Patient Safety Climate in Danish Primary Care: Adaption and Validation of the Danish Safety Attitudes Questionnaire (SAQ-DK-PRIM)

Abstract

Marie Haase Juhl,1,2 Anne Estrup Olesen,1,2 Ellen Tveter Deilkås,3 Niels Henrik Bruun,4 Kirsten Høgh Obling,5 Nikoline Rytter,6 Maya Damgaard Larsen,6 Solvejg Kristensen7 1Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark; 2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 3Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; 4Research Data and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; 5Care and Rehabilitation, Department of Health and Care Services (Danish: “pleje Og Rehabilitering, Staben Sundhed Og Omsorg”), the Municipality of Aarhus, Aarhus, Denmark; 6Digitalization and Quality, Department of Health and Care Services (Danish: “digitalisering og Kvalitet, Sundhed og Omsorg”), The Municipality of Aarhus, Aarhus, Denmark; 7Aalborg University Hospital, Psychiatry, Aalborg, DenmarkCorrespondence: Anne Estrup Olesen, Department of Clinical Pharmacology, Aalborg University Hospital, Gartnerboligen, Ground Floor, Mølleparkvej 8a, Aalborg, 9000, Denmark, Tel [phone], Email [email protected]: A lack of instruments to assess patient safety climate within primary care exists. The objectives of this study were as follows: 1) To adapt the Danish hospital version of the Safety Attitudes Questionnaire (SAQ-DK) for use in primary care; 2) Test the internal consistency and the construct validity of this version; 3) Present benchmark data; and 4) Analyze variance.Methods: The SAQ-DK was adapted for use in Danish primary care settings (SAQ-DK-PRIM) and distributed to healthcare staff members from nursing homes (N = 11), homecare units (N = 4) and healthcare units (N = 2), within the municipality of Aarhus, Central Denmark Region, Denmark. Face- and content validity were assessed. The construct validity was evaluated by a set of goodness-of-fit indices. The internal reliability was evaluated using the item-rest correlations, the inter-item correlations, and Cronbach’s alpha (α).Results: The adaptation process resulted in a questionnaire of 10 items. Eight hundred and thirty healthcare staffs participated (78% of the eligible respondents). In total 586 (70.6%) responses were complete and were included in the analysis. Goodness-of-fit indices from the confirmatory factor analysis showed: Chi2=46.90CFI=0.97, RMSEA = 0.063 (90% CI: 0.044– 0.084), Probability RMSEA (p close)=0.12. Internal reliability was high (Cronbach’s α=0.76). Proportions of participants with a positive attitude was 41.1% and did not differ between the healthcare services. Scale mean score was 70.19 (SD: 18.05) and differed between healthcare services. The safety climate scale scores did not vary according to healthcare service type. ICC was 0.68% indicating no clustering of scores by healthcare service type.Conclusion: Considering the questionnaire’s applicability, short length, strengthened focus on one area of interest and validity, the SAQ-DK-PRIM can serve as a valuable tool for measuring patient safety climate within primary care settings in Denmark.Keywords: primary care, patient safety culture, patient safety climate, questionnaire, validity, reliability, Denmark

Keywords

• primary care
• patient safety culture
• patient safety climate
• questionnaire
• validity
• reliability
• denmark