Are Spanish primary care professionals aware of patient safety?

BACKGROUND: Knowledge about safety culture improves patient safety (PS) in health-care organizations. The first contact a patient has with health care occurs at the primary level. We conducted a survey to measure patient safety culture (PSC) among primary care professionals (PCPs) of health centres (HCs) in Spain and analyzed PS dimensions that influence PSC. METHODS: We used Agency for Healthcare Research and Quality (AHRQ) Medical Office Survey on Patient Safety Culture translated and validated into Spanish to conduct a cross-sectional anonymous postal survey. We randomly selected a sample of 8378 PCPs at 289 HCs operated by 17 Regional Health Services. Statistical analysis was performed on sociodemographic variables, survey items, PS dimensions and a patient safety synthetic index (PSSI), calculated as average score of the items per dimension, to identify potential predictors of PSC. We used AHRQ data to conduct international comparison. RESULTS: A total of 4344 PCPs completed the questionnaire. The response rate was 55.69%. Forty-two percent were general practitioners, 34.9% nurses, 18% administrative staff and 4.9% other professionals. The highest scoring dimension was 'PS and quality issues' 4.18 (4.1-4.20) 'Work pressure and pace' was the lowest scored dimension with 2.76 (2.74-2.79). Professionals over 55 years, with managerial responsibilities, women, nurses and administrative staff, had better PSSI scores. Professionals with more than 1500 patients and working for more than 11 years at primary care had lower PSSI scores. CONCLUSIONS: This is the first national study to measure PSC in primary care in Spain. Results may reflect on-going efforts to build a strong PSC. Further research into its association with safety outcomes and patients' perceptions is required.

[Validation of a questionnaire to assess patient safety culture in Spanish Primary Health Care professionals]. / Validación de un cuestionario para evaluar la cultura de seguridad del paciente de los profesionales de atención primaria en España.

OBJECTIVE: [corrected] To validate a tool to measure patient safety culture in Spanish primary care professionals. METHODS: Medical Office Survey on Patient Safety Culture (MOSPSC), from the Agency for Healthcare and Research in Quality (AHRQ). The process has been performed in five steps: original version traslation, conceptual equivalence evaluation, acceptability and viability assessment, content validity and questionnaire test and response analysis and psichometric properties assessment. SETTING: Primary care. SUBJECTS: 185 Primary care professionals from different Spanish regions represented the sample test. MAIN OUTCOME MEASURES: Frecuency, response pattern and discrimination power of each item. Cronbach's alpha coefficient and dimensions obtained through factor analysis. RESULTS: 17, 8% of respondents answered all the items and 28, 7% of them did not answer, or answered the option "Don't know/Does not apply", to one to four items. All the sentences, with only one exception, present discrimination capacity. Cronbach's alpha coefficient results 0,96 and information is sumarized in 15 factors obtaining the same items in 7 of the total 12 factors in the original questionnaire. CONCLUSIONS: Traslated, adapted, extended and validated AHRQ questionnaire is, in this setting, a reliable and useful instrument and it must be used for international comparisons.