BACKGROUND: When @entity1 safety climate (PSC) surveys are used in healthcare, reporting typically focuses on PSC level (mean or per cent positive scores). This paper explores how an additional focus on PSC strength can enhance the utility of PSC survey data. SETTING AND @entity1 : 442 care providers from 24 @entity341 ( @entity341 ) across Canada. METHODS: We use anonymised data from the Can-PSCS PSC instrument collected in 2011 as part of the Qmentum accreditation programme. We examine differences in climate strength across @entity341 using the Rwg(j) and intraclass correlation coefficients measures of inter-rater agreement. RESULTS: Across the six survey dimensions, median Rwg(j) was sufficiently high to support shared climate perceptions (0.64-0.83), but varied widely across the 24 ED units. We provide an illustrative example showing vastly different climate strength (Rwg(j) range=0.17-0.86) for units with an equivalent level of PSC (eg, climate mean score=3). CONCLUSIONS: Most PSC survey results focus solely on climate level. To facilitate improvement in PSC, we advocate a simple, holistic safety climate profile including three metrics: climate level (using mean or per cent positive climate scores), climate strength (using the Rwg(j), or @entity168 as a proxy) and the shape of the distribution (using histograms to see the distribution of scores within units). In PSC research, we advocate paying attention to climate strength as an important variable in its own right. Focusing on PSC level and strength can further understanding of the extent to which PSC is a key variable in the domain of @entity1 safety.

XXXX safety climate strength: a concept that requires more attention.

@entity1 :: ('9606', 'Species') :: ['patient', 'PARTICIPANTS'] @entity168 :: ('MESH:D029461', 'Disease') :: ['SD'] @entity341 :: ('MESH:D004630', 'Disease') :: ['emergency departments', 'EDs']
@entity1 :: (9606,Species) :: ['Patient']
