title: Error disclosure: a new domain for safety culture assessment.
abstract: OBJECTIVE
  To (1) develop and test survey items that measure error disclosure culture, (2) examine relationships among error disclosure culture, teamwork culture and safety culture and (3) establish predictive validity for survey items measuring error disclosure culture.
  
  
  METHODS
  All clinical faculty from six health institutions (four medical schools, one cancer centre and one health science centre) in The University of Texas System were invited to anonymously complete an electronic survey containing questions about safety culture and error disclosure.
  
  
  RESULTS
  The authors found two factors to measure error disclosure culture: one factor is focused on the general culture of error disclosure and the second factor is focused on trust. Both error disclosure culture factors were unique from safety culture and teamwork culture (correlations were less than r=0.85). Also, error disclosure general culture and error disclosure trust culture predicted intent to disclose a hypothetical error to a patient (r=0.25, p<0.001 and r=0.16, p<0.001, respectively) while teamwork and safety culture did not predict such an intent (r=0.09, p=NS and r=0.12, p=NS). Those who received prior error disclosure training reported significantly higher levels of error disclosure general culture (t=3.7, p<0.05) and error disclosure trust culture (t=2.9, p<0.05).
  
  
  CONCLUSIONS
  The authors created and validated a new measure of error disclosure culture that predicts intent to disclose an error better than other measures of healthcare culture. This measure fills an existing gap in organisational assessments by assessing transparent communication after medical error, an important aspect of culture.
authors.affiliation: Department of Internal Medicine, The University of Texas Medical School at Houston, 6410 Fannin Street, Houston, TX 77030, USA. jason.etchegaray@uth.tmc.edu
authors.forename: Jason M
authors.initials: JM
authors.lastname: Etchegaray
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Gallagher
authors.forename: Sigall K
authors.initials: SK
authors.lastname: Bell
authors.forename: Ben
authors.initials: B
authors.lastname: Dunlap
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Thomas
mesh_terms: D001291:Attitude of Health Personnel; D019985:Benchmarking; D030881:Disclosure; D005163:Factor Analysis, Statistical; D005180:Faculty, Medical; D005260:Female; D006306:Health Surveys / Q000295:instrumentation*; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D019300:Medical Errors / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D015279:Organizational Culture; D010348:Patient Care Team / Q000592:standards; D061214:Patient Safety; D018802:Patient-Centered Care; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012944:Social Support; D011795:Surveys and Questionnaires; D013781:Texas