The validity of the Nordic patient safety culture questionnaire (TUKU)

BACKGROUND: Patient safety culture (PSC) has been postulated to have a significant influence on the quality of health care. OBJECTIVE: This study aims to evaluate the psychometric properties of the TUKU PSC questionnaire. METHODS: The questionnaire development was based on the view that patient safety constitutes not only the absence of adverse events, but also the presence of certain organizational attributes that enable safety. The TUKU questionnaire has two parts: a measure of psychological dimensions, and a measure of employees' perceptions of organizational functions. The TUKU questionnaire was validated using a sample of 1162 health care professionals from seven Finnish health care organizations. Two studies were carried out, one focusing on construct validity and the other on criterion validity. RESULTS: Regarding construct validity, the empirical model matched the theory quite well. The results of Study 2 concerning criterion validity were more ambiguous. Four of the organizational dimensions and two of the psychological dimensions were related to patient safety incidents occurring 16 months after administering the questionnaire. CONCLUSIONS: The study provided evidence on the key organizational dimensions that comprise patient safety culture and affect patient safety. The study further contributed towards validation of an instrument for measuring these dimensions.