EMExpectation maximization

FLRFornell-Larcker Ratio

HSOPSHospital Survey on Patient Safety Culture

HSOPS MHospital Survey on Patient Safety Culture for hospital management

IOMInstitute of Medicine

KMOKaiser-Meyer-Olkin coefficient

MSAMeasure of Sample Adequacy coefficient

RMSEARoot Mean Square Error of Approximation

SRMRStandardised Root Mean Residual

TLITucker-Lewis Index.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-11-165 contains supplementary material, which is available to authorized users.

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Autor: Antje Hammer - Nicole Ernstmann - Oliver Ommen - Markus Wirtz - Tanja Manser - Yvonne Pfeiffer - Holger Pfaff


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