[Validation of a questionnaire to assess patient safety culture in Spanish Primary Health Care professionals]

Evaluation of the psychometric performance of the Spanish and Catalan versions of the patient reported experiences and Outcomes of Safety in Primary Care (PREOS-PC)-Compact questionnaire

BACKGROUND

Patients provide a unique, irreplaceable, and essential perspective in evaluating patient safety. The suite of Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) tools are a notable exception to the scarcity of patient-reported patient safety measures. Full evaluation of their performance has only been attempted for the English version, thereby limiting its international applicability.

OBJECTIVES

To assess the psychometric performance of the Spanish and Catalan versions of the PREOS-PC-Compact.

METHODS

Cross-sectional validation study. We used Classical Test Theory methods to examine scale score distribution, internal consistency, and construct validity; and Item Response Theory (IRT) methods to further explore construct validity.

RESULTS

3287 patients completed the Spanish version, and 1007 the Catalan version. Similar results were obtained for both versions. Confirmatory Factor Analysis supported a single construct for each scale. The correlations between PREOS-PC-Compact scales and known group analysis suggested adequate construct validity (inconclusive for known groups at the provider level). All four multi-item scales demonstrated adequate internal consistency reliability (α > 0.7), which was only confirmed for test-retest reliability for 'Practice activation.' A sample between 60-90 patients per practice was estimated sufficient to produce scores with reliability > 0.7 for all scales except for harm scales. IRT models showed disordered thresholds for 'Practice activation' and 'Harm burden' but showed excellent fit after reducing the response categories.

CONCLUSION

The Spanish and Catalan versions of the PREOS-PC-Compact are broadly valid and reliable tools to measure patient safety in Spanish primary care centres; confirmation of lower-than-expected test-rest reliability merits further examination .

[Validation of a questionnaire to assess patient safety culture in healthcare managers: Psychometric properties and usability]

AIM

To validate a reduced and applicable to distinct location version of the only validated questionnaire of patient safety culture in managers in Spanish language.

METHOD

Questionnaire validation study. Community of Madrid 2022. Reduction/adaptation of the original questionnaire: Giménez-Aibar-Gutiérrez, 2013 Questionnaire was reduced from 85 items to 25; those local or not applicable were removed. Pre-test: Semi-structured survey on comprehension and response scale. There was no need to modify the questionnaire.

VALIDATION

It was tested in 39 primary care managers without care activity. Internal consistency (α Cronbach), content validity (experts) and construct validity (factor analysis) were analysed. Usability analysis: Survey on time spent and non-response rate.

RESULTS

α Cronbach=0.894. Content validity: Experts deemed questionnaire was complete. Factor analysis: five factors explain 68% of variance. The factors corresponded to the dimensions of the theoretical construct. Factors, internal consistency of each and correlation with global score were: commitment with patient safety: α Cronbach=0.793, r=0.778; P<.001; procedures/reporting: α Cronbach=0.83, r=0.806; P<.001; attitudes with patient safety: α Cronbach=0.766, r=0.596; P<.001; clinicians involving: α Cronbach=0.773, r=0.798; P<.001; patient safety communication: α Cronbach=0.615, r=0.518; P=.001; usability survey: 95% thought spent time was adequate. Non-response rate was 0%, except one item.

CONCLUSION

In this work, a reduced and adapted version of questionnaire of Giménez-Aibar-Gutiérrez was validated at distinct location (Madrid region). Psychometric properties and usability, which were found, suggest that the reduced questionnaire is a reliable, valid and usable instrument to assess patient safety culture in managers of any place.

Feasibility of the SINERGIAPS ("Sinergias entre profesionales y pacientes para una Atención Primaria Segura") intervention for improving patient safety in primary care

AIM

The primary aim was to examine the feasibility of intervention delivery and of trial procedures. Secondary aims were to study the intervention uptake; its acceptability and perceived utility; and its potential to improve safety culture and avoidable hospital admissions.

