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Parent perceptions of children's hospital safety climate
  1. Elizabeth D Cox1,
  2. Pascale Carayon2,
  3. Kristofer W Hansen1,3,
  4. Victoria P Rajamanickam4,
  5. Roger L Brown5,
  6. Paul J Rathouz4,
  7. Lori L DuBenske6,
  8. Michelle M Kelly1,
  9. Linda A Buel7
  1. 1Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
  2. 2Department of Industrial and Systems Engineering, Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, Wisconsin, USA
  3. 3Department of Pediatrics and the Institute on Aging, University of Wisconsin-Madison Graduate School, Madison, Wisconsin, USA
  4. 4Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
  5. 5Department of Research Design and Statistics, University of Wisconsin School of Nursing, Madison, Wisconsin, USA
  6. 6Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
  7. 7Department of Quality Resources, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA
  1. Correspondence to Dr Elizabeth D Cox, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave., H6/558 Clinical Science Center, Madison, WI 53792, USA; ecox{at}wisc.edu

Abstract

Background Because patients are at the frontline of care where safety climate is closely tied to safety events, understanding patient perceptions of safety climate is crucial. We sought to develop and evaluate a parent-reported version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture and to relate parent-reported responses to parental need to watch over their child's care to ensure mistakes are not made.

Methods Parents (n=172) were surveyed about perceptions of hospital safety climate (14 items representing four domains—overall perceptions of safety, openness of staff and parent communication, and handoffs and transitions) and perceived need to watch over their child's care. Confirmatory factor analysis (CFA) was used to validate safety climate domain measures. Logistic regression was used to relate need to watch over care to safety climate domains.

Results CFA indices suggested good model fit for safety climate domains. Thirty-nine per cent of parents agreed or strongly agreed they needed to watch over care. In adjusted models, need to watch over care was significantly related to overall perceptions of safety (OR 0.20, 95% CI 0.11 to 0.37) and to handoffs and transitions (0.25, 0.14 to 0.46), but not to openness of staff (0.67, 0.40 to 1.12) or parent (0.83, 0.48 to 1.45) communication.

Conclusions Findings suggest parents can provide valuable data on specific safety climate domains. Opportunities exist to improve our safety climate's impact on parent burden to watch over their child's care, such as targeting overall perceptions of safety as well as handoffs and transitions.

  • Communication
  • Patient safety
  • Patient-centred care

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