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Table 2 Cronbach’s Alpha and distribution of positive responses and scores for survey composites and items

From: Patient safety culture in a large teaching hospital in Riyadh: baseline assessment, comparative analysis and opportunities for improvement

Composites and survey items Average % positive response* Mean standard deviation
Overall perception of safety (Cronbach’s α = 0.214) 65.3 3.43 (0.59)
 It is just by chance that more serious mistakes do not happen around here (R)** 36.9 2.99 (1.16)
 Patient safety is never sacrificed to get more work done 70.6 3.71 (1.07)
 We have patient safety problems in this unit (R) 50.0 3.25 (1.15)
 Our policies and procedures and systems are effective in preventing errors 75.3 3.76 (0.93)
Supervisor/Manager expectations & actions promoting patient safety (Cronbach’s α = 0.436) 60.6 3.46 (0.65)
 My supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures 71.8 3.69 (1.05)
 My supervisor/manager seriously considers staff suggestions for improving patient safety 74.8 3.77 (0.97)
 Whenever pressure builds up, my supervisor/manager wants us to work faster, even if it means taking shortcuts (R) 51.0 3.27 (1.09)
 My supervisor/manager overlooks patient safety problems that happen over and over (R) 44.5 3.13 (1.18)
Organizational learning and continuous improvement (Cronbach’s α = 0.704) 79.6 3.89 (0.69)
 We are actively doing things to improve patient safety 90.0 4.19 (0.82)
 Mistake have led to positive changes here 69.5 3.63 (0.93)
 After we make changes to improve patient safety, we evaluate their effectiveness 79.3 3.84 (0.87)
Teamwork within units (Cronbach’s α = 0.814) 78.5 3.85 (0.75)
 Staff support one another in this unit 84.7 3.97 (0.88)
 When a lot of work needs to be done quickly, we work together as a team to get the work done 81.6 3.93 (0.89)
 In this unit, people treat each other with respect 80.7 3.92 (0.91)
 When members of this unit get really busy, other members of the same unit help out 66.7 3.57 (1.08)
Non-punitive response to error (Cronbach’s α = 0.643) 26.8 2.68 (0.81)
 Staff feel like their mistakes are held against them (R) 31.4 2.83 (1.09)
 When an event is reported, it feels like the person is being written up, not the problem (R) 32.5 2.85 (1.09)
 Staff worry that mistakes they make are kept in their personnel file (R) 16.5 2.37 (1.02)
Staffing (Cronbach’s α = 0.238) 35.1 2.84 (0.62)
 We have enough staff to handle the workload 47.5 3.05 (1.20)
 Staff in this unit work longer hours than is best for patient care (R) 19.3 2.41 (1.09)
 We use agency/temporary staff than is best for patient care (R) 48.8 3.34 (1.11)
 When the work is in “crisis mode” we try to do too much, too quickly (R) 24.8 2.58 (1.09)
Hospital management support for patient safety (Cronbach’s α = 0.577) 70.4 3.69 (0.76)
 Hospital management provides a work climate that promotes patient safety 76.8 3.76 (0.96)
 The actions of hospital management show that patient safety is a top priority 79.6 3.97 (0.96)
 Hospital management seems interested in patient safety only after an adverse event happens (R) 54.6 3.32 (1.15)
Teamwork across hospital units (Cronbach’s α = 0.643) 61.6 3.36 (0.79)
 There is good cooperation among hospital units that need to work together 65.5 3.58 (0.96)
 Hospital units work well together to provide the best care for patients 77.1 3.90 (0.96)
 Hospital units do not coordinate well with each other and this might affect patient care (R) 53.6 3.29 (1.12)
 It is often not easy to work with staff from other hospital units (R) 50.1 3.30 (1.03)
Hospital handoffs & transitions (Cronbach’s α = 0.770) 51.5 3.52 (0.71)
 Things “fall between the cracks”, i.e., things might go uncontrolled and get lost (ex: medical records, medical treatment, patient information and education, discharge criteria) when transferring patients from one unit to another (R) 43.5 3.20 (1.04)
 Important patient care information is often lost during shift changes (R) 62.3 3.59 (1.02)
 Problems often occur in the exchange of information across hospital units (R) 41.6 3.15 (0.99)
 Shift changes are problematic for patients in this hospital (R) 58.5 3.51 (1.05)
Communication openness (Cronbach’s α = 0.536) 42.9 3.25 (0.85)
 Staff will freely speak up if they see something that may negatively affect patient care 54.2 3.53 (1.16)
 Staff feel free to question the decisions or actions of those with more authority 33.3 2.94 (1.23)
 Staff are afraid to ask questions when something does not feel right (R) 41.1 3.30 (1.16)
Feedback and communications about error (Cronbach’s α = 0.793) 63.3 3.73 (0.95)
 We are given feedback about changes put into place based on event reports 48.9 3.39 (1.13)
 We are informed about errors that happen in this unit 68.9 3.85 (1.147)
 In this unit, we discuss ways to prevent errors from happening again 72.0 3.94 (1.1)
Frequency of events reported (Cronbach’s α = 0.892) 59.4 3.63 (1.16)
 When a mistake is made, but is caught and corrected affecting the patient, how often is this reported? 58.2 3.59 (1.29)
 When a mistake is made, but has no potential to harm the patient, how often is this reported? 56.3 3.56 (1.27)
 When a mistake is made that could harm the patient, but does not, how often is this reported? 63.7 3.74 (1.29)
  1. *the composite-level percentage of positive responses was calculated using the following formula: (number of positive responses to the items in the composite/total number of responses to the items (positive, neutral, and negative) in the composite (excluding missing responses))*100.
  2. **Negatively worded items that were reverse coded.