Table 2 Problematic responses ^†

Senior leadership (0.95)

Good communication flow exists up and down the chain of command regarding patient safety issues

Senior management supports a climate that promotes patient safety

Senior management has a clear planning and actions to deal with the risks that associated with patient care

Senior management uses proper ways to deal with the mistakes that actually occur in this facility

Senior management considers patient safety when program changes are discussed

Patient safety decisions are made by people regardless of rank or hierarchy

Resources for safety (0.95)

Staff is provided with adequate resources (personnel, budget, and equipment) to provide safe patient care

Staff has enough time to complete patient care tasks safely

Staff has received sufficient training to enable them to address patient safety problems

This facility devotes sufficient resources to follow-up on identified safety problems

Facility characteristics (0.89)

Compared with other facilities in the area, this facility cares more about the equipment safety

Overall the level of patient safety at this facility is improving

Workgroup leadership (0.26)^‡

Management in the unit helps staff overcome problems

Management puts safety at importance

Whenever pressure builds up, management in the unit wants us to work faster, even if it means taking shortcuts that might negatively affect patient safety

Workgroup norms (0.92)

My unit takes the time to identify and assess risks to ensure patient safety

My unit has risk management to ensure patient safety

We have learned how to do our job better by learning about mistakes

There is significant peer pressure to discourage unsafe patient care

Anyone found to violate standards or safety rules is corrected

Deliberate violations of standard operating procedures are rare

Workgroup recognition (0.90)

Taking quick action to identify a serious mistake is rewarded

Individual safety achievement is recognized through rewards

Teamwork is encouraged in order to improve patient safety in medical care

Fear of shame (0.95)

Asking for help is a sign of incompetence

People will not tell others about a mistake that has significant consequences and if nobody notices the mistake

Telling others about the mistakes is embarrassing

Learning (0.81)

Mistakes have led to positive changes in the unit

Personal performance is evaluated against defined safety standards

Patient safety problems and errors are communicated to the right people so that the problem can be corrected

Fear of blame (0.82)

If a person makes a mistake and is found, he will be disciplined.

Clinicians who make serious mistakes are usually punished

Psychological safety(0.95)

Staff can feel comfortable questioning the actions of those with more authority when patient safety is at risk

Staff can freely voice their opinions on patient safety.

Staff can freely identify events that may negatively affect patient safety

Staff can freely report patient safety incidents to the relevant administrative department in hospital.

Problem responsiveness(0.95)

Patient safety concerns usually results in the problem being addressed

We identify and fix safety problems timely

There is appropriate follow-up when patient safety issues are communicated

We will analyze the accidents or unexpected events timely

Outcomes (0.37)^△

In the last year, I have witnessed a coworker do something that appeared to me to be unsafe for the patient

I have never witnessed a coworker do something that appeared to me to be unsafe patient care

I have done something that was not safe for the patient

Overall average (0.959)^#