Safety Culture in Indian Hospitals: A Cultural Adaptation of the Safety Attitudes Questionnaire

Objectives: Patient safety is increasingly recognized as a global health concern because of a staggering number of health care-related injuries and deaths. Although many hospitals are attempting to promote a patient safety agenda, there are relatively few options to track progress. The aims of this study were to translate and culturally adapt the Safety Attitudes Questionnaire (SAQ) into Gujarati and to provide evidence for its reliability and validity in hospitals in Gujarat, India. We also present preliminary data on the safety culture in these organizations. Methods: The first phase was the cultural adaptation and translation of the SAQ into Gujarati. The second phase was a cross-sectional survey of safety attitudes in 4 private hospitals. Results: The survey was distributed to 424 health care workers and elicited an overall response rate of 79%. The questionnaire showed acceptable reliability and preliminary evidence for construct validity among health careworkers in 4 private hospitals of varying size. The initial culture score results showed outcomes similar to international standards, with twothirds of the respondents describing teamwork climate positively and more than half of the respondents describing safety climate positively. Conclusions: This study reveals promising initial results for patient safety culture in India, but further study is needed. The development and validation of the SAQ-Gujarati allow additional hospitals to evaluate their patient safety culture. As the first rendition of the SAQ to an Indian setting, the tool could help to initiate safety discourse and improve the potential for institutions to provide feedback to their staff members.