Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

The cross‐level effects of culture and climate in human service teams

This two‐level study of child welfare and juvenile justice case management teams addresses construct, measurement, and composition issues that plague multilevel research on organizational culture and climate. Very few empirical studies have examined both culture and climate simultaneously, and none have provided evidence that culture and climate are distinct or similar constructs. Confirmatory factor analysis (CFA), within‐group consistency analysis (r_wg), between‐group differences (ICC and eta‐squared), and hierarchical linear models (HLM) analysis provide evidence that climate and culture are separate constructs that vary by organizational unit, and are related to work attitudes, perceptions, and behavior. Findings link team‐level culture and climate to individual‐level job satisfaction and commitment, perceptions of service quality, and turnover. Copyright © 2002 John Wiley & Sons, Ltd.     

The predictive validity of safety climate

PROBLEM: Safety professionals have increasingly turned their attention to social science for insight into the causation of industrial accidents. One social construct, safety climate, has been examined by several researchers [Cooper, M. D., & Phillips, R. A. (2004). Exploratory analysis of the safety climate and safety behavior relationship. Journal of Safety Research, 35(5), 497-512; Gillen, M., Baltz, D., Gassel, M., Kirsch, L., & Vacarro, D. (2002). Perceived safety climate, job Demands, and coworker support among union and nonunion injured construction workers. Journal of Safety Research, 33(1), 33-51; Neal, A., & Griffin, M. A. (2002). Safety climate and safety behaviour. Australian Journal of Management, 27, 66-76; Zohar, D. (2000). A group-level model of safety climate: Testing the effect of group climate on microaccidents in manufacturing jobs. Journal of Applied Psychology, 85(4), 587-596; Zohar, D., & Luria, G. (2005). A multilevel model of safety climate: Cross-level relationships between organization and group-level climates. Journal of Applied Psychology, 90(4), 616-628] who have documented its importance as a factor explaining the variation of safety-related outcomes (e.g., behavior, accidents). Researchers have developed instruments for measuring safety climate and have established some degree of psychometric reliability and validity. The problem, however, is that predictive validity has not been firmly established, which reduces the credibility of safety climate as a meaningful social construct. The research described in this article addresses this problem and provides additional support for safety climate as a viable construct and as a predictive indicator of safety-related outcomes. METHODS: This study used 292 employees at three locations of a heavy manufacturing organization to complete the 16 item Zohar Safety Climate Questionnaire (ZSCQ) [Zohar, D., & Luria, G. (2005). A multilevel model of safety climate: Cross-level relationships between organization and group-level climates. Journal of Applied Psychology, 90(4), 616-628]. In addition, safety behavior and accident experience data were collected for 5 months following the survey and were statistically analyzed (structural equation modeling, confirmatory factor analysis, exploratory factor analysis, etc.) to identify correlations, associations, internal consistency, and factorial structures. RESULTS: Results revealed that the ZSCQ: (a) was psychometrically reliable and valid, (b) served as an effective predictor of safety-related outcomes (behavior and accident experience), and (c) could be trimmed to an 11 item survey with little loss of explanatory power. IMPACT ON INDUSTRY: Practitioners and researchers can use the ZSCQ with reasonable certainty of the questionnaire's reliability and validity. This provides a solid foundation for the development of meaningful organizational interventions and/or continued research into social factors affecting industrial accident experience.     

A short scale for measuring safety climate

A 6-item measure that assesses global work safety climate was validated using multiple samples each from a hospital and a nuclear energy population. Across all 14 samples the 6-item measure had acceptable internal consistency. The measure was associated with better adherence to safe work practices, reduced exposure to environmental stressors, the presence of more safety policies and procedures, a positive general organizational climate, and decreased accidents. As evidence for discriminant validity, safety climate was unrelated to most demographic measures and had relatively small relationships with sleeping problems and negative mood. Evidence suggests that this measure is a reliable and valid way to assess global safety climate.     