METHODS

We conducted a 3-month, single-arm feasibility study in 10 primary care (PC) centres in Spain. Centres received information regarding patients' experiences of safety (through the Patient Reported Experiences and Outcomes of Safety in Primary Care [PREOS-PC] questionnaire), and were instructed to plan safety improvements based on that feedback. We used a bespoke online tool to recruit PC professionals, collect patient feedback, and deliver it to the centres, and to collect outcome data (patient safety culture [Medical Office Survey on Patient Safety Culture, MOSPSC questionnaire]). We measured recruitment and follow-up rates and intervention uptake (based on the number of safety improvement plans registered). We conducted semistructured interviews with 9 professionals to explore the intervention acceptability and perceived utility.

RESULTS

Of 256 professionals invited, 120 (47%) agreed to participate, and 97 completed baseline and postintervention measures. Of 780 patients invited, 585 (75%) completed the PREOS-PC questionnaire. Five of 10 centres (50%) designed an improvement plan, providing 27 plans in total (range per centre, 1-14). The intervention was perceived as a novel strategy for improving safety, although the healthcare professionals identified several factors limiting its acceptability and utility: lack of feedback at the individual professional level; potentially unrepresentative sample of patients providing feedback; and number of educational materials deemed overwhelming.

DISCUSSION

It is feasible to deliver the proposed intervention so long as the identified limitations are addressed.

Correlación del grado de percepción y cultura de seguridad del paciente en una Institución de tercer nivel 2015-2019

Introducción: La seguridad del paciente es considerado como un patrón integrado de comportamiento individual y organizacional, basado en creencias y valores compartidos que continuamente busca minimizar el daño al paciente, que resulta de la atención. Objetivo: Analizar la correlación de percepción de cultura de seguridad del paciente, y grado de seguridad percibido en funcionarios de una Institución de Salud de tercer nivel de atención (2015-2017-2019). Materiales y Métodos: Estudio cuantitativo correlacional, con una muestra intencional derivada del registro de una base de datos de cultura de seguridad del paciente, con un total de 402 registros. La medición se realizó mediante el cuestionario Hospital Survey on Patient Safety Culture. Resultados: En los resultados globales el mayor porcentaje de encuestados correspondió al personal asistencial (73,4%). El principal servicio asistencial es unidad de cuidado intensivo (18,2%) y la mayor participación correspondió al rol de enfermeras y auxiliares de enfermería (45,7%). Según las respuestas positivas para los datos globales se determina 2 de 12 dimensiones clasificadas como fortaleza en el componente de Aprendizaje organizacional (81,5%) y Trabajo en equipo (85,5%) y el grado de seguridad percibido con correlaciones (p: 0,000) que se identifican en seis dimensiones entre ellas notificación de eventos, y aprendizaje organizacional. Discusión: La correlación del grado de seguridad percibido con las dimensiones del cuestionario guarda similitud en especial la notificación de eventos. Conclusión: La seguridad del paciente y el grado de seguridad percibido guardan correspondencia en la medida que en las instituciones realizan intervenciones en diferentes componentes entre ellos la notificación de eventos y trabajo en equipo.

Nurses' perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services

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Critical care nurses have had to perform tasks for which they have not received proper training.

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Nurses have had to manage the fear of becoming infected and spreading it to their families.

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Moral suffering and emotional exhaustion are major consequences of front-line care.

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Heavy workloads, high patient-nurse ratios, and lack of rest are causing exhaustion among nurses.

Background

The COVID-19 pandemic is a public health challenge that puts health systems in a highly vulnerable situation. Nurses in critical care units (CCUs) and hospital emergency services (HESs) have provided care to patients with COVID-19 under pressure and uncertainty.

Objective

To identify needs related to safety, organisation, decision-making, communication and psycho-socio-emotional needs perceived by critical care and emergency nurses in the region of Madrid, Spain, during the acute phase of the epidemic crisis.

Methods

This is a cross-sectional study (the first phase of a mixed methods study) with critical care and emergency nurses from 26 public hospitals in Madrid using an online questionnaire.

Results

The response rate was 557, with 37.5% reporting working with the fear of becoming infected and its consequences, 28.2% reported elevated workloads, high patient-nurse ratios and shifts that did not allow them to disconnect or rest, while taking on more responsibilities when managing patients with COVID-19 (23.9%). They also reported deficiencies in communication with middle management (21.2%), inability to provide psycho-social care to patients and families and being emotionally exhausted (53.5%), with difficulty in venting emotions (44.9%).

