The German version of the high-performance work systems questionnaire (HPWS-G) in the context of patient safety: a validation study in a Swiss university hospital

BackgroundHigh performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety. The 10-item HPWS questionnaire is a validated instrument developed to assess existing HPWS structures in hospitals. The objectives of this cross-sectional study were to translate the English HPWS questionnaire into German (HPWS-G), to rate its content validity, and to examine its psychometric properties.MethodsContent validity was examined by a panel of 12 physicians and nurses, and I-CVI and S-CVI calculated. For internal consistency, Cronbach's and item-scale correlations were determined. Construct validity was measured via confirmatory factor analysis.A convenience sample of 782 nurses and physicians in a University hospital setting in Switzerland's German-speaking region was surveyed. Four inclusion criteria were applied: working in intensive care, emergency department or operating room; having daily patient contact; having worked in the current clinical area for more than three months; and more than 40% employment.ResultsA total of 281 questionnaires were completed (response rate: 35.9%). Overall, the 10-item HPWS-G questionnaire showed good content validity (I-CVI=.83-1; S-CVI=.86) and internal consistency (Cronbach's =.853). HPWS-G scores correlated significantly with safety climate (r(s)=.657, p<.01) and teamwork climate (r(s)=.615, p<.01). The proposed 1-factor model was accepted considering results of applied minimum rank factor analysis; a confirmatory factor analysis indicated an acceptable to good model fit (GFI=.968; CFI=.902; RMSEA=.043).ConclusionsThe HPWS-G showed good psychometric properties. In clinical practice it can be used to assess HPWS practices and for intra- and inter-hospital benchmarking. Some minor adaptions to the wording could be made as well as reassessing the psychometric properties at other clinical sites.