Probing deeper in single item performance of the hospital survey on patient safety climate using item response theory

Safety climate is a key topic of interest to researchers in the field of patient safety. However, there is less agreement about how to define and measure patient safety culture, and a range of different measurement tools have been developed. The Hospital Survey on Patient Safety Culture (HSOPSC) designed for the Agency for Healthcare Research and Quality (AHRQ) (Sorra & Nieva, 2006) has proved to be especially popular and is now recommended by some reviewers (European Society for Quality in Healthcare, 2010). Psychometric criteria (such as validity and reliability) have not been reported for many safety culture questionnaires, raising concerns about their validity for informing healthcare managers in designing effective safety management systems and interventions (Flin et al., 2006). However, both validity and reliability are important to consider when judging the quality of measurement instruments and ensuring that patient safety improvements will be effective and sustainable.