Table 2 Percent average positive response for an item-level and composite

Teamwork within units (Cronbach’s α = 0.71)

 A1. People support one another in this unit

 A3. When a lot of work needs to be done quickly, we work together as a team to get the work done

 A4. In this unit, people treat each other with respect

 A10.When one area in this unit gets really busy, others help out

Supervisor/manager expectations and actions promoting patient safety (Cronbach’s α = 0.48)

 B1. My supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures

 B2. My supervisor/manager seriously considers staff suggestions for improving patient safety

 B3. Whenever pressure builds up, my supervisor/manager wants us to work faster, even if it means taking shortcuts (R)^b

 B4. My supervisor/manager overlooks patient safety problems that happen over and over (R)

Organizational learning–continuous improvement (Cronbach’s α = 0.54)

 A6. We are actively doing things to improve patient safety

 A8. Mistakes have led to positive changes here

 A12. After we make changes to improve patient safety, we evaluate their effectiveness

Management support for patient safety (Cronbach’s α = 0.48)

 F1. Hospital management provides a work climate that promotes patient safety

 F8. The actions of hospital management show that patient safety is a top priority

 F9. Hospital management seems interested in patient safety only after an adverse event happens (R)

Feedback and communication about error (Cronbach’s α = 0.71)

 C1. We are given feedback about changes put into place based on event reports

 C3. We are informed about errors that happen in this unit

 C5. In this unit, we discuss ways to prevent errors from happening again

Frequency of events reported (Cronbach’s α = 0.75)

 D1. When a mistake is made, but is caught and corrected before affecting the patient, how often is this reported?

 D2. When a mistake is made, but has no potential to harm the patient, how often is this reported?

 D3. When a mistake is made that could harm the patient, but does not, how often is this reported?

Overall perceptions of patient safety (Cronbach’s α = 0.22)

 A9. It is just by chance that more serious mistakes do not happen around here (R)

 A14. Patient safety is never sacrificed to get more work done

 A16. We have patient safety problems in this unit (R)

 A17. Our procedures and systems are good at preventing errors from happening

Communication openness (Cronbach’s α = 0.37)

 C2. Staff will freely speak up if they see something that may negatively affect patient care

 C4. Staff feel free to question the decisions or actions of those with more authority

 C6. Staff are afraid to ask questions when something does not seem right (R)

Teamwork across units (Cronbach’s α = 0.51)

 F2. Hospital units do not coordinate well with each other (R)

 F4. There is good cooperation among hospital units that need to work together

 F6. It is often unpleasant to work with staff from other hospital units (R)

 F10. Hospital units work well together to provide the best care for patients

Staffing (Cronbach’s α = 0.16)

 A2. We have enough staff to handle the workload

 A5. Staff in this unit work longer hours than is best for patient care (R)

 A13. We work in ‘crisis mode’ trying to do too much, too quickly (R)

Handoffs and transitions (Cronbach’s α = 0.60)

 F3. Things ‘fall between the cracks’ when transferring patients from one unit to another (R)

 F5. Important patient care information is often lost during shift changes (R)

 F7. Problems often occur in the exchange of information across hospital units (R)

 F11. Shift changes are problematic for patients in this hospital (R)

Non-punitive response to error (Cronbach’s α = 0.44)

 A7. Staff feel like their mistakes are held against them (R)

 A11. When an event is reported, it feels like the person is being written up, not the problem (R)

 A15. Staff worry that mistakes they make are kept in their personnel file (R)

Overall (Cronbach’s α = 0.77)