The German version of the high-performance work systems questionnaire (HPWS-G) in the context of patient safety: a validation study in a Swiss university hospital

Abstract

Background High performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety. The 10-item HPWS questionnaire is a validated instrument developed to assess existing HPWS structures in hospitals. The objectives of this cross-sectional study were to translate the English HPWS questionnaire into German (HPWS-G), to rate its content validity, and to examine its psychometric properties. Methods Content validity was examined by a panel of 12 physicians and nurses, and I-CVI and S-CVI calculated. For internal consistency, Cronbach’s α and item-scale correlations were determined. Construct validity was measured via confirmatory factor analysis. A convenience sample of 782 nurses and physicians in a University hospital setting in Switzerland’s German-speaking region was surveyed. Four inclusion criteria were applied: working in intensive care, emergency department or operating room; having daily patient contact; having worked in the current clinical area for more than three months; and more than 40% employment. Results A total of 281 questionnaires were completed (response rate: 35.9%). Overall, the 10-item HPWS-G questionnaire showed good content validity (I-CVI = .83–1; S-CVI = .86) and internal consistency (Cronbach’s α = .853). HPWS-G scores correlated significantly with safety climate ( r s = .657, p < .01) and teamwork climate ( r s = .615, p < .01). The proposed 1-factor model was accepted considering results of applied minimum rank factor analysis; a confirmatory factor analysis indicated an acceptable to good model fit (GFI = .968; CFI = .902; RMSEA = .043). Conclusions The HPWS-G showed good psychometric properties. In clinical practice it can be used to assess HPWS practices and for intra- and inter-hospital benchmarking. Some minor adaptions to the wording could be made as well as reassessing the psychometric properties at other clinical sites.

1. Development of the high-performance work systems scale for hospitals: validity and reliability Study

“…They found that organizational cynicism mediates the relationship between high-performance work practices and intention to quit and that this indirect effect is dependent on the educational background of nurses which was a dimension of human resource management (Gkorezis, Georgiou, & Theodorou, 2018). Mielke et al, (2019) conducted a study with 281 healthcare professionals from a hospital in Switzerland. They used the 10-item HPWS scale, previously developed by Etchegaray and Thomas (2015) to ensure its cultural validity and reliability.…”

“…In clinical practice, it was stated that the HPWS scale fits the model very well with its 9-item structure and can be used for in-hospital and inter-hospital comparison. However, the scale has only one dimension and requires some adaptation to express and re-evaluate psychometric properties in other clinical areas (Mielke et al, 2019). Wang, Xing, and Zhang (2019) investigated the dark side of HPWS in the health sector in a study conducted with 80 physicians, 125 nurses, and 18 other healthcare personnel from a hospital in China in 2019.…”

“…A simultaneous application is conducted for Concurrent validity. The developed scale is administered simultaneously with another scale that examines the same or an associated construct and was previously proven to be valid (Mielke et al, 2019). This analysis was used to examine the associations between the subdimensions of the HPWS scale and the empowerment scale, with the latter chosen because various relationships of these two scales have been discussed in previous studies (Laschinger, Finegan, Shamian, & Wilk, 2004;Spence Laschinger et al, 2001).…”

Work Climate Scale in Emergency Services: Abridged Version

“…A six-dimension instrument that measures the physical environment: ambience (six items, Cronbach’s α 0.86), user-friendliness (six items, Cronbach’s α 0.76), layout (four items, Cronbach’s α 0.71), amenities (three items, Cronbach’s α 0.62), cleanliness (two items, Cronbach’s α 0.76), and adaptability (three items, Cronbach’s α 0.61), and presents values of internal consistency and dimensionality. The safety climate [ 30 , 31 , 32 , 33 , 34 , 35 ] and other safety-related concepts, such as patient safety culture [ 36 ] or safety attitudes [ 37 ], understood as all individual and group values that determine the commitment, style, and competence of an organization’s health and safety management. Worker relations [ 38 ] and its relationship to job satisfaction.…”

“…The safety climate [ 30 , 31 , 32 , 33 , 34 , 35 ] and other safety-related concepts, such as patient safety culture [ 36 ] or safety attitudes [ 37 ], understood as all individual and group values that determine the commitment, style, and competence of an organization’s health and safety management.…”