Table 2.
Problematic responses †
| Scales and text of item (Cronbach’s α Coefficient) | % Problematic | % Problematic + % Neutral |
|---|---|---|
| Senior leadership (0.95) | 5.55 | 14.99 |
| Good communication flow exists up and down the chain of command regarding patient safety issues | 8.83 | 15.95 |
| Senior management supports a climate that promotes patient safety | 4.71 | 11.01 |
| Senior management has a clear planning and actions to deal with the risks that associated with patient care | 4.71 | 12.43 |
| Senior management uses proper ways to deal with the mistakes that actually occur in this facility | 4.74 | 12.74 |
| Senior management considers patient safety when program changes are discussed | 4.50 | 12.56 |
| Patient safety decisions are made by people regardless of rank or hierarchy | 5.90 | 15.18 |
| Resources for safety (0.95) | 8.91 | 21.66 |
| Staff is provided with adequate resources (personnel, budget, and equipment) to provide safe patient care | 8.69 | 19.25 |
| Staff has enough time to complete patient care tasks safely | 8.66 | 20.51 |
| Staff has received sufficient training to enable them to address patient safety problems | 9.40 | 19.64 |
| This facility devotes sufficient resources to follow-up on identified safety problems | 8.89 | 21.41 |
| Facility characteristics (0.89) | 7.06 | 17.69 |
| Compared with other facilities in the area, this facility cares more about the equipment safety | 9.06 | 18.05 |
| Overall the level of patient safety at this facility is improving | 5.06 | 12.78 |
| Workgroup leadership (0.26)‡ | 23.61 | 32.73 |
| Management in the unit helps staff overcome problems | 6.80 | 15.41 |
| Management puts safety at importance | 5.29 | 12.37 |
| Whenever pressure builds up, management in the unit wants us to work faster, even if it means taking shortcuts that might negatively affect patient safety | 58.74 | 70.41 |
| Workgroup norms (0.92) | 4.13 | 13.15 |
| My unit takes the time to identify and assess risks to ensure patient safety | 3.67 | 10.44 |
| My unit has risk management to ensure patient safety | 3.62 | 11.06 |
| We have learned how to do our job better by learning about mistakes | 2.51 | 9.18 |
| There is significant peer pressure to discourage unsafe patient care | 8.07 | 17.77 |
| Anyone found to violate standards or safety rules is corrected | 2.74 | 9.74 |
| Deliberate violations of standard operating procedures are rare | 4.16 | 10.71 |
| Workgroup recognition (0.90) | 6.51 | 16.76 |
| Taking quick action to identify a serious mistake is rewarded | 6.92 | 15.26 |
| Individual safety achievement is recognized through rewards | 7.74 | 16.41 |
| Teamwork is encouraged in order to improve patient safety in medical care | 4.88 | 10.94 |
| Fear of shame (0.95) | 41.16 | 51.94 |
| Asking for help is a sign of incompetence | 42.10 | 51.34 |
| People will not tell others about a mistake that has significant consequences and if nobody notices the mistake | 39.82 | 50.11 |
| Telling others about the mistakes is embarrassing | 41.56 | 52.55 |
| Learning (0.81) | 12.76 | 23.07 |
| Mistakes have led to positive changes in the unit | 19.21 | 28.97 |
| Personal performance is evaluated against defined safety standards | 10.48 | 20.29 |
| Patient safety problems and errors are communicated to the right people so that the problem can be corrected | 8.58 | 17.00 |
| Fear of blame (0.82) | 78.53 | 88.37 |
| If a person makes a mistake and is found, he will be disciplined. | 76.14 | 85.63 |
| Clinicians who make serious mistakes are usually punished | 80.91 | 89.71 |
| Psychological safety(0.95) | 7.81 | 20.08 |
| Staff can feel comfortable questioning the actions of those with more authority when patient safety is at risk | 9.37 | 20.32 |
| Staff can freely voice their opinions on patient safety. | 7.72 | 19.04 |
| Staff can freely identify events that may negatively affect patient safety | 7.04 | 17.81 |
| Staff can freely report patient safety incidents to the relevant administrative department in hospital. | 7.10 | 19.57 |
| Problem responsiveness(0.95) | 3.84 | 12.32 |
| Patient safety concerns usually results in the problem being addressed | 3.74 | 11.28 |
| We identify and fix safety problems timely | 3.51 | 10.08 |
| There is appropriate follow-up when patient safety issues are communicated | 4.11 | 10.93 |
| We will analyze the accidents or unexpected events timely | 3.99 | 10.14 |
| Outcomes (0.37)△ | 34.04 | 41.77 |
| In the last year, I have witnessed a coworker do something that appeared to me to be unsafe for the patient | 38.54 | 45.67 |
| I have never witnessed a coworker do something that appeared to me to be unsafe patient care | 29.24 | 38.33 |
| I have done something that was not safe for the patient | 34.33 | 41.10 |
| Overall average (0.959)# | 15.43 | 25.52 |
†Responses weighted for sampling and for non-response. ‡If the item of “Whenever pressure builds up, management in the unit wants us to work faster, even if it means taking shortcuts that might negatively affect patient safety” was deleted, the Cronbach’s α Coefficient, PPR and neutral percent rate of the scale of “workgroup leadership” would be 0.90, 6.04, and 9.48 respectively.
△If the item of “I have never witnessed a coworker do something that appeared to me to be unsafe patient care” was deleted, the Cronbach’s α Coefficient, PPR and neutral percent rate of the scale of “outcome” would be 0.87, 36.44, 7.63 respectively.
#If the two items of “whenever pressure builds up, management in the unit wants us to work faster, even if it means taking shortcuts that might negatively affect patient safety” and “I have never witnessed a coworker do something that appeared to me to be unsafe patient care” were deleted, the Cronbach’s α Coefficient, PPR and neutral percent rate of the overall safety climate would be 0.963, 14.04, 8.63 respectively.