Safety management system: Development and validation of a multidimensional scale

The literature has recognised that implementing a safety management system is the most efficient way of allocating resources for safety, since it not only improves working conditions, but also positively influences employees’ attitudes and behaviours with regards safety, consequently improving the safety climate. The safety climate and the safety management system are considered basic components of the firm's safety culture in various models. However, the literature has focused more on measuring the safety climate, while few studies have correctly tested the psychometric properties of the instruments used to measure how advanced the firm's safety management system is. This paper reviews the most important works on safety management, with the aim of developing a measurement scale operationalising the safety management system concept, and subsequently calculating its reliability and validity. For this purpose, exploratory factor analyses and confirmatory factor analyses are conducted, using structural equation models, on a sample of 455 Spanish companies. This scale provides organisations with a tool for evaluating their situation with regards safety management, as well as guidance about which areas they must improve if they wish to reduce occupational accidents.     

Towards a model of safety climate measurement.

In this study, a survey instrument was developed to measure safety climate. A review of the scientific literature as well as consultation with an expert panel was used to determine the survey's dimensions. Next, the survey was administered, first as a pilot study (n = 15) and then as a full scale study (n = 229), to employees of the City of Cincinnati Department of Public Works. The psychometric integrity of the survey was assessed according to validity, reliability and utility criteria. Results are presented and discussed.     

Measuring safety climate in aviation: A review and recommendations for the future

This paper reviews 23 studies that have examined safety climate within commercial and military aviation. The safety climate factors identified in the aviation safety climate questionnaires were found to be consistent with the literature examining safety climate in non-aviation high reliability organizations. Therefore, it was concluded that the aviation safety climate tools had some construct validity (the extent to which the questionnaire measures what it is intended to measure). However, the majority of the studies made no attempt to establish the discriminate validity (the ability of the tool to differentiate between organizations or personnel with different levels of safety performance) of the tools. It is recommended that rather than constructing more aviation safety climate questionnaires, researchers should focus on establishing the construct and discriminate validity of existing measures by correlating safety climate with other metrics of safety performance. It is recognized that the accident rate in commercial aviation is too low to provide a sufficiently sensitive measure of safety performance. However, there are other measures of safety performance, collected as part of a company’s Aviation Safety Action Program or Flight Operational Quality Assurance, which could be used to assess the discriminate validity of an aviation safety climate tool.     

Development of the German version of the Hospital Survey on Patient Safety Culture: Dimensionality and psychometric properties

Despite the importance of safety climate assessment in healthcare, the psychometric properties of existing safety climate surveys have seldom been tested. We developed a German version of the HSOPSC and investigated its dimensionality and predictive validity. In adapting the survey we differentiated between the two management levels (hospital, unit) by duplicating dimensions of the HSOPSC. Based on a sample of n = 568, confirmatory and exploratory factor analyses (CFA, EFA) were applied. Relationships between safety climate and outcome variables were investigated by regression analyses. CFA did not replicate the proposed factor structure, supporting evidence from other European countries. EFAs revealed eight factors (instead of twelve proposed for the original instrument) and allowed for differentiating between management levels (hospital, unit). For physicians and nurses, different predictors were identified for overall safety climate perception. Further cross-cultural investigations of dimensionality are necessary for international comparisons of safety climate in healthcare. Our results highlight the importance of capturing the impact of different management levels, especially in large hospitals, and differences between professional groups in order to design interventions accordingly.     

Psychosocial safety climate: Conceptual distinctiveness and effect on job demands and worker psychological health

