[Developing a questionnaire to assess the safety climate in general practices (FraSiK): transcultural adaptation--a method report].

Background: Safety climate comprises shared perceptions of safety issues and is a visible feature of a safety culture. Usually self-report questionnaires are used to assess a safety climate. The aim of this project was to develop the first German questionnaire for the assessment of the patient safety climate in general practices.
Methods: The development of the instrument was based on a US questionnaire. The ambulatory care setting differs considerably between the two countries in terms of organisational and economic issues as well as the number and variety of healthcare professionals. The process of adaptation therefore required the following steps: 1) translation of the Safety Attitudes Questionnaire, ambulatory version (SAQ-A), 2) interviews with experts on quality improvement in order to evaluate the comprehensiveness and relevance of the SAQ-A in the new context, 3) revision of items, 4) pretesting of the preliminary version on a sample of healthcare professionals from general practices and 5) a final revision.
Results: The "Fragebogen zum Sicherheitsklima in Hausarztpraxen" (FraSiK) is a questionnaire consisting of 68 items, 36 of which were adapted from the original. Altogether, 32 items, relating to the involvement of patients, communication, education and training, error management and dealing with regulations were added.
Conclusion: Substantial changes were made to the original questionnaire and items added in order to obtain an appropriate instrument for the assessment of the content and relevance of patient safety culture in the socio-cultural context of German general practices.