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

From: Improving patient safety culture in Saudi Arabia (2012–2015): trending, improvement and benchmarking

Composites and survey items

Average% positive responsea

Mean (Standard deviation)

Overall Perception of Safety (Cronbach’s α = 0.234)

59.5

3.41 (0.54)

 It is just by chance that more serious mistakes do not happen around here (R)b

29.4

2.72 (1.06)

 Patient safety is never sacrificed to get more work done

76.6

3.80 (0.97)

 We have patient safety problems in this unit (R)

49.7

3.19 (1.09)

 Our policies and procedures and systems are effective in preventing errors

82.1

3.91 (0.75)

Supervisor/Manager Expectations & Actions Promoting Patient Safety (Cronbach’s α = 0.395)

60.8

3.44 (0.60)

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

74.2

3.74 (0.94)

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

76.4

3.80 (0.87)

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

52.1

3.27 (1.06)

 My supervisor/manager overlooks patient safety problems that happen over and over (R)

40.4

2.94 (1.16)

Organizational learning and Continuous Improvement (Cronbach’s α = 0.614)

86.3

4.03 (0.53)

 We are actively doing things to improve patient safety

94.8

4.31 (0.64)

 Mistake have led to positive changes here

76.8

3.78 (0.78)

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

87.4

4.01 (0.69)

Teamwork within units (Cronbach’s α = 0.757)

84.8

3.40 (0.60)

 Staff support one another in this unit

90.1

4.11 (0.71)

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

89.3

4.11 (0.71)

 In this unit, people treat each other with respect

85.4

4.03 (0.75)

 When members of this unit get really busy, other members of the same unit help out

74.2

3.75 (0.95)

Non-punitive Response to Error (Cronbach’s α = 0.694)

24.8

2.62 (0.79)

 Staff feel like their mistakes are held against them (R)

31.4

2.82 (1.04)

 When an event is reported, it feels like the person is being written up, not the problem (R)

29.3

2.76 (1.02)

 Staff worry that mistakes they make are kept in their personnel file (R)

13.7

2.29 (0.93)

Staffing (Cronbach’s α = 0.210)

33.8

2.79 (0.57)

 We have enough staff to handle the workload

56.1

3.29 (1.18)

 Staff in this unit work longer hours than is best for patient care (R)

11.2

2.17 (0.89)

 We use agency/temporary staff than is best for patient care (R)

45.2

3.14 (1.08)

 When the work is in “crisis mode” we try to do too much, too quickly (R)

22.8

2.56 (1.01)

Hospital Management Support for Patient Safety (Cronbach’s α = 0.519)

75.3

3.76 (0.62)

 Hospital management provides a work climate that promotes patient safety

85.3

3.95 (0.68)

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

86.9

4.07 (0.77)

 Hospital management seems interested in patient safety only after an adverse event happens (R)

53.6

3.26 (1.10)

Teamwork Across Hospital Units (Cronbach’s α = 0.627)

67.0

3.59 (0.62)

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

73.0

3.69 (0.82)

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

85.5

4.03 (0.77)

 Hospital units do not coordinate well with each other and this might affect patient care (R)

55.8

3.30 (1.04)

 It is often not easy to work with staff from other hospital units (R)

53.7

3.35 (0.97)

Hospital Handoffs & Transitions (Cronbach’s α = 0.783)

55.8

3.39 (0.75)

 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)

45.5

3.18 (1.01)

 Important patient care information is often lost during shift changes (R)

66.8

3.59 (0.96)

 Problems often occur in the exchange of information across hospital units (R)

46.2

3.22 (0.95)

 Shift changes are problematic for patients in this hospital (R)

64.5

3.56 (0.93)

Communication Openness (Cronbach’s α = 0.533)

45.0

3.36 (0.83)

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

64.5

3.84 (1.07)

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

34.3

3.08 (1.21)

 Staff are afraid to ask questions when something does not feel right (R)

36.2

3.15 (1.15)

Feedback and Communications About Error (Cronbach’s α = 0.732)

71.8

4.04 (0.79)

 We are given feedback about changes put into place based on event reports

56.5

3.69 (1.06)

 We are informed about errors that happen in this unit

79.0

4.21 (0.95)

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

79.9

4.22 (0.93)

Frequency of events reported (Cronbach’s α = 0.902)

68.8

3.92 (1.10)

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

65.6

3.83 (1.21)

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

65.9

3.86 (1.22)

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

74.9

4.07 (1.17)

  1. athe 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. bNegatively worded items that were reverse coded