Development of a patient safety climate scale in Japan

Background. Although patient safety climate is an important factor in preventing adverse events in health care organizations, there is no usable Japanese scale. Objective. To develop a Japanese scale to measure patient safety climate and to evaluate its psychometric properties. Methods. Cross-sectional questionnaire survey was conducted with respect to 9 non-academic general hospitals in Japan. A total of 1878 health care professionals (nurses, therapists, technicians, pharmacists and physicians) were included in a study. Results. The eight dimensions measuring worker attitudes (free communication flow, continuous improvement, reporting/rules compliance and patient/family involvement) and organizational factors (supervisors' safety leadership, allied professionals' safety leadership, patient safety committee leadership and rules/equipment availability) were extracted by factor analysis. The internal consistency (measured by Cronbach's alpha) and repeatability (measured by intraclass correlation) were more than 0.70 for all subscales. In addition, the mean score, the within-group interrater reliability statistic (r(wg)) and the correlation coefficients of the mean score were confirmed at the workplace level. Conclusions. The scale showed acceptable dimensionality, reliability and validity. It also provided workplace team-evaluation and a tool for assessing the patient safety climate at the level of the workplace.