Internal consistency, factor structure and construct validity of the French version of the Hospital Survey on Patient Safety Culture

Abstract

Objective: To assess the psychometric properties of the French-language version of the Hospital Survey on Patient Safety Culture (HSOPSC).

Methods: Data were obtained from a staff survey at a Swiss multisite hospital. We computed descriptive statistics and internal consistency coefficients, then conducted a confirmatory and exploratory factor analysis, and performed construct validity tests.

Results: 1171 staff members participated (response rate 74%). The internal consistency coefficients of the 12 dimension scores ranged from 0.57 to 0.86 (median 0.73). Confirmatory factor analysis indicated a reasonable but not perfect fit of the hypothesised measurement model (root mean square error of approximation 0.043, comparative fit index 0.89). Exploratory data analysis suggested 10 dimensions instead of 12, grouping items from teamwork across hospital units with those of hospital handoffs and transitions, and items from communication openness with those of feedback and communication about error. However, the loading pattern was clean: 41 of 42 main loadings exceeded 0.40, and only 3 of 378 cross-loadings exceeded 0.30. All 10 process scores were higher among respondents who rated the global safety grade as 'excellent' or 'very good' rather than 'good', 'fair' or 'poor' (effect sizes 0.41-0.79, all p<0.001), but score differences between those who have and have not reported an incident in the past year were weak or inconsistent with theory.

Discussion: The French version of the HSOPSC did not perform as well as the original in standard psychometric analyses.