Table 1

Modified version of the HSOPC questionnaire

Question number	Dimension/item
Overall perceptions of safety (outcome dimension)
A25	Patient safety is never sacrificed to get the work done
A30	Our procedures and systems are good at preventing errors from happening
A18	It is just by chance that serious mistakes don't happen around here
A28^*	We have patient safety problems in this ward/department
Frequency of error reporting (outcome dimension)
D1	When an event occurs, but is caught and identified before affecting the patient, how often is it reported?
D2	When an event occurs, but it has no adverse outcome to the patient, how often is it reported?
D3	When an event occurs that could have an adverse outcome to the patient but does not, how often is it reported?
Supervisor/manager expectations and actions promoting patient safety
B1	My supervisor/manager provides positive feedback when he/she sees a job done according to established patient safety procedures
B2	My supervisor/manager seriously considers staff suggestions for improving patient safety
B3	Whenever pressure build up, my supervisor/manager wants us to work faster, even if it means taking shortcuts
B4	My supervisor/manager overlooks patient safety problems that happen repeatedly
Organisational learning—continuous improvement
A14	We are actively doing things to improve patient safety
A16	Mistakes have led to positive changes around here
A22	After we make changes to patient safety, we evaluate their effectiveness
Teamwork within units
A1^*	People support one another in this ward/department
A3	When a lot of work needs to be done quickly, we work together as a team to get the work done
A7^*	In this ward/department, people treat each other with respect
A20^*	When one area in this ward/department gets busy, others help out
Communication openness
C3	Staff will freely speak up if they see something that may negatively affect patient care
C8	Staff feel free to question the decisions and actions of those with more authority
C11	Staff are afraid to ask questions where something doesn't seem right
Feedback and communication about error
C1	We are given feedback about changes put into place based on event reports
C7	We are informed about events that happen in this ward/department
C9	In this ward/department, we discuss ways to prevent events from happening again
Non-punitive response to error
A19^†	When an event is reported, it feels like the person is being written up, not the problem
A15	Staff feel that their mistakes are held against them
A26	Staff worry that mistakes they make are kept in their personal files
Staffing
A2	We have enough staff to handle the workload
A12^*	Staff in this ward/department work longer hours that is best for patient care
A13	We use more agency/temporary staff than is best for patient care
A24	We often work in “crisis mode” trying to do too much, too quickly
Hospital management support for patient safety
F1^†	Hospital management provides a work climate that promotes patient safety
F10	The actions of hospital management show that patient safety is a top priority
F11	Hospital management seems interested in patient safety only after an adverse event happens
Teamwork across hospital units
F4^*	There is good cooperation across hospital wards/departments that need to work together
F13^*	Hospital wards/departments work well together to provide the best care for patients
F2^*	Hospital wards/departments do not coordinate well with each other
F7^*	It is often unpleasant to work with staff from other hospital wards/departments
Hospital handoffs/transitions
F3^*	Things “fall between the cracks” when transferring patients from one ward/department to another
F5	Important patient care information is often lost during shift changes
F9^*	Problems often occur in the exchange of information across hospital wards/departments
F14	Shift changes are problematic for patients in this hospital

↵* Item changed from original HSOPC questionnaire.
↵† Item not used in the questionnaire or discarded from the analysis.
HSOPC, Hospital Survey on Patient Safety Culture.