Psychosocial safety climate is an emerging construct that refers to shared perceptions regarding policies, practices, and procedures for the protection of worker psychological health and safety. The purpose of the research was to: (1) demonstrate that psychosocial safety climate is a construct distinct from related climate measures (i.e., physical safety climate, team psychological safety, and perceived organizational support); and (2) test the proposition that organizational psychosocial safety climate determines work conditions (i.e., job demands) and subsequently worker psychological health. We used samples from two different cultures; an Australian sample (N = 126 workers in 16 teams within a primary health care organization) and a Malaysian sample (N = 180 workers in 31 teams from different organizations and diverse industries). In both samples confirmatory factor analysis verified that psychosocial safety climate is a construct distinct from related climate measures. Using hierarchical linear modeling, psychosocial safety climate was superior to other team level climate measures in its negative relationship to both job demands and psychological health problems. Results supported a mediation process, psychosocial safety climate → job demands → psychological health problems, corroborating psychosocial safety climate as a preeminent stress risk factor, and an efficient target for intervention. We found both physical and psychosocial safety climates were stronger in the Australian, compared with the Malaysian work context. Levels of psychosocial safety climate were significantly lower than those of physical safety climate in both countries indicating a ‘universal’ lack of attention to workplace psychological health.     

Safety compliance and safety climate: A repeated cross-sectional study in the oil and gas industry

IntroductionViolations of safety rules and procedures are commonly identified as a causal factor in accidents in the oil and gas industry. Extensive knowledge on effective management practices related to improved compliance with safety procedures is therefore needed. Previous studies of the causal relationship between safety climate and safety compliance demonstrate that the propensity to act in accordance with prevailing rules and procedures is influenced to a large degree by workers' safety climate. Commonly, the climate measures employed differ from one study to another and identical measures of safety climate are seldom tested repeatedly over extended periods of time. This research gap is addressed in the present study.MethodThe study is based on a survey conducted four times among sharp-end workers of the Norwegian oil and gas industry (N = 31,350). This is done by performing multiple tests (regression analysis) over a period of 7 years of the causal relationship between safety climate and safety compliance. The safety climate measure employed is identical across the 7-year period.ConclusionsTaking all periods together, the employed safety climate model explained roughly 27% of the variance in safety compliance. The causal relationship was found to be stable across the period, thereby increasing the reliability and the predictive validity of the factor structure. The safety climate factor that had the most powerful effect on safety compliance was work pressure.Practical applicationsThe factor structure employed shows high predictive validity and should therefore be relevant to organizations seeking to improve safety in the petroleum sector. The findings should also be relevant to other high-hazard industries where safety rules and procedures constitute a central part of the approach to managing safety.     

Safety climate factors, group differences and safety behaviour in road construction

This study determines the factor structure of safety climate within a road construction organization using a modified version of the safety climate questionnaire (SCQ). It also investigates the relationship between safety climate and safety performance. The SCQ was administered to 192 employees from two districts and in two job categories — construction and maintenance. A behavioural observation measure of safety performance was also developed. Factor analysis derived six factors, which were similar to those obtained in an earlier study using the SCQ. Differences in the safety climate of job sub-groups were found on two of the factors. No differences between the two districts were found. No relationship was found between safety climate and the safety performance measure. While identical safety climate factors cannot apply to all organizations, some general safety climate factors may emerge. Discussion focuses upon the measurement of safety climate.     

A cross-validation of safety climate scale using confirmatory factor analytic approach

PROBLEM: Given the lack of a consistent factor structure of safety climate, this study tested the stability of a factor structure of a safety climate scale developed through an extensive literature review using confirmatory factor analytic approach and cross-validation. METHODS: A cross-sectional sample of 722 U.S. grain industry workers participated in the questionnaire survey. RESULTS: The safety climate scale developed through the generation of an item pool based on a table of specifications, subsequent scientific item reduction procedures, reviews from experts, and pilot test yielded adequate reliabilities for each dimension. Each item showed proper discriminative power based on both internal and external criteria. Criterion validity was manifested by the significant positive correlation of the scale with five criteria. Evidence of construct validity was provided by both exploratory and confirmatory factor analyses. Both calibration and validation samples supported a consistent factor structure. Management commitment and supervisor support were found to influence other dimensions of safety climate. DISCUSSION: This study provides an insight into the primary reason why previous attempts have failed to find a consistent factor structure of safety climate: No specification of the influence of management commitment and supervisor support on other dimensions of safety in their models. IMPACT ON INDUSTRY: The findings of this study provide a framework upon which accident prevention efforts can be effectively organized and underscore the importance of management commitment and supervisor support as they affect employee safety perceptions.     

