Validation of a questionnaire measuring transitional patient safety climate indicated differences in transitional patient safety climate between primary and secondary care

Marije A. van Melle, Henk F. van Stel, Judith M. Poldervaart, Niek J. de Wit, Dorien L.M. Zwart

This study describes the development and validation of the TRAnsitional patient safety Climate Evaluation (TRACE) questionnaire, measuring transitional patient safety climate from the perspective of general practitioners and hospital physicians. Patient safety climate reflects the professionals' perception of the organizational patient safety culture. In the development of the TRACE we adjusted existing questionnaires on patient safety culture. Exploratory factor analysis (EFA) was performed. Internal consistency and correlations between factors and a global transitional patient safety rating were calculated. In total, 162 questionnaires were completed (response 23%; general practice: N=97, hospital physicians: N=65). Analysis of all respondents did not provide an interpretable factor solution. However, the EFA on the results of hospital physicians revealed 4 relevant factors: (1) Collaboration, (2) Speaking up, (3) Communication on transitional incidents and improvement measures, and (4) Transitional patient safety management. The internal consistency of these factors was good for hospital respondents (0.71 to 0.87) and fair to acceptable for general practices' respondents (0.63 to 0.72). Although the TRACE questionnaire did not provide a solid factor structure in a combined sample of general practice and hospital respondents, the factors found reliable in hospital setting had acceptable reliability in general practice setting.