Conclusions

Critical care and emegency nurses may be categorised as a vulnerable population. It is thus necessary to delve deeper into further aspects of their experiences of the pandemic.

Percepción de enfermería. Una mirada actual a la cultura de seguridad en el quirófano

Introducción: La cultura de seguridad del paciente se considera una prioridad en la asistencia sanitaria para la disminución de los eventos adversos en los quirófanos donde su ocurrencia no se informa y ello genera riesgos. Objetivo: Caracterizar la cultura de seguridad del paciente desde la percepción de los profesionales de enfermería de quirófano. Método: Estudio descriptivo transversal que recogió los resultados de la encuesta anónima de cultura de seguridad del paciente elaborada por la Agencia para la Investigación y Calidad en Salud, adaptada al español en el curso poscongreso en Electrocirugías para Instrumentistas, realizado a una muestra de 67 profesionales de enfermería, trabajadores de 10 quirófanos, localizados en La Habana (Cuba). Se evaluó la percepción que tienen los profesionales de enfermería. Se analizaron las respuestas positivas y negativas a los 50 ítems, incluyendo la calificación global de seguridad. El procesamiento de la información de la encuesta se codificó y se colectó en una base de datos confeccionada en el procesador estadístico Excel y luego, para su análisis, se convirtió a SPSS versión 21.0 para Windows. Resultado: Se analizaron 67 encuestas; el 100 % de los encuestados calificó de positivo el grado global de seguridad. Como fortaleza se destacan las dimensiones: aprendizaje organizacional, apoyo de la dirección y trabajo en equipo entre unidades. El resto de las dimensiones, excepto la respuesta no punitiva (clasificada como debilidad), se clasificaron como oportunidades de mejora. Conclusiones: La cultura de seguridad del paciente debe progresar de la culpabilidad al aprendizaje.

Development and evaluation of an intervention based on the provision of patient feedback to improve patient safety in Spanish primary healthcare centres: study protocol

INTRODUCTION

Despite the enormous potential for adverse events in primary healthcare (PHC), the knowledge about how to improve patient safety in this context is still sparse. We describe the methods for the development and evaluation of an intervention targeted at PHC professionals to improve patient safety in Spanish PHC centres.

METHODS AND ANALYSIS

The intervention will consist in using the patient reported experiences and outcomes of safety in primary care (PREOS-PC) survey to gather patient-reported experiences and outcomes concerning the safety of the healthcare patients receive in their PHC centres, and feed that information back to the PHC professionals to help them identify opportunities for safer healthcare provision. The study will involve three stages. Stage 1 (developing the intervention) will involve: (i) qualitative study with 40 PHC providers to optimise the acceptability and perceived utility of the proposed intervention; (ii) Spanish translation, cross-cultural adaptation and validation of the PREOS-PC survey; (iii) developing the intervention components; and (iv) developing an online tool to electronically administrate PREOS-PC and automatically generate feedback reports to PHC centres. Stage 2 (piloting the intervention) will involve a 3-month feasibility (one group pre-post) study in 10 PHC centres (500 patients, 260 providers). Stage 3 (evaluating the intervention) will involve: (i) a 12-month, two-arm, two-level cluster randomised controlled trial (1248 PHC professionals within 48 PHC centres; with randomisation at the centre level in a 1:1 ratio) to evaluate the impact of the intervention on patient safety culture (primary outcome), patient-reported safety experiences and outcomes (using the PREOS-PC survey), and avoidable hospitalisations; (ii) qualitative study with 20 PHC providers to evaluate the acceptability and perceived utility of the intervention and identify implementation barriers.

ETHICS AND DISSEMINATION

The study was approved by the Ethics Committee of the Balearic Islands (CEI IB: 3686/18) with the 1964 Helsinki Declaration and its later amendments. The results will be disseminated in peer-reviewed publications and national and international conferences.

TRIAL REGISTRATION NUMBER

NCT03837912; pre-results.

[Translation, adaptation and validation in Catalan of a questionnaire about patient safety culture: The MOSPSC (Medical Office Survey on Patient Safety Culture) questionnaire]

INTRODUCTION

Patient safety is an essential dimension of quality of care and a priority in health policies. The diffusion of the security culture is a key strategy and the questionnaire MOSPSC (Medical Office Survey on Patient Safety Culture), in its English and Spanish versions, has proved to be a good instrument to 'measure it'. The aim of this work is to translate, adapt and validate the questionnaire in Catalan.

