Item response theory-based validation of Taiwanese patient safety culture measurement instrument

“Everything boils down to culture.” For anyone who works in the field of patient safety, it does not take long to recognize the truth of this statement. Yet this consensus did not emerge at the very beginning of the patient safety era. Rather, we thought that just changing care processes and adding automated systems would suffice in dropping the adverse event rate—probably to zero. However, it did not take much time till such naïve optimism was completely nullified. Many researchers have focused on why such efforts, represented by physical improvement, could not solve problems perfectly. As evidence has grown, healthcare professionals reached an agreement: safety culture is a must-have ingredient to true improvement in patient safety.1–4