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International Journal for Quality in Health Care Advance Access originally published online on March 4, 2008
International Journal for Quality in Health Care 2008 20(3):211-220; doi:10.1093/intqhc/mzn003
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© The Author 2008. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved

Development of a patient safety climate scale in Japan

Shinichi Matsubara1, Akihito Hagihara2 and Koichi Nobutomo1

1 Department of Health Services Management and Policy, Kyushu University Graduate School of Medicine, Fukuoka, Japan
2 Department of Health Care Administration and Management, Kyushu University Graduate School of Medicine, Fukuoka, Japan

Background. Although patient safety climate is an important factor in preventing adverse events in health care organizations, there is no usable Japanese scale.

Objective. To develop a Japanese scale to measure patient safety climate and to evaluate its psychometric properties.

Methods. Cross-sectional questionnaire survey was conducted with respect to 9 non-academic general hospitals in Japan. A total of 1878 health care professionals (nurses, therapists, technicians, pharmacists and physicians) were included in a study.

Results. The eight dimensions measuring worker attitudes (free communication flow, continuous improvement, reporting/rules compliance and patient/family involvement) and organizational factors (supervisors' safety leadership, allied professionals' safety leadership, patient safety committee leadership and rules/equipment availability) were extracted by factor analysis. The internal consistency (measured by Cronbach's alpha) and repeatability (measured by intraclass correlation) were more than 0.70 for all subscales. In addition, the mean score, the within-group interrater reliability statistic (rwg) and the correlation coefficients of the mean score were confirmed at the workplace level.

Conclusions. The scale showed acceptable dimensionality, reliability and validity. It also provided workplace team-evaluation and a tool for assessing the patient safety climate at the level of the workplace.

Keywords: health care organization, medical errors, patient safety, questionnaire, safety climate

Address reprint requests to: Akihito Hagihara, Department of Health Care Administration and Management, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Tel: +81-092-642-6950; Fax: +81-092-642-6961; E-mail: hagihara{at}hsmp.med.kyushu-u.ac.jp and s-matsubara{at}umin.ac.jp

Accepted for publication January 5, 2008.


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