Patient Safety Climate in Healthcare Organizations (PSCHO)


Author of Tool: 

Singer, S., Meterko, M., Baker, L., Gaba, D., Falwell, A., & Rosen, A.

Key references: 

Singer, S., Meterko, M., Baker, L., Gaba, D., Falwell, A., & Rosen, A. (2007). Workforce Perceptions of Hospital Safety Culture: Development and Validation of the Patient Safety Climate in Healthcare Organizations Survey. Health Services Research, 24, 1999-2021.

Singer, S. J., Hartmann, C. W., Hanchate, A., Zhao, S., Meterko, M., Shokeen, P., … & Rosen, A. K. (2009). Comparing safety climate between two populations of hospitals in the united states. Health Services Research, 44, 1563-1584.

Singer, S. J., D. M. Gaba, J. J. Geppert, A. D. Sinalko, S. K. Howard, and K. C. Park. (2003). ‘‘The Culture of Safety in California Hospitals.’’ Quality and Safety in Health Care 12 (2): 112–18.

Singer, S., Lin, S., Falwell, A., Gaba, D., & Baker, L. (2009). Relationship of Safety Climate and Safety Performance in Hospitals. Health Services Research, 44, 399-421.

Primary use / Purpose: 

The PSCHO is designed to assess healthcare employees’ perception of the safety culture in their organization.


The PSCHO is a 45 item measure that assesses safety culture in healthcare organizations. Six close-ended demographic items are also included. The PSCHO is comprised of 12 subscales that assess different aspects of safety climate. These subscales are grouped into four categories: hospital contributions to safety climate, work unit contributions to safety climate, interpersonal contributions to safety climate, and other aspects of safety climate. The hospital contributions to safety climate is composed of the senior managers’ engagement, organizational resources for safety, and overall emphasis on patient safety subscales. The work unit contributions to safety is composed of the unit managers’ support, unit safety norms, unit recognition and support for safety efforts, collective learning, psychological safety, and problem responsiveness subscales. The interpersonal contributions to safety climate is composed of the fear of shame and fear of blame and punishment subscales. Finally, the other aspects of safety climate section examines the provision of safe care.


The psychometric properties of the instrument are examined in Singer et al. (2009).



PDF iconPatient Safety Climate in Healthcare Organization

Other Information: 

Scoring is described in Singer et al. (2009).

Digital Object Identifier (DOI):


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