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.

dc.contributor.author

Adair, Kathryn C

dc.contributor.author

Heath, Annemarie

dc.contributor.author

Frye, Maureen A

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Frankel, Allan

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Proulx, Joshua

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Rehder, Kyle J

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Eckert, Erin

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Penny, Caitlin

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Belz, Franz

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Sexton, J Bryan

dc.date.accessioned

2022-10-03T02:05:14Z

dc.date.available

2022-10-03T02:05:14Z

dc.date.issued

2022-09

dc.date.updated

2022-10-03T02:05:12Z

dc.description.abstract

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.
dc.identifier

01209203-202209000-00001

dc.identifier.issn

1549-8417

dc.identifier.issn

1549-8425

dc.identifier.uri

https://hdl.handle.net/10161/26017

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Journal of patient safety

dc.relation.isversionof

10.1097/pts.0000000000001048

dc.subject

Humans

dc.subject

Reproducibility of Results

dc.subject

Communication

dc.subject

Psychometrics

dc.subject

Safety Management

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Delivery of Health Care

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Surveys and Questionnaires

dc.title

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.

dc.type

Journal article

duke.contributor.orcid

Adair, Kathryn C|0000-0003-4886-0002

duke.contributor.orcid

Sexton, J Bryan|0000-0002-0578-2924

pubs.begin-page

513

pubs.end-page

520

pubs.issue

6

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Staff

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Pediatrics

pubs.organisational-group

Psychiatry & Behavioral Sciences

pubs.organisational-group

Pediatrics, Critical Care Medicine

pubs.organisational-group

Psychiatry & Behavioral Sciences, Adult Psychiatry & Psychology

pubs.publication-status

Published

pubs.volume

18

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