Title
The ecometric properties of a measurement instrument for prospective risk analysis in hospital departments
Author
van Schoten, S.M.
Baines, R.J.
Spreeuwenberg, P.
de Bruijne, M.C.
Groenewegen, P.P.
Groeneweg, J.
Wagner, C.
Publication year
2014
Abstract
Safety management systems have been set up in healthcare institutions to reduce the number of adverse events. Safety management systems use a combination of activities, such as identifying and assessing safety risks in the organizational processes through retrospective and prospective risk assessments. A complementary method to already existing prospective risk analysis methods is Tripod, which measures latent risk factors in organizations through staff questionnaires. The purpose of this study is to investigate whether Tripod can be used as a method for prospective risk analysis in hospitals and whether it can assess differences in risk factors between hospital departments. Methods. Tripod measures risk factors in five organizational domains: (1) Procedures, (2) Training, (3) Communication, (4) Incompatible Goals and (5) Organization. Each domain is covered by 15 items in the questionnaire. A total of thirteen departments from two hospitals participated in this study. All healthcare staff working in the participating departments were approached. The multilevel method ecometrics was used to evaluate the validity and reliability of Tripod. Ecometrics was needed to ensure that the differences between departments were attributable to differences in risk at the departmental level and not to differences between individual perceptions of the healthcare staff. Results: A total of 626 healthcare staff completed the questionnaire, resulting in a response rate of 61.7%. Reliability coefficients were calculated for the individual level and department level. At the individual level, reliability coefficients ranged from 0.78 to 0.87, at the departmental level they ranged from 0.55 to 0.73. Intraclass correlations at the departmental level ranged from 3.7% to 8.5%, which indicate sufficient clustering of answers within departments. At both levels the domains from the questionnaire were positively interrelated and all significant. Conclusions: The results of this study show that Tripod can be used as a method for prospective risk analysis in hospitals. Results of the questionnaire provide information about latent risk factors in hospital departments. However, this study also shows that there are indications that the method is not sensitive enough to detect differences between hospital departments. Therefore, it is important to be careful when interpreting differences in potential risks between departments when using Tripod. © 2014van Schoten et al.; licensee BioMed Central Ltd.
Subject
ELSS - Earth, Life and Social Sciences
Resilient Organisations
Healthy Living
Work and Employment
Adverse event
Ecometric
Hospitals
Patient safety
Prospective risk
Prospective risk analysis
Risk factors
SHB - Safe & Healthy Business
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http://resolver.tudelft.nl/uuid:b2037698-21bf-4d51-9763-94d1cc21acad
DOI
https://doi.org/10.1186/1472-6963-14-103
TNO identifier
503247
ISSN
1472-6963
Source
BMC Health Services Research, 14 (14)
Document type
article