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\begin{document}

\title{Psychometric properties of the Safety Climate Survey (SCS) in Austrian
acute care: factor structure, reliability and usability}



\author[1]{Manela Glarcher}%
\author[1]{Karin Kaiser}%
\author[1]{Nadja Nestler}%
\author[1]{Patrick Kutschar}%
\affil[1]{Paracelsus Medical Private University}%


\vspace{-1em}



  
  \date{June 17, 2024}


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\begin{abstract}
Rationale, Aims and Objectives Hospitals are complex organizations with
a high potential for medical errors that can be influenced by safety
culture, a central aspect in research and practice to increase patient
safety. Safety climate as a measurable element of safety culture,
illustrates the perception of safety-relevant aspects of health care
staff at a certain time. The Safety Climate Survey (SCS) is applied
internationally to measure safety climate. However, psychometrics for
the German SCS have yet not been evaluated. Aim of this study is to
explore the factor structure, reliability, and potential usefulness of
the German SCS in Austrian acute care. Methods Cross-sectional
online-surveys of physicians, therapists and nurses/midwives from eight
hospitals from one hospital operator were implemented. An exploratory
factor analysis (EFA) was carried out, both, for the total sample and
also split by two select professions (physicians, nurses/midwives).
After deriving a factor structure for both professions, internal
consistency and scale means were calculated for the subscales. Finally,
mean subscale differences between physicians and nurses/midwives were
tested. Results In summary, 933 respondents out of 5,160 eligible staff
participated, reaching a response rate of 18.1\%. A six-factor solution
explaining 59.1\% of total variance was identified in the total sample.
Comparison by profession illustrated that the factor structures and item
loading patterns differ between physicians (n=124) and nurses/midwives
(n=713). To achieve an overarching solution, five items were excluded
from consecutive subscale measures due to cross-loadings and
contradictory factor loadings. Subscales demonstrated good to low
internal consistency (\selectlanguage{greek}α\selectlanguage{english}=0.794 to 0.535). Significant mean differences
between subscales of professions were found relating to three factors.
Conclusions The German SCS measures safety climate multi- rather than
unidimensional, demonstrated limitations in factor structures and item
loadings but overall satisfactory reliability of the subscales. When
assessing safety climate, a multi-dimensional and profession-related
approach must be explicitly considered.%
\end{abstract}%



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