Safety climate

Safety climate, the objective measurement of attitudes and perceptions toward Occupational Health & Safety (OH&S) issues, has been largely ignored and measures such as lost time and frequency rate have been used to determine the efficacy of OH&S programs. Yet, it is clear that measuring the precursors of accidents identified in a safety climate analysis provides a powerful proactive management tool. This paper reports on safety climate factors found in clerical and service organizations in Australia. Concurrent validity studies are reported. In contradistinction to published studies, it is argued that safety climate factors are not stable across organizations. The significance of this for planning and assessing the efficacy of OH&S programs is discussed. It is concluded that although safety climate factors are not stable, the safety climate factor pattern identified in organizations provides a powerful management tool for designing OH&S programs.     

Measuring safety climate in elderly homes

IntroductionProvision of a valid and reliable safety climate dimension brings enormous benefits to the elderly home sector. The aim of the present study was to make use of the safety climate instrument developed by OSHC to measure the safety perceptions of employees in elderly homes such that the factor structure of the safety climate dimensions of elderly homes could be explored.MethodIn 2010, surveys by mustering on site method were administered in 27 elderly homes that had participated in the "Hong Kong Safe and Healthy Residential Care Home Accreditation Scheme" organized by the Occupational Safety and Health Council.ResultsSix hundred and fifty-one surveys were returned with a response rate of 54.3%. To examine the factor structure of safety climate dimensions in our study, an exploratory factor analysis (EFA) using principal components analysis method was conducted to identify the underlying factors. The results of the modified seven-factor's safety climate structure extracted from 35 items better reflected the safety climate dimensions of elderly homes. The Cronbach alpha range for this study (0.655 to 0.851) indicated good internal consistency among the seven-factor structure. Responses from managerial level, supervisory and professional level, and front-line staff were analyzed to come up with the suggestion on effective ways of improving the safety culture of elderly homes. The overall results showed that managers generally gave positive responses in the factors evaluated, such as "management commitment and concern to safety," "perception of work risks and some contributory influences," "safety communication and awareness," and "safe working attitude and participation." Supervisors / professionals, and frontline level staff on the other hand, have less positive responses. The result of the lowest score in the factors - "perception of safety rules and procedures" underlined the importance of the relevance and practicability of safety rules and procedures.ConclusionThe modified OSHC safety climate tool provided better evidence of structural validity and reliability for use by elderly homes' decision makers as an indicator of employee perception of safety in their institution.Impact on industryThe findings and suggestions in the study provide useful information for the management, supervisors/professionals and frontline level staff to cultivate the safety culture in the elderly home sector. Most important, elderly homes can use the modified safety climate scale to identify problem areas in their safety culture and safety management practices and then target these for intervention.     

A theory‐based measure of conflict management strategies in the workplace

Conflict management influences individual wellbeing, group performance and organizational effectiveness. This research examined the psychometric qualities of two versions of the newly developed test for conflict handling. The lean version (Study 1 and 2) included problem solving, forcing, yielding and avoiding as distinct conflict management strategies, and the expanded version (Study 3) also included compromising. A negotiation study (Study 1) showed substantial convergence between self‐reports, opponent‐reports and observer rated behavior for problem solving, forcing and yielding, but not for avoiding. In Study 2 and Study 3 the psychometric properties were examined of the lean and the expanded version, respectively. Confirmatory factor analyses revealed good to excellent psychometric qualities of both versions of the scale. We conclude that the scale is a parsimonious, flexible and valid instrument to assess conflict management strategies at work. Copyright © 2001 John Wiley & Sons, Ltd.     

