title: Parent perceptions of children's hospital safety climate.
abstract: BACKGROUND
  Because patients are at the frontline of care where safety climate is closely tied to safety events, understanding patient perceptions of safety climate is crucial. We sought to develop and evaluate a parent-reported version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture and to relate parent-reported responses to parental need to watch over their child's care to ensure mistakes are not made.
  
  
  METHODS
  Parents (n=172) were surveyed about perceptions of hospital safety climate (14 items representing four domains-overall perceptions of safety, openness of staff and parent communication, and handoffs and transitions) and perceived need to watch over their child's care. Confirmatory factor analysis (CFA) was used to validate safety climate domain measures. Logistic regression was used to relate need to watch over care to safety climate domains.
  
  
  RESULTS
  CFA indices suggested good model fit for safety climate domains. Thirty-nine per cent of parents agreed or strongly agreed they needed to watch over care. In adjusted models, need to watch over care was significantly related to overall perceptions of safety (OR 0.20, 95% CI 0.11 to 0.37) and to handoffs and transitions (0.25, 0.14 to 0.46), but not to openness of staff (0.67, 0.40 to 1.12) or parent (0.83, 0.48 to 1.45) communication.
  
  
  CONCLUSIONS
  Findings suggest parents can provide valuable data on specific safety climate domains. Opportunities exist to improve our safety climate's impact on parent burden to watch over their child's care, such as targeting overall perceptions of safety as well as handoffs and transitions.
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA. ecox@wisc.edu
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Cox
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
authors.forename: Kristofer W
authors.initials: KW
authors.lastname: Hansen
authors.forename: Victoria P
authors.initials: VP
authors.lastname: Rajamanickam
authors.forename: Roger L
authors.initials: RL
authors.lastname: Brown
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Rathouz
authors.forename: Lori L
authors.initials: LL
authors.lastname: DuBenske
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Kelly
authors.forename: Linda A
authors.initials: LA
authors.lastname: Buel
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005163:Factor Analysis, Statistical; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology*; D061214:Patient Safety; D017751:Safety Management
keywords: Communication; Patient safety; Patient-centred care
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