MATERIAL AND METHODS

Translation, retrotranslation and adaptation of MOSPSC questionnaire of the AHRQ (Agency for Healthcare Research and Quality). Reliability and validity analysis of the adapted questionnaire.

RESULTS

It is a simple, well accepted and valued questionnaire, although extensive. Catalan version facilitates more precise comprehension and improves completion. We found small response percentages 'do not apply or do not know' in questions from Section F (At the Center) but notable in some questions referred to specific professional staff. For most items show suitable discrimination rates and both the complete questionnaire and subscales extracted after factor analysis obtain good reliability indexes.

CONCLUSIONS

Final version, very similar to original and Spanish adapted, will allow comparisons as well as monitoring/follow-up after implementation of improvement strategies. Due to its length, it could be assessed using only related dimensions.

[Transcultural adaptation into Spanish of the Patient empowerment in long-term conditions questionnaire]

Objetivo

Describir el proceso de traducción y adaptación transcultural del instrumento Patient empowerment in long-term condition al español.

Diseño

Traducción, adaptación transcultural y análisis de la comprensibilidad mediante entrevistas cognitivas.

Emplazamiento

Asistencia primaria y hospitalaria.

Participantes

Diez pacientes ingresados en un servicio de cardiología de un hospital universitario.

Mediciones principales

1) Traducción directa; 2) síntesis y conciliación de las versiones por un comité de expertos; 3) traducción inversa; 4) conciliación de la traducción inversa con la autora del cuestionario original, y 5) análisis de la comprensibilidad mediante entrevistas cognitivas a una muestra de pacientes.

Resultados

Las versiones de traducción directa no presentaron grandes diferencias entre ellas. De los 47 ítems que componen el cuestionario, el comité de expertos introdujo cambios en 23 ítems. La versión de la traducción inversa fue aceptada por la autora del cuestionario original. En las entrevistas cognitivas, los pacientes señalaron una dificultad alta en un ítem y baja en 4.

Conclusiones

La versión española del cuestionario Patient Empowerment in long-term conditions es equivalente semántica y conceptualmente al instrumento original. En una fase posterior se procederá a un proceso de validación en el que se establecerán las propiedades psicométricas.

[Design and validation of a questionnaire to assess the level of general knowledge on eating disorders in students of Health Sciences]

OBJECTIVE

To design and validate a questionnaire to assess the level of knowledge regarding eating disorders in college students.

DESIGN

Observational, prospective, and longitudinal study, with the design of the questionnaire based on a conceptual review and validation by a cognitive pre-test and pilot test-retest, with analysis of the psychometric properties in each application.

LOCATION

University Foundation of Bages, Barcelona. Marco community care.

PARTICIPANTS

A total of 140 students from Health Sciences; 53 women and 87 men with a mean age of 21.87 years; 28 participated in the pre-test and 112 in the test-retests, 110 students completed the study.

MAIN MEASUREMENTS

Validity and stability study using Cronbach α and Pearson product-moment correlation coefficient statistics; relationship skills with sex and type of study, non-parametric statistical Mann-Whitney and Kruskal-Wallis tests; for demographic variables, absolute or percentage frequencies, as well as mean, central tendency and standard deviation as measures of dispersion were calculated. The statistical significance level was 95% confidence.

RESULTS

The questionnaire was obtained that had 10 questions divided into four dimensions (classification, demographics characteristics of patients, risk factors and clinical manifestations of eating disorders). The scale showed good internal consistency in its final version (Cronbach α=0.724) and adequate stability (Pearson correlation 0.749).

CONCLUSIONS

The designed tool can be accurately used to assess Health Sciences students' knowledge of eating disorders.

Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen

BACKGROUND

Patient safety culture in primary care is the first step to achieve high quality health care. This study aims to provide a baseline assessment of patient safety culture in primary care settings in Al-Mukala, Yemen as a first published study from a least developed country.

METHODS

A survey was conducted in primary healthcare centres and units in Al-Mukala District, Yemen. A comprehensive sample from the available 16 centres was included. An Arabic version of the Medical Office Survey on Patient Safety Culture was distributed to all health workers (110). Participants were physicians, nurses and administrative staff.