Validation of the group nuclear safety climate questionnaire

IntroductionGroup safety climate is a leading indicator of safety performance in high reliability organizations. Zohar and Luria (2005) developed a Group Safety Climate scale (ZGSC) and found it to have a single factor.MethodThe ZGSC scale was used as a basis in this study with the researchers rewording almost half of the items on this scale, changing the referents from the leader to the group, and trying to validate a two-factor scale. The sample was composed of 566 employees in 50 groups from a Spanish nuclear power plant. Item analysis, reliability, correlations, aggregation indexes and CFA were performed.ResultsResults revealed that the construct was shared by each unit, and our reworded Group Safety Climate (GSC) scale showed a one-factor structure and correlated to organizational safety climate, formalized procedures, safety behavior, and time pressure.“Impact on IndustryThis validation of the one-factor structure of the Zohar and Luria (2005) scale could strengthen and spread this scale and measure group safety climate more effectively.     

Development of a multilevel health and safety climate survey tool within a mining setting

IntroductionThis study aimed to design, implement and evaluate the reliability and validity of a multifactorial and multilevel health and safety climate survey (HSCS) tool with utility in the Australian mining setting.MethodsAn 84-item questionnaire was developed and pilot tested on a sample of 302 Australian miners across two open cut sites.ResultsA 67-item, 10 factor solution was obtained via exploratory factor analysis (EFA) representing prioritization and attitudes to health and safety across multiple domains and organizational levels. Each factor demonstrated a high level of internal reliability, and a series of ANOVAs determined a high level of consistency in responses across the workforce, and generally irrespective of age, experience or job category. Participants tended to hold favorable views of occupational health and safety (OH&S) climate at the management, supervisor, workgroup and individual level.ConclusionThe survey tool demonstrated reliability and validity for use within an open cut Australian mining setting and supports a multilevel, industry specific approach to OH&S climate. Findings suggested a need for mining companies to maintain high OH&S standards to minimize risks to employee health and safety. Future research is required to determine the ability of this measure to predict OH&S outcomes and its utility within other mine settings.Practical applicationsAs this tool integrates health and safety, it may have benefits for assessment, monitoring and evaluation in the industry, and improving the understanding of how health and safety climate interact at multiple levels to influence OH&S outcomes.     

Polish adaptation of three self-report measures of job stressors: the Interpersonal Conflict at Work Scale,the Quantitative Workload Inventory and the Organizational Constraints Scale

Aim. The objective of the present study was to test the psychometric properties, reliability and validity of three job stressor measures, namely, the Interpersonal Conflict at Work Scale, the Organizational Constraints Scale and the Quantitative Workload Inventory. Method. The study was conducted on two samples (N?=?382 and 3368) representing a wide range of occupations. The estimation of internal consistency with Cronbach's α and the test–retest method as well as both exploratory and confirmatory factor analyses were the main statistical methods. Results. The internal consistency of the scales proved satisfactory, ranging from 0.80 to 0.90 for Cronbach's α test and from 0.72 to 0.86 for the test–retest method. The one-dimensional structure of the three measurements was confirmed. The three scales have acceptable fit to the data. The one-factor structures and other psychometric properties of the Polish version of the scales seem to be similar to those found in the US version of the scales. It was also proved that the three job stressors are positively related to all the job strain measures. Conclusions. The Polish versions of the three analysed scales can be used to measure the job stressors in Polish conditions.     

Multiple organizational identification levels and the impact of perceived external prestige and communication climate

Earlier studies have shown that perceived external prestige and communication climate influence organizational identification. In this paper we present the results of a study of the influence of communication climate and perceived external prestige on organizational identification at various organizational levels of a regional police organization. In total, 314 respondents filled out a questionnaire on communication climate, perceived external prestige and organizational identification. The results of this study show that communication climate has the strongest link with employee identification when it concerns the identification with the daily work group and a weaker one with the organization as a whole. It also appears that perceived external prestige has a stronger influence on the identification with the organization as a whole than on the identification at the more concrete organizational levels (such as department or work group). This research offers reasons to presuppose that organizational identification and communication climate are multiple constructs. If management wishes to influence organizational identification through a bottom‐up process, it is wise to pay particular attention to the communication climate in the work groups. Influencing organizational identification with the organization as a whole is better conducted through perceived external prestige. Copyright © 2006 John Wiley & Sons, Ltd.