Article Text

Download PDFPDF
Comparing two safety culture surveys: Safety Attitudes Questionnaire and Hospital Survey on Patient Safety
  1. Jason M Etchegaray,
  2. Eric J Thomas
  1. University of Texas Medical School, University of Texas, Memorial Hermann Center for Healthcare Quality and Safety, Houston, Texas, USA
  1. Correspondence to Dr Jason M Etchegaray, University of Texas Medical School, University of Texas, Memorial Hermann Center for Healthcare Quality and Safety, 6410 Fannin St., UTPB 1100.45, Houston, TX 77030, USA; jason.etchegaray{at}


Objective To examine the reliability and predictive validity of two patient safety culture surveys—Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPS)—when administered to the same participants. Also to determine the ability to convert HSOPS scores to SAQ scores.

Method Employees working in intensive care units in 12 hospitals within a large hospital system in the southern United States were invited to anonymously complete both safety culture surveys electronically.

Results All safety culture dimensions from both surveys (with the exception of HSOPS's Staffing) had adequate levels of reliability. Three of HSOPS's outcomes—frequency of event reporting, overall perceptions of patient safety, and overall patient safety grade—were significantly correlated with SAQ and HSOPS dimensions of culture at the individual level, with correlations ranging from r=0.41 to 0.65 for the SAQ dimensions and from r=0.22 to 0.72 for the HSOPS dimensions. Neither the SAQ dimensions nor the HSOPS dimensions predicted the fourth HSOPS outcome—number of events reported within the last 12 months. Regression analyses indicated that HSOPS safety culture dimensions were the best predictors of frequency of event reporting and overall perceptions of patient safety while SAQ and HSOPS dimensions both predicted patient safety grade. Unit-level analyses were not conducted because indices did not indicate that aggregation was appropriate. Scores were converted between the surveys, although much variance remained unexplained.

Conclusions Given that the SAQ and HSOPS had similar reliability and predictive validity, investigators and quality and safety leaders should consider survey length, content, sensitivity to change and the ability to benchmark when selecting a patient safety culture survey.

  • Patient safety
  • culture
  • SAQ
  • attitudes
  • health services research
  • safety culture
  • social sciences
  • organisational theory
  • healthcare quality improvement
  • teamwork

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding Funding for the first author was provided by a K02 award from the Agency for Healthcare Research and Quality (1K02HS017145-02).

  • Competing interests None.

  • Ethics approval University of Texas CPHS.

  • Provenance and peer review Not commissioned; externally peer reviewed.