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Title: An evaluation of a patient safety culture tool in Saudi Arabia
Author: Alonazi, Mamdooh Shrier
ISNI:       0000 0004 2705 1852
Awarding Body: University of Sheffield
Current Institution: University of Sheffield
Date of Award: 2011
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Background Safety culture is considered to be an essential element of patient safety. Several tools are available to assess patient safety culture in hospitals. One of the most common methods of assessing safety culture is the use of safety climate questionnaires. Research question Is there an existing patient safety culture measure that can be demonstrated to be a valid and reliable tool for use with the workforce in hospitals in Saudi Arabia? Aim and objectives This study aims to identify whether there is an existing English language tool that would be suitable for assessing patient safety culture in Saudi context. The objectives of the study are: 1. To select an appropriate questionnaire to assess hospital patient safety culture. 2. To evaluate the face validity of the selected patient safety climate questionnaire. 3. To assess the psychometric properties of the selected patient safety climate questionnaire in hospitals in Saudi Arabia. 4. To develop the most appropriate measure for assessing patient safety culture for use in hospitals in Saudi Arabia. Methods Qualitative methods were used to evaluate face validity (n=12 hospital staft). Quantitative methods were used to assess psychometric properties (n=862 doctors and nurses in three hospitals in Saudi Arabia). Findings Evaluation of face validity identified a need for minor changes to the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire wording before it was used to collect data for psychometric assessment. The results of Confirmatory Factor Analysis (CF A) and reliability analysis showed an unsatisfactory fit for the factor structure of the original HSOPSC questionnaire to the Saudi data. Exploratory Factor Analysis (EF A) was used on one half of the Saudi dataset to produce an optimal model(s). This was followed by CFA of the resulting measurement model on the second (validation) half of the data to test the fit of the resulting optimal factor structure. The result of EF A showed that eight factors (23 safety climate items) is the optimal model to the Saudi data. I All factors consisted of two to four items. The items loading were between 0.43 and 0.97. The result of CF A confirmed the eight factors solution (CF A=O.94, RMSEA=0.045, SRMR=O.040, TLI=O.97). The results of EFA, CFA, correlation and reliability analysis (Cronbach's alpha) showed that the optimal model for the Saudi data consists of eight patient safety culture dimensions (23 safety climate items). Conclusion This is one of very few studies to provide an assessment of an American patient safety culture tool using data from Saudi Arabia. The results indicate the importance of appropriate validation of patient safety climate questionnaires prior to applying them to populations outside contexts in which they were developed. The validated Saudi English language version of the HSOPSC questionnaire is an appropriate patient safety climate questionnaire to assess patient safety culture in Saudi hospitals.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available