Use of the Hospital Survey of Patient Safety Culture in Norwegian Hospitals: A Systematic Review

This review aims to provide an overview of empirical studies using the HSOPSC in Norway and to develop recommendations for further research on patient safety culture. Oria, an online catalogue of scientific databases, was searched for patient safety culture in February 2021. In addition, three articles were identified via Google Scholar searches. Out of 113 retrieved articles, a total of 20 articles were included in our review. These were divided into three categories: seven perception studies, six intervention studies, and seven reliability and validation studies. The first study conducted in Norway indicated a need to improve patient safety culture. Only one intervention study was able to substantially improve patient safety culture. The validity of HSOPSC is supported in most studies. However, one study indicated poor quality in relation to the testing of criteria related to validity. This review is limited to Norwegian healthcare but has several relevant implications across the research field, namely that intervention studies should (1) validate dimensions more carefully, (2) avoid pitfalls related to both factor analysis methods and criteria validity testing, (3) consider integrating structural models into multilevel improvement programs, and (4) benefit from applying different, new versions of HSOPSC developed in Norway.

Automated summary

This review focuses on empirical studies of patient safety culture in Norway using the HSOPSC tool, identifying the need for improvement and potential strategies for intervention. While most studies support the validity of HSOPSC, there are also concerns about the quality of certain studies' testing criteria. The review emphasizes the importance of careful validation of dimensions, avoiding methodological pitfalls, integrating structural models into improvement programs, and utilizing newer versions of the HSOPSC.