Developing a reliable and valid patient measure of safety in hospitals (PMOS): A validation study
Armitage, Gerry R.
Yorkshire Quality and Safety Research Group
MetadataShow full item record
AbstractIntroduction Patients represent an important and as yet untapped source of information about the factors that contribute to the safety of their care. The aim of the current study is to test the reliability and validity of the Patient Measure of Safety (PMOS), a brief patient-completed questionnaire that allows hospitals to proactively identify areas of safety concern and vulnerability, and to intervene before incidents occur. Methods 297 patients from 11 hospital wards completed the PMOS questionnaire during their stay; 25 completed a second 1 week later. The Agency for Healthcare Research and Quality (AHRQ) safety culture survey was completed by 190 staff on 10 of these wards. Factor structure, internal reliability, test-retest reliability, discriminant validity and convergent validity were assessed. Results Factor analyses revealed 8 key domains of safety (eg, communication and team work, access to resources, staff roles and responsibilities) explaining 58% variance of the original questionnaire. Cronbach’s α (range 0.66–0.89) and test-retest reliability (r=0.75) were good. The PMOS positive index significantly correlated with staff reported ‘perceptions of patient safety’ (r=0.79) and ‘patient safety grade’ (r=−0.81) outcomes from the AHRQ (demonstrating convergent validity). A multivariate analysis of variance (MAMOVA) revealed that three PMOS factors and one retained single item discriminated significantly across the 11 wards. Discussion The PMOS is the first patient questionnaire used to assess factors contributing to safety in hospital settings from a patient perspective. It has demonstrated acceptable reliability and validity. Such information is useful to help hospitals/units proactively improve the safety of their care.
VersionNo full-text available in the repository
CitationMcEachan RRC, Lawton RJ, O’Hara JK., Armitage G, Giles S, Parveen S, Watt IS and Wright J on behalf of the Yorkshire Quality and Safety Research Group (2014) Developing a reliable and valid patient measure of safety in hospitals (PMOS): A validation study. British Medical Journal Quality and Safety. 23 (7): 565-73.
Link to publisher’s versionhttp://dx.doi.org/10.1136/bmjqs-2013-002312
Showing items related by title, author, creator and subject.
A safety analysis of industrial accidents. Accident records of major coal producing countries are analysed to obtain fatal and non-fatal accident rates. Significant factors influencing these rates are identified with efficacy of preventive measures.Keller, Alf; Habibi, Ehsanollah (University of BradfordDepartment of Industrial Technology, 2010-02-12)A comprehensive study of accident records which have occured in Coal Mining Industries of Europe and U. S. A are analysed. The intention of the research was to establish relationships between the various accidents and prevention methods adopted by each country are evaluated and to assess the impact of industrial legislation in these various countries on accident rate are examined. The study analyses in paricular the fatal accident rate, and major and minor rate. The Major health hazards associated with coal mining are described in detail and discusses together with the Measurement of safety performance and its application in the Safety field. The study also examines the role of human factors in accidents also includes a summaries of fatal and major injury rates for 46 countries. Arising from the research a number of recommendations for improving safety are requires further research are indentified.
Evaluating the PRASE patient safety intervention - a multi-centre, cluster trial with a qualitative process evaluation: study protocol for a randomised controlled trial.Sheard, L.; O'Hara, J.K.; Armitage, Gerry R.; Wright, J.; Cocks, K.; McEachan, R.R.C.; Watt, I.S.; Lawton, R. (2014-10-29)Background Estimates show that as many as one in 10 patients are harmed while receiving hospital care. Previous strategies to improve safety have focused on developing incident reporting systems and changing systems of care and professional behaviour, with little involvement of patients. The need to engage with patients about the quality and safety of their care has never been more evident with recent high profile reviews of poor hospital care all emphasising the need to develop and support better systems for capturing and responding to the patient perspective on their care. Over the past 3 years, our research team have developed, tested and refined the PRASE (Patient Reporting and Action for a Safe Environment) intervention, which gains patient feedback about quality and safety on hospital wards. Methods/design A multi-centre, cluster, wait list design, randomised controlled trial with an embedded qualitative process evaluation. The aim is to assess the efficacy of the PRASE intervention, in achieving patient safety improvements over a 12-month period. The trial will take place across 32 hospital wards in three NHS Hospital Trusts in the North of England. The PRASE intervention comprises two tools: (1) a 44-item questionnaire which asks patients about safety concerns and issues; and (2) a proforma for patients to report (a) any specific patient safety incidents they have been involved in or witnessed and (b) any positive experiences. These two tools then provide data which are fed back to wards in a structured feedback report. Using this report, ward staff are asked to hold action planning meetings (APMs) in order to action plan, then implement their plans in line with the issues raised by patients in order to improve patient safety and the patient experience. The trial will be subjected to a rigorous qualitative process evaluation which will enable interpretation of the trial results. Methods: fieldworker diaries, ethnographic observation of APMs, structured interviews with APM lead and collection of key data about intervention wards. Intervention fidelity will be assessed primarily by adherence to the intervention via scoring based on an adapted framework. Discussion This study will be one of the largest patient safety trials ever conducted, involving 32 hospital wards. The results will further understanding about how patient feedback on the safety of care can be used to improve safety at a ward level. Incorporating the ‘patient voice’ is critical if patient feedback is to be situated as an integral part of patient safety improvements.
Patient safety culture in maternity units: a reviewAl Nadabi, W.; McIntosh, Bryan; McClelland, Gabrielle T.; Mohammed, Mohammed A. (2018)Purpose: To summarize studies that have examined patient safety culture (PSC) in maternity units and describe the different purposes, study designs and tools reported in these studies, whilst highlighting gaps in the literature. Methodology: Peer-reviewed studies published in English during 1961-2016 across eight electronic databases were subjected to a narrative literature review. Findings: Among 100 articles considered, 28 met the inclusion criteria. The main purposes for studying PSC were: (a) assessing intervention effects on PSC (n= 17); and (b) assessing PSC level (n=7). Patient safety culture was mostly assessed quantitatively using validated questionnaires (n=23). The Safety Attitude Questionnaire was the most commonly used questionnaire (n=17). Intervention varied from a single action lasting five weeks to a more comprehensive package lasting more than four years. The time between the baseline and the follow-up assessment varied from six months up to 24 months. No study reported measurement or intervention costs, and none incorporated the patient’s voice in assessing PSC. Practical Implications: Assessing PSC in maternity units is feasible using validated questionnaires. Interventions to enhance PSC have not been rigorously evaluated. Future studies should report PSC measurement costs, adopt more rigorous evaluation designs, and find ways to incorporate the patient’s voice. Originality/Value: This review summarized studies examining PSC in a highly important area and highlighted main limitations that future studies should consider.