Psychometric properties of the AHRQ Community Pharmacy Survey on Patient Safety Culture: a factor analysis

BMJ Qual Saf. 2016 May;25(5):355-63. doi: 10.1136/bmjqs-2015-004001. Epub 2015 Jul 24.

Abstract

Background: The U.S. Agency for Healthcare Research and Quality (AHRQ) developed a hospital patient safety culture survey in 2004 and has adapted this survey to other healthcare settings, such as nursing homes and medical offices, and most recently, community pharmacies. However, it is unknown whether safety culture dimensions developed for hospitals can be transferred to community pharmacies. The aim of this study was to assess the psychometric properties of the Community Pharmacy Survey on Patient Safety Culture.

Method: The survey was administered to 543 community pharmacists in Wisconsin, USA. Confirmatory factor analysis was used to assess the fit of our data with the proposed AHRQ model. Exploratory factor analysis was used to determine the underlying factor structure. Internal consistency reliabilities were calculated.

Results: A total of 433 usable surveys were returned (response rate 80%). Results from the confirmatory factor analysis showed inadequate model fit for the original 36 item, 11-factor structure. Exploratory factor analysis showed that a modified 27-item, four-factor structure better reflected the underlying safety culture dimensions in community pharmacies. The communication openness factor, with three items, dropped in its entirety while six items dropped from multiple factors. The remaining 27 items redistributed to form the four-factor structure: safety-related communication, staff training and work environment, organisational response to safety events, and staffing, work pressure and pace. Cronbach's α of 0.95 suggested good internal consistency.

Conclusions: Our findings suggest that validation studies need to be conducted before applying safety dimensions from other healthcare settings into community pharmacies.

Keywords: Medication safety; Patient safety; Safety culture.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attitude of Health Personnel*
  • Community Health Services
  • Cross-Sectional Studies
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Organizational Culture
  • Patient Safety
  • Pharmacies / organization & administration*
  • Psychometrics*
  • Safety Management / organization & administration*
  • Wisconsin