title: Hospital safety climate surveys: measurement issues.
abstract: OBJECTIVE
  Organizational safety culture relates to behavioural norms in the workplace and is usually assessed by safety climate surveys. These can be a diagnostic indicator on the state of safety in a hospital. This review examines recent studies using staff surveys of hospital safety climate, focussing on measurement issues.
  
  
  RESULTS
  Four questionnaires (hospital survey on patient safety culture, safety attitudes questionnaire, patient safety climate in healthcare organizations, hospital safety climate scale), with acceptable psychometric properties, are now applied across countries and clinical settings. Comparisons for benchmarking must be made with caution in case of questionnaire modifications. Increasing attention is being paid to the unit and hospital level wherein distinct cultures may be located, as well as to associated measurement and study design issues. Predictive validity of safety climate is tested against safety behaviours/outcomes, with some relationships reported, although effects may be specific to professional groups/units. Few studies test the role of intervening variables that could influence the effect of climate on outcomes.
  
  
  CONCLUSIONS
  Hospital climate studies are becoming a key component of healthcare safety management systems. Large datasets have established more reliable instruments that allow a more focussed investigation of the role of culture in the improvement and maintenance of staff's safety perceptions within units, as well as within hospitals.
authors.affiliation: Industrial Psychology Research Centre, University of Aberdeen, Aberdeen, Scotland, UK. j.jackson@abdn.ac.uk
authors.forename: Jeanette
authors.initials: J
authors.lastname: Jackson
authors.forename: Cakil
authors.initials: C
authors.lastname: Sarac
authors.forename: Rhona
authors.initials: R
authors.lastname: Flin
mesh_terms: D001291:Attitude of Health Personnel; D003625:Data Collection; D006739:Hospital Administration; D006801:Humans; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration; D010564:Personnel, Hospital / Q000523:psychology*; D015203:Reproducibility of Results; D017751:Safety Management / Q000458:organization & administration*; D017132:Workplace