Development of a patient safety culture measurement tool for ambulatory health care settings: analysis of content validity

The development of patient safety culture in health care organizations is a necessary precursor to patient safety improvement. However, existing tools to measure patient safety culture are intended for implementation in hospitals. A new, abbreviated patient safety culture survey was developed for use in ambulatory health care settings. This survey was tested for content validity utilizing a panel of six experts. It had a clarity interrater agreement (IR) of 0.75, a clarity content validity index (CVI) of 0.95, a representativeness IR of 0.75 and a representativeness CVI of 0.95. The content validity analysis served as a useful tool for assessing the relevance and comprehensiveness of this survey of patient safety culture in ambulatory care organizations.

[1]  C. Ross,et al.  Quality of outpatient pediatric care: the influence of physicians' background, socialization, and work/information environment on performance. , 1978, Journal of health and social behavior.

[2]  Kate Lorig,et al.  Patients as partners in managing chronic disease , 2000, BMJ : British Medical Journal.

[3]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[4]  R. Gibberd,et al.  Epidemiology of medical error , 2000, BMJ : British Medical Journal.

[5]  V. Nieva,et al.  Safety culture assessment: a tool for improving patient safety in healthcare organizations , 2003, Quality & safety in health care.

[6]  John B. Schorling,et al.  Patient safety in the ambulatory setting , 2004, Journal of General Internal Medicine.

[7]  T. Hammons,et al.  Ambulatory Patient Safety: What We Know and Need to Know , 2003, The Journal of ambulatory care management.

[8]  R. Wachter.  The end of the beginning: patient safety five years after 'to err is human'. , 2004, Health affairs.

[9]  R. Narins,et al.  Does the location of the surgery or the specialty of the physician affect malpractice claims in liposuction? , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[10]  J. Rolph,et al.  Omission-Related Malpractice Claims and the Limits of Defensive Medicine , 1997, Medical care research and review : MCRR.

[11]  A. Wall,et al.  Book ReviewTo Err is Human: building a safer health system Kohn L T Corrigan J M Donaldson M S Washington DC USA: Institute of Medicine/National Academy Press ISBN 0 309 06837 1 $34.95 , 2000 .

[12]  M. Meaney.  Error Reduction, Patient Safety and Institutional Ethics Committees , 2004, The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics.

[13]  Eitan Naveh,et al.  Safety Climate in Health Care Organizations: A Multidimensional Approach , 2005 .

[14]  J. Reason.  Human error: models and management , 2000, BMJ : British Medical Journal.

[15]  S. Haynes,et al.  Content validity in psychological assessment: A functional approach to concepts and methods. , 1995 .

[16]  L. Stern,et al.  Conducting Interorganizational Research Using Key Informants , 1993 .

[17]  B. Golden.  The past is the past--or is it? The use of retrospective accounts as indicators of past strategy. , 1992, Academy of Management journal. Academy of Management.

[18]  M. Lynn.  Determination and quantification of content validity. , 1986, Nursing research.

[19]  John P. Campbell,et al.  Measurement Theory for the Behavioral Sciences. , 1983 .

[20]  S. Dovey,et al.  Classification of medical errors and preventable adverse events in primary care: a synthesis of the literature. , 2002, The Journal of family practice.

[21]  D. Bates,et al.  What practices will most improve safety? Evidence-based medicine meets patient safety. , 2002, JAMA.

[22]  D. Streiner,et al.  Health Measurement Scales: A practical guide to thier development and use , 1989 .

[23]  L. Leape.  Error in Medicine , 1994 .

[24]  Janet M. Corrigan,et al.  COMMITTEE ON THE NATIONAL QUALITY REPORT ON HEALTH CARE DELIVERY , 2001 .

[25]  P. Gertman,et al.  Utilization review in the United States: results from a 1976-1977 national survey of hospitals. , 1979, Medical care.

[26]  Douglas McCarthy,et al.  Stories from the sharp end: case studies in safety improvement. , 2006, The Milbank quarterly.

[27]  R Flin,et al.  Measuring safety climate in health care , 2006, Quality and Safety in Health Care.

[28]  P. Pronovost,et al.  Assessing safety culture: guidelines and recommendations , 2005, Quality and Safety in Health Care.

[29]  J S Zinn,et al.  Organizational structure and the delivery of primary care to older Americans. , 1998, Health services research.

[30]  C. Waltz,et al.  Measurement in nursing research , 1984 .

[31]  L. Davis,et al.  Selection and use of content experts for instrument development. , 1997, Research in nursing & health.

[32]  R A Deyo,et al.  A key medical decision maker: the patient , 2001, BMJ : British Medical Journal.

[33]  W. Weeks,et al.  Measuring patient safety climate: a review of surveys , 2005, Quality and Safety in Health Care.

[34]  William H. Glick,et al.  Studying Changes in Organizational Design and Effectiveness: Retrospective Event Histories and Periodic Assessments , 1990 .

[35]  Ambulatory surgery ... how far can we go? , 1993, The Medical clinics of North America.

[36]  L. Kohn,et al.  To Err Is Human : Building a Safer Health System , 2007 .

[37]  B. Hulka,et al.  Peer review in ambulatory care: use of explicit criteria and implicit judgments. , 1979, Medical care.

[38]  Duffy Sq,et al.  Patterns of decline among inpatient procedures. , 1995 .

[39]  E. Wagner.  The role of patient care teams in chronic disease management , 2000, BMJ : British Medical Journal.