title: Patient safety culture measurement in general practice. Clinimetric properties of 'SCOPE'.
abstract: BACKGROUND
  A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS).
  
  
  METHODS
  The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' patient safety grade of their practices correlated with their scores on the questionnaire.
  
  
  RESULTS
  Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety and expectations and actions of managers. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not.
  
  
  CONCLUSIONS
  The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.
authors: Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands. d.zwart@umcutrecht.nl
authors: Dorien L M
authors: DL
authors: Zwart
authors: Maaike
authors: M
authors: Langelaan
authors: Rosalinde C
authors: RC
authors: van de Vooren
authors: Marijke M
authors: MM
authors: Kuyvenhoven
authors: Cor J
authors: CJ
authors: Kalkman
authors: Theo J M
authors: TJ
authors: Verheij
authors: Cordula
authors: C
authors: Wagner
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care / Q000458:organization & administration / Q000592:standards*; D005163:Factor Analysis, Statistical; D005260:Female; D058006:General Practice / Q000379:methods / Q000592:standards*; D058005:General Practitioners / Q000523:psychology / Q000592:standards*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D061214:Patient Safety / Q000592:standards*; D015203:Reproducibility of Results; D017751:Safety Management / Q000458:organization & administration* / Q000592:standards