Development and Validation of the Veterans Health Administration Patient Safety Culture Survey.
Development and Validation of the Veterans Health Administration Patient Safety Culture Survey.
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DOI：
10.1097/pts.0000000000001027
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发表时间：
2022-09-01
影响因子：
2.2
通讯作者：
Damschroder, Laura
中科院分区：
文献类型：
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作者：
Mohr, David C.;Chen, Charity;Sullivan, Jennifer;Gunnar, William;Damschroder, Laura
患者安全文化(PSC)是医疗保健组织中的一个重要概念，衡量它可以改进患者安全事件报告。我们试图在退伍军人健康管理局(VHA)内测试和验证PSC测量的简化版本。最初的34个项目被确定为代表VHA患者安全文化调查(VHA-PSCS)。这些项目是作为2019年6月年度调查管理的一部分进行的(N=205,117，回复率为66.1%)。我们得出了一个分半样本，并进行了探索性和验证性因素分析，以确定因素。我们检验了VHA-PSCs的信度、结构和效度，并与其他工作场所态度和行为进行了比较。最终的量表包括20个项目，4个量表，由因子分析得出：a)风险识别和公正的文化；b.)错误透明度和缓解；c.)主管沟通和信任；以及d.)团队凝聚力和敬业度。信度的支持基于克朗巴赫的α系数和分半检验。在标准效度方面，VHA-PSCs量表与员工满意度和内在工作经验之间的相关系数大于0.40。VHA-PSC量表与离职意向、职业倦怠和错误事件的自我报告之间的相关性大于0.20。VHA-PSCS反映了患者安全的四个维度。该工具可用于在整个组织和医疗中心内对VHA的PSC转型进度进行基准测试和比较；以加强患者安全事件报告、调查和护理质量。
Patient safety culture (PSC) is an important concept in healthcare organization and measuring it can lead to improved patient safety event reporting. We sought to test and validate an abbreviated version of a PSC measure within the Veterans Health Administration (VHA). An initial set of 34 items was identified to represent the VHA Patient Safety Culture Survey (VHA-PSCS). The items were administered as part of an annual survey administration in June 2019 (N=205,117, 66.1% response rate). We derived a split-half sample and conducted exploratory and confirmatory factor analysis to identify factors. We examined reliability along with construct and criterion validity of VHA-PSCS in relation to other workplace attitudes and behaviors. The final instrument includes 20 items with four scales derived from factor analysis: a.) risk identification and just culture; b.) error transparency and mitigation; c.) supervisor communication and trust; and d.) team cohesion and engagement. Reliability was supported based on Cronbach’s α coefficients and split-half testing. For criterion validity, Spearman correlations were greater than .40 between VHA-PSCS scales and employee satisfaction and intrinsic work experience. Correlations were greater than .20 between VHA-PSC scales and intent to leave, burnout, and self-rated reporting of error incidents. The VHA-PSCS reflects four dimensions of patient safety. The instrument can be used to benchmark and compare progress of VHA’s PSC transformation across the organization and within medical centers; to strengthen patient safety event reporting, investigation, and quality of care.