RESULTS

The response rate from the participating centres was 71 %. (N = 78). The percent positive responses of the items is equal to the percentage of participants who answered positively. Composite scores were calculated by averaging the percent positive response on the items within a dimension. Positive safety culture was defined as 60 % or more positive responses on items or dimensions. Patient safety culture was perceived to be generally positive with the exception of the dimensions of 'Communication openness', 'Work pressure and pace' and 'Patient care tracking/follow-up', as the percent positive response of these dimensions were 58, 57, and 52 % respectively. Overall, positive rating on quality and patient safety were low (49 and 46 % respectively).

CONCLUSIONS

Although patient safety culture in Al-Mukala primary care setting is generally positive, patient safety and quality rating were fairly low. Implementation of a safety and quality management system in Al-Mukala primary care setting are paramount. Further research is needed to confirm the applicability of the Medical Office Survey on Patient Safety Culture (MOSPSC) for Al-Mukala primary care.

The aftermath of adverse events in Spanish primary care and hospital health professionals

BACKGROUND

Adverse events (AEs) cause harm in patients and disturbance for the professionals involved in the event (second victims). This study assessed the impact of AEs in primary care (PC) and hospitals in Spain on second victims.

METHODS

A cross-sectional study was conducted. We carried out a survey based on a random sample of doctors and nurses from PC and hospital settings in Spain. A total of 1087 health professionals responded, 610 from PC and 477 from hospitals.

RESULTS

A total of 430 health professionals (39.6%) had informed a patient of an error. Reporting to patients was carried out by those with the strongest safety culture (Odds Ratio -OR- 1.1, 95% Confidence Interval -CI- 1.0-1.2), nurses (OR 1.9, 95% CI 1.5-2.3), those under 50 years of age (OR 0.7, 95% CI 0.6-0.9) and primary care staff (OR 0.6, 95% CI 0.5-0.9). A total of 381 (62.5%, 95% CI 59-66%) and 346 (72.5%, IC95% 69-77%) primary care and hospital health professionals, respectively, reported having gone through the second-victim experience, either directly or through a colleague, in the previous 5 years. The emotional responses were: feelings of guilt (521, 58.8%), anxiety (426, 49.6%), re-living the event (360, 42.2%), tiredness (341, 39.4%), insomnia (317, 38.0%) and persistent feelings of insecurity (284, 32.8%). In doctors, the most common responses were: feelings of guilt (OR 0.7 IC95% 0.6-0.8), re-living the event (OR 0.7, IC95% o.6-0.8), and anxiety (OR 0.8, IC95% 0.6-0.9), while nurses showed greater solidarity in terms of supporting the second victim, in both PC (p = 0.019) and hospital (p = 0.019) settings.

CONCLUSIONS

Adverse events cause guilt, anxiety, and loss of confidence in health professionals. Most are involved in such events as second victims at least once in their careers. They rarely receive any training or education on coping strategies for this phenomenon.

Are Spanish primary care professionals aware of patient safety?

BACKGROUND

Knowledge about safety culture improves patient safety (PS) in health-care organizations. The first contact a patient has with health care occurs at the primary level. We conducted a survey to measure patient safety culture (PSC) among primary care professionals (PCPs) of health centres (HCs) in Spain and analyzed PS dimensions that influence PSC.

METHODS

We used Agency for Healthcare Research and Quality (AHRQ) Medical Office Survey on Patient Safety Culture translated and validated into Spanish to conduct a cross-sectional anonymous postal survey. We randomly selected a sample of 8378 PCPs at 289 HCs operated by 17 Regional Health Services. Statistical analysis was performed on sociodemographic variables, survey items, PS dimensions and a patient safety synthetic index (PSSI), calculated as average score of the items per dimension, to identify potential predictors of PSC. We used AHRQ data to conduct international comparison.

RESULTS

A total of 4344 PCPs completed the questionnaire. The response rate was 55.69%. Forty-two percent were general practitioners, 34.9% nurses, 18% administrative staff and 4.9% other professionals. The highest scoring dimension was 'PS and quality issues' 4.18 (4.1-4.20) 'Work pressure and pace' was the lowest scored dimension with 2.76 (2.74-2.79). Professionals over 55 years, with managerial responsibilities, women, nurses and administrative staff, had better PSSI scores. Professionals with more than 1500 patients and working for more than 11 years at primary care had lower PSSI scores.

