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Measuring safety climate in health care
  1. R Flin1,
  2. C Burns1,
  3. K Mearns1,
  4. S Yule1,
  5. E M Robertson2
  1. 1Industrial Psychology Research Centre, University of Aberdeen, Aberdeen, UK
  2. 2Grampian University Hospitals NHS Trust, UK
  1. Correspondence to:
 Professor R Flin
 Industrial Psychology Research Centre, University of Aberdeen, Aberdeen AB24 2UB, UK; r.flin{at}


Aim: To review quantitative studies of safety climate in health care to examine the psychometric properties of the questionnaires designed to measure this construct.

Method: A systematic literature review was undertaken to study sample and questionnaire design characteristics (source, no of items, scale type), construct validity (content validity, factor structure and internal reliability, concurrent validity), within group agreement, and level of analysis.

Results: Twelve studies were examined. There was a lack of explicit theoretical underpinning for most questionnaires and some instruments did not report standard psychometric criteria. Where this information was available, several questionnaires appeared to have limitations.

Conclusions: More consideration should be given to psychometric factors in the design of healthcare safety climate instruments, especially as these are beginning to be used in large scale surveys across healthcare organisations.

  • safety climate
  • patient safety
  • worker safety
  • questionnaires
  • psychometric factors

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  • This research was funded by Grampian University Hospitals NHS Trust Endowment Fund. The views presented are those of the authors and should not be taken to represent the position or policy of the funding body.

  • Calvin Burns is now at the Business School, University of Strathclyde.

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