Table 1 Factor loadings, standard path coefficient CFA and Cronbach’s alphas of the HSOPSC/AV

1

2

3

4

5

6

7

8

9

10

11

Factor 1: Teamwork within departments (α = 0.77)

A1: People support one another in this unit

0.81

0.73

A3: When a lot of work needs to be done quickly, we work together as a team to get the

work done

0.77

0.77

A4: In this unit, people treat each other with respect

0.76

0.71

A11: When one area in this unit gets really busy, others help out

0.60

0.56

Factor 2: Supervisor/manager expectations and actions promoting patient safety (α = 0.75)

B1: My supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures

0.53

0.74

B2: My supervisor/manager seriously considers staff suggestions for improving patient safety

0.60

0.81

B3: Whenever pressure builds up, my supervisor/manager wants us to work faster, even if it means taking shortcuts

0.79

0.50

B4: My supervisor/manager overlooks patient safety problems that happen over and over

0.83

0.68

Factor 3: Hospital hand-offs and transitions (α = 0.73)

F3: Things “fall between the cracks” when transferring patients from one unit to another

0.63

0.58

F5: Important patient care information is often lost during shift changes

0.77

0.71

F7: Problems often occur in the exchange of information across hospital units

0.76

0.63

F11: Shift changes are problematic for patients in this hospital

0.65

0.61

Factor 4: Frequency of event reporting (α = 0.87)

D1: When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?

0.82

0.81

D2: When a mistake is made, but has no potential to harm the patient, how often is this reported?

0.86

0.87

D3: When a mistake is made that could harm the patient, but does not, how often is this reported?

0.82

0.80

Factor 5: Feedback and communication openness about error (α = 0.73)

C2: Staff will freely speak up if they see something that may negatively affect patient care

0.74

0.66

C4: Staff feel free to question the decisions or actions of those with more authority

0.71

0.49

C3: We are informed about errors that happen in this unit

0.62

0.72

C5: In this unit, we discuss ways to prevent errors from happening again

0.50

0.69

Factor 6: Staffing (α = 0.75)

A2: We have enough staff to handle the workload

0.78

0.80

A5: Staff in this unit work longer hours than is best for patient care

0.77

0.73

A14: We work in "crisis mode" trying to do too much, too quickly

0.79

0.65

Factor 7: Organizational learning – continuous improvement (α = 0.80)

A6: We are actively doing things to improve patient safety

0.86

0.88

A9: Mistakes have led to positive changes here

0.87

0.87

A13: After we make changes to improve patient safety, we evaluate their effectiveness

0.63

0.56

Factor 8: Overall perceptions of safety (α = 0.75)

A15: Patient safety is never sacrificed to get more work done

0.87

0.88

A18: Our procedures and systems are good at preventing errors from happening

0.88

0.86

A17: We have patient safety problems in this unit

0.56

0.36

Factor 9: Hospital management support for patient safety (α = 0.66)

F8: The actions of hospital management show that patient safety is a top priority

0.65

0.70

F9: Hospital management seems interested in patient safety only after an adverse event happens

0.57

0.36

F1: Hospital management provides a work climate that promotes patient safety

0.69

0.76

Factor 10: Teamwork across hospital departments (α = 0.61)

F4: There is good cooperation among hospital units that need to work together

0.76

0.61

F10: Hospital units work well together to provide the best care for patients

0.77

0.62

F2: Hospital units do not coordinate well with each other

0.43

0.45

F6: It is often unpleasant to work with staff from other hospital units

0.61

0.47

Factor 11: No punitive response to error (α = 0.60)

A16: Staff worry that mistakes they make are kept in their personnel file

0.67

0.60

A8: Staff feel like their mistakes are held against them

0.69

0.60

A12: When an event is reported, it feels like the person is being written up, not the problem

0.75

0.50