Translation, Cultural Adaption and Validation of Hospital Survey on Patient Safety Culture in Kosovo

Abstract

Background: An essential condition to improve patient safety is considered to ensure a supportive patient safety culture. Measuring the culture of patient safety in all health care institutions may be a first step to target improvements. Creating a culture of safety requires eliminating the culture of blame. In order to formulate actions for improvement, it is important for hospitals to assess their baseline scores for the existing safety culture and to determine the areas of priority. Aim: The aim of this study was first to measure the use, translation in Albanian and adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) assessment as a tool for improving patient safety in Kosovo Hospitals. The second aim was to measure the level of patient safety culture in Kosovo, in seven hospitals and one University Clinical Center (hospitals with over 50 beds, including psychiatric hospitals). Method: The questionnaire (HSOPSC) was translated into Albanian for use in the Kosovo. It was used forward-backward translation: the questions were translated into Albanian by one translator and then translated back into English by an independent translator who was blinded to the original questionnaire. Results: In the eight-factor model, the internal consistency of the factors and the construct validity of the HSOPSC questionnaire were mostly satisfactory. The construct validity was sufficient for all subscales, except for the 4 other subscale regarding intention to report incidents which correlated poorly with other subscales. In total, HSOPSC has 12 dimensions. Cronbach's α showed that in Kosovarian society, we could use only 8 dimensions model. Conclusion: The hypothesis that HSOPSC would be a suitable instrument to provide important indicators for the improvement of patient safety culture was tested and it was confirmed, that HSOPSC could be used as 8 dimension model. HSOPSC is suitable to improve patient safety culture and provide each hospital with a basic profile on patient safety culture and recommendations for an oriented intervention plan.

Changes in patient safety culture: A patient safety intervention for Finnish forensic psychiatric hospital staff

“…The original HSOPSC was developed based on literature reviews, examinations of existing safety culture instruments (both published and unpublished), and psychometric analyses (Sorra & Nieva, 2004). This instrument has been translated into various languages (Brajshori & Behrens, 2016;Pfeiffer & Manser, 2010) and is currently used in several European countries, including Finland (Kuosmanen et al, 2013).…”

Dimensions analysis of the Hospital Survey on Patient Safety Culture questionnaire in Iran: Psychometric properties

“…In this regard, only the reliability of the "frequency of events reported" with Cronbach's alpha of .86 was appropriate, which is similar to the studies of Bodur in Turkey, 33 Vlayen in Belgium, 34 Al-Nawafleh in Jordan, 35 Brajshori in Kosovo 36 and Reis in Brazil. 37 Cronbach's alpha for the dimensions in the study of Fujita in Japan Among the questions in the original questionnaire, the question "hospital units work well together to provide the best care for patients" was deleted because of the similarity with another question, and a new question " When a serious mistake occurs, the error is identified and corrected before harming the patient " was added.…”

“…In this regard, only the reliability of the “frequency of events reported” with Cronbach's alpha of .86 was appropriate, which is similar to the studies of Bodur in Turkey, 33 Vlayen in Belgium, 34 Al‐Nawafleh in Jordan, 35 Brajshori in Kosovo 36 and Reis in Brazil 37 . Cronbach's alpha for the dimensions in the study of Fujita in Japan and Taiwan 38 was also between .47 and .88, and between .26 and .83, respectively.…”

The psychometric properties of "Hospital Survey on Patient Safety Culture" in a Czech environment

“…(Netherlands, 2008); and Waterson et al (UK, 2010). In other studies, the lowest Cronbach alpha values were found in different components such as; Overall perception of patient safety (Blegen et al, 2009;Brajshori, Behrens, 2016); Organizational learning and continuous improvement (Hammer et al, 2011;Robida, 2013;Hedsköld et al, 2013;Vlayen et al, 2015); and Nonpunitive response to errors (Olsen, 2008). According to the AHRQ, the overall acceptable level of reliability for the Cronbachʼs alpha coefficient (α) is ≥ 0.60; in our research, the lower values for acceptable level of reliability were recorded for different components to those mentioned above: Nonpunitive response to errors (α = 0.585); Handoffs and transitions (α = 0.574); and for the new component identified by PCA in our study Critical situations on the unit (α = 0.578).…”

“…In a Turkish study (Bodur, Filiz, 2010), a Scottish study (Sarac et al, 2011) and a French study (Ocelli et al, 2013) the authors recommend the division of the statements into ten components. Bodur and Filiz (2010) Waterson et al (2010) recommend dividing the questionnaire into nine components, while the authors of a study conducted in Kosovo (Brajshori, Behrens, 2016) recommend dividing the questionnaire into only eight components. Cronbach alpha coefficients of components identified by PCA analysis in our study suggested that more than half of the individual components of patient safety culture had an acceptable level of reliability (from α = 0.619 for Organisational learning and continuous improvement to α = 0.817 for Teamwork across units).…”