Validação de conteúdo de instrumento para avaliação da gestão de riscos assistenciais em serviços de saúde

Abstract

Reducing risks related to health care is a widely recommended practice, but it is necessary to develop valid instruments that measure adherence to this good practice for patient safety. The objective of this study is to perform the validity analysis of the Questionnaire for Assessment of Management of Health Care Risks (AGRASS). It is a validation study developed in 4 stages: 1) Multidisciplinary formal assessment; 2) Nominal group for validity analysis with national specialists (n = 10 participants); 3) Development of software and national pilot study in 62 hospitals in all regions of Brazil; 4) Delphi for validity analysis with users of the state and municipal spheres questionnaire (n = 34 participants). In steps 2 and 4, items were judged on face validity, content validity, utility and viability, on a likert 1-7 scale (median cut-off point <6). The initial version of the instrument (98 items) was adapted during steps 1 to 3 for the version with 40 items considered relevant, of adequate content, useful and viable. The instrument has two dimensions and nine sub-dimensions, applies by interview, requires verification of compliance vouchers, and items have a closed answer option (yes or no). The automatic collection and analysis software generate automatic indicators, tables and graphs for the evaluated institution and aggregated sets, facilitating the decision-making of the evaluator. After applying to hospitals, the professionals who applied the instrument assigned a median of 7 in all the criteria and items evaluated. The AGRASS questionnaire is a potentially useful instrument for the management of care risks and can contribute to the surveillance and monitoring of patient safety in health services.