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BMC Health Services Research
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Research article

The German version of the high-performance work systems questionnaire (HPWS-G) in the context of patient safety: a validation study in a Swiss university hospital

Authors: Juliane Mielke, Sabina De Geest, Sonja Beckmann, Lynn Leppla, Xhyljeta Luta, Raphaelle-Ashley Guerbaai, Sabina Hunziker, René Schwendimann

Published in: BMC Health Services Research | Issue 1/2019

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Abstract

Background

High performance work systems (HPWSs) are successful work systems in the context of safety climate and patient safety. The 10-item HPWS questionnaire is a validated instrument developed to assess existing HPWS structures in hospitals. The objectives of this cross-sectional study were to translate the English HPWS questionnaire into German (HPWS-G), to rate its content validity, and to examine its psychometric properties.

Methods

Content validity was examined by a panel of 12 physicians and nurses, and I-CVI and S-CVI calculated. For internal consistency, Cronbach’s α and item-scale correlations were determined. Construct validity was measured via confirmatory factor analysis.
A convenience sample of 782 nurses and physicians in a University hospital setting in Switzerland’s German-speaking region was surveyed. Four inclusion criteria were applied: working in intensive care, emergency department or operating room; having daily patient contact; having worked in the current clinical area for more than three months; and more than 40% employment.

Results

A total of 281 questionnaires were completed (response rate: 35.9%). Overall, the 10-item HPWS-G questionnaire showed good content validity (I-CVI = .83–1; S-CVI = .86) and internal consistency (Cronbach’s α = .853). HPWS-G scores correlated significantly with safety climate (rs = .657, p < .01) and teamwork climate (rs = .615, p < .01). The proposed 1-factor model was accepted considering results of applied minimum rank factor analysis; a confirmatory factor analysis indicated an acceptable to good model fit (GFI = .968; CFI = .902; RMSEA = .043).

Conclusions

The HPWS-G showed good psychometric properties. In clinical practice it can be used to assess HPWS practices and for intra- and inter-hospital benchmarking. Some minor adaptions to the wording could be made as well as reassessing the psychometric properties at other clinical sites.
Footnotes
1
How many times in the last six months had CIRS cases been discussed in your clinical area, e.g. in case reviews or team meetings? (‘not at all’ to ‘once a month’).
 
2
What is the overall grade of patient safety in your clinical area? (Scale from 1 to 10).
 
3
calculated using Maximum likelihood, N = 281.
 
4
corrected p-value performing Bollen-Stine bootstrap.
 
5
Bootstrap confidence intervals.
 
6
‘teamwork is important for providing quality service to patients’.
 
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Metadata
Title
The German version of the high-performance work systems questionnaire (HPWS-G) in the context of patient safety: a validation study in a Swiss university hospital
Authors
Juliane Mielke
Sabina De Geest
Sonja Beckmann
Lynn Leppla
Xhyljeta Luta
Raphaelle-Ashley Guerbaai
Sabina Hunziker
René Schwendimann
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4189-8

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