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The Psychological Safety Scale of the Safety, Communication, Operational, Reliability, and Engagement (SCORE) Survey: A Brief, Diagnostic, and Actionable Metric for the Ability to Speak Up in Healthcare Settings.

Publication ,  Journal Article
Adair, KC; Heath, A; Frye, MA; Frankel, A; Proulx, J; Rehder, KJ; Eckert, E; Penny, C; Belz, F; Sexton, JB
Published in: J Patient Saf
September 1, 2022

OBJECTIVES: The current study aimed to guide the assessment and improvement of psychological safety (PS) by (1) examining the psychometric properties of a brief novel PS scale, (2) assessing relationships between PS and other safety culture domains, (3) exploring whether PS differs by healthcare worker demographic factors, and (4) exploring whether PS differs by participation in 2 institutional programs, which encourage PS and speaking-up with patient safety concerns (i.e., Safety WalkRounds and Positive Leadership WalkRounds). METHODS: Of 13,040 eligible healthcare workers across a large academic health system, 10,627 (response rate, 81%) completed the 6-item PS scale, demographics, safety culture scales, and questions on exposure to institutional initiatives. Psychometric analyses, correlations, analyses of variance, and t tests were used to test the properties of the PS scale and how it differs by demographic factors and exposure to PS-enhancing initiatives. RESULTS: The PS scale exhibited strong psychometric properties, and a 1-factor model fit the data well (Cronbach α = 0.80; root mean square error approximation = 0.08; Confirmatory Fit Index = 0.97; Tucker-Lewis Fit Index = 0.95). Psychological Safety scores differed significantly by role, shift, shift length, and years in specialty. The PS scale correlated significantly and in expected directions with safety culture scales. The PS score was significantly higher in work settings with higher rates of exposure to Safety WalkRounds or Positive Leadership WalkRounds. CONCLUSIONS: The PS scale is brief, diagnostic, and actionable. It exhibits strong psychometric properties; is associated with better safety, teamwork climate, and well-being; differs by demographic factors; and is significantly higher for those who have been exposed to PS-enhancing initiatives.

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Published In

J Patient Saf

DOI

EISSN

1549-8425

Publication Date

September 1, 2022

Volume

18

Issue

6

Start / End Page

513 / 520

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Safety Management
  • Reproducibility of Results
  • Psychometrics
  • Humans
  • Health Policy & Services
  • Delivery of Health Care
  • Communication
  • 4203 Health services and systems
  • 1117 Public Health and Health Services
 

Citation

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Adair, K. C., Heath, A., Frye, M. A., Frankel, A., Proulx, J., Rehder, K. J., … Sexton, J. B. (2022). The Psychological Safety Scale of the Safety, Communication, Operational, Reliability, and Engagement (SCORE) Survey: A Brief, Diagnostic, and Actionable Metric for the Ability to Speak Up in Healthcare Settings. J Patient Saf, 18(6), 513–520. https://doi.org/10.1097/PTS.0000000000001048
Adair, Kathryn C., Annemarie Heath, Maureen A. Frye, Allan Frankel, Joshua Proulx, Kyle J. Rehder, Erin Eckert, Caitlin Penny, Franz Belz, and J Bryan Sexton. “The Psychological Safety Scale of the Safety, Communication, Operational, Reliability, and Engagement (SCORE) Survey: A Brief, Diagnostic, and Actionable Metric for the Ability to Speak Up in Healthcare Settings.J Patient Saf 18, no. 6 (September 1, 2022): 513–20. https://doi.org/10.1097/PTS.0000000000001048.

Published In

J Patient Saf

DOI

EISSN

1549-8425

Publication Date

September 1, 2022

Volume

18

Issue

6

Start / End Page

513 / 520

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Safety Management
  • Reproducibility of Results
  • Psychometrics
  • Humans
  • Health Policy & Services
  • Delivery of Health Care
  • Communication
  • 4203 Health services and systems
  • 1117 Public Health and Health Services