The Frankfurt Patient Safety Climate Questionnaire for General Practices (FraSiK): analysis of psychometric properties

Abstract

BACKGROUND Safety culture has been identified as having a major impact on how safety is managed in healthcare. However, it has not received much attention in general practices. Hence, no instrument yet exists to assess safety climate-the measurable artefact of safety culture-in this setting. This study aims to evaluate psychometric properties of a newly developed safety climate questionnaire for use in German general practices. METHODS The existing Safety Attitudes Questionnaire, Ambulatory Version, was considerably modified and enhanced in order to be applicable in general practice. After pilot tests and its application in a random sample of 400 German practices, a first psychometric analysis led to modifications in several items. A further psychometric analysis was conducted with an additional sample of 60 practices and a response rate of 97.08%. Exploratory factor analysis with orthogonal varimax rotation was carried out and the internal consistency of the identified factors was calculated. RESULTS Nine factors emerged, representing a wide range of dimensions associated with safety culture: teamwork climate, error management, safety of clinical processes, perception of causes of errors, job satisfaction, safety of office structure, receptiveness to healthcare assistants and patients, staff perception of management, and quality and safety of medical care. Internal consistency of factors is moderate to good. CONCLUSIONS This study demonstrates the development of a patient safety climate instrument. The questionnaire displays established features of safety climate and additionally contains features that might be specific to small-scale general practices.

Improving patient safety culture in general practice: an interview study

“…[28][29][30][31][32][33] A survey as a change instrument is comprehensible, usable, and affordable for practices. However, Sexton and colleagues 11 stated it to be unlikely that questionnaire results and spontaneous discussion would lead to meaningful improvements and developed a discussion tool.…”

Impact of Individual and Team Features of Patient Safety Climate: A Survey in Family Practices

“…Based on our experiences during a previous survey, we expected a response rate of about 37% of practices. 6 Because 25% to 30% of family practices are estimated to be group practices, 18 we calculated that we would need responses from at least 150 group practices to get a sufficiently large data set for multivariate analysis. We therefore chose to contact 1,800 practices (150 × 1/0.25% of group practices × 1/0.37 response rate, plus an additional 180 practices as a safety margin).…”

“…6 It consists of 44, 5-point Likert items with moderate to good internal consistency that circumscribe 9 factors. One factor is addressed only to doctors and 1 to only employees (Table 1).…”

Effects of a team-based assessment and intervention on patient safety culture in general practice: an open randomised controlled trial

“…In other high-risk industries, safety culture is measured by means of staff questionnaires that are usually complemented by audits evaluating risk management documents45 and interviews with staff on how they actually conduct their work 46. We therefore followed recent recommendations2 15 and combined both methods (incident reporting documents and PSCI) with a recently validated safety climate questionnaire (FraSiK)21 that was developed for German general practice.…”

“…To evaluate these ‘espoused values’ and attitudes of the team, we measured safety climate with the Frankfurt Patient Safety Climate Questionnaire for General Practices (FraSiK), as developed and validated by our research group 21. The instrument consists of 44 items with moderate to good internal consistency that circumscribe nine scales.…”