CONCLUSIONS

This is the first national study to measure PSC in primary care in Spain. Results may reflect on-going efforts to build a strong PSC. Further research into its association with safety outcomes and patients' perceptions is required.

[Adaptation of the Medical Office Survey on Patient Safety Culture (MOSPSC) tool]

OBJECTIVE

To adapt the Medical Office Survey on Patient Safety Culture (MOSPSC) Excel(®) tool for its use by Primary Care Teams of the Spanish National Public Health System.

METHODS

The process of translation and adaptation of MOSPSC from the Agency for Healthcare and Research in Quality (AHRQ) was performed in five steps: Original version translation, Conceptual equivalence evaluation, Acceptability and viability assessment, Content validity and Questionnaire test and response analysis, and psychometric properties assessment. After confirming MOSPSC as a valid, reliable, consistent and useful tool for assessing patient safety culture in our setting, an Excel(®) worksheet was translated and adapted in the same way. It was decided to develop a tool to analyze the "Spanish survey" and to keep it linked to the "Original version" tool. The "Spanish survey" comparison data are those obtained in a 2011 nationwide Spanish survey, while the "Original version" comparison data are those provided by the AHRQ in 2012.

RESULTS

The translated and adapted tool and the analysis of the results from a 2011 nationwide Spanish survey are available on the website of the Ministry of Health, Social Services and Equality. It allows the questions which are decisive in the different dimensions to be determined, and it provides a comparison of the results with graphical representation.

CONCLUSIONS

Translation and adaptation of this tool enables a patient safety culture in Primary Care in Spain to be more effectively applied.

[Out of hospital emergencies towards a safety culture]

OBJECTIVES

The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies.

MATERIAL AND METHODS

A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013.

RESULTS

The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%).

CONCLUSIONS

The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary.

[Cross-cultural adaptation into Spanish of the Nursing Home Survey on Patient Safety Culture questionnaire]

OBJECTIVE

This article presents the first phase of a research project aimed at adapting a tool for assessing safety culture in nursing homes into Spanish.

MATERIAL AND METHODS

The Nursing Home on Patient Safety Culture of the Agency for Health Care Research and Quality was translated and culturally adapted. The International Quality of Life Assessment protocol was followed, which included, translation, conceptual equivalence evaluation, back-translation, content validity and a pilot study.

RESULTS

Three of the 42 items were modified with respect to the original version. The remaining modifications were introduced in the F Section, containing sociodemographic information and job related questions.

CONCLUSIONS

The adapted questionnaire will help to assess the level of safety of the resident culture among healthcare professionals in these centres, to identity areas for improvement, and to analyze how to evolve when organizational changes are introduced.

[Assessment of the patient-safety culture in a healthcare district]

OBJECTIVES

1) To describe the frequency of positive attitudes and behaviours, in terms of patient safety, among the healthcare providers working in a healthcare district; 2) to determine whether the level of safety-related culture differs from other studies; and 3) to analyse negatively valued dimensions, and to establish areas for their improvement.

MATERIAL AND METHODS

A descriptive, cross-sectional study based on the results of an evaluation of the safety-related culture was conducted on a randomly selected sample of 247 healthcare providers, by using the Spanish adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) designed by the Agency for Healthcare Research and Quality (AHRQ), as the evaluation tool. Positive and negative responses were analysed, as well as the global score. Results were compared with international and national results.

RESULTS

A total of 176 completed survey questionnaires were analysed (response rate: 71.26%); 50% of responders described the safety climate as very good, 37% as acceptable, and 7% as excellent. Strong points were: «Teamwork within the units» (80.82%) and «Supervisor/manager expectations and actions» (80.54%). Dimensions identified for potential improvement included: «Staffing» (37.93%), «Non-punitive response to error» (41.67%), and «Frequency of event reporting» (49.05%).

CONCLUSIONS

Strong and weak points were identified in the safety-related culture of the healthcare district studied, together with potential improvement areas. Benchmarking at the international level showed that our safety-related culture was within the average of hospitals, while at the national level, our results were above the average of hospitals.