Publish in this journal
Journal Information
Vol. 46. Issue 10.
Pages 568-576 (October 2022)
Download PDF
More article options
Vol. 46. Issue 10.
Pages 568-576 (October 2022)
Original article
Cross-cultural adaptation of the SCORE survey and evaluation of the impact of Real-Time Random Safety Audits in organizational culture: A multicenter study
Adaptación transcultural de la encuesta SCORE y evaluación del impacto de los análisis aleatorios de seguridad en tiempo real en la cultura organizacional: estudio multicéntrico
G. Sirgoa,
Corresponding author

Corresponding author.
, M. Olonab, M.C. Martín-Delgadoc, F. Gordod, J. Trenadoe, M. Garcíaf, M. Bodía
a Intensive Care Unit, University Hospital Joan XXIII, Pere Virgili Institute for Health Research, Rovira i Virgili University, Tarragona, Spain
b Department of Preventive Medicine, University Hospital Joan XXIII, Rovira i Virgili University, Tarragona, Spain
c Intensive Care Unit, University Hospital Torrejón, Torrejón de Ardoz, Madrid, Spain
d Intensive Care Unit, University Hospital Henares, Coslada, Madrid, Spain
e Intensive Care Unit, University Hospital Mutua de Terrasa, Terrasa, Barcelona , Spain
f Intensive Care Unit, University Hospital Río Ortega, Valladolid, Spain
Article information
Full Text
Download PDF
Additional material (1)

To establish a cross-cultural adaptation of the Safety, Communication, Operational Reliability, and Engagement (SCORE) survey and to use this instrument to evaluate the impact of a safety intervention.


Cross-cultural adaptation and before-and-after evaluation study.


5 ICU.


Medical residents, attending physicians, and nurses at those ICU.


Adaptation of the SCORE survey to Spanish culture. The adapted survey was used to assess all safety-culture-related domains before and one-year after implementing the use of a safety tool, Real-Time Random Safety Audits (in Spanish: Análisis Aleatorios de Seguridad en Tiempo Real, AASTRE).

Main outcome measure

Adaptabiliy of the Spanish version of SCORE survey in the ICU setting and evaluation of the effect of AASTRE on their domains.


The cross-cultural adaptation was adequate. Post-AASTRE survey scores [mean (standard deviation, SD)] were significantly better in the domains learning environment [50.55 (SD 20.62) vs 60.76 (SD 23.66), p<.0001], perception of local leadership [47.98 (SD 23.57) vs 62.82 (SD 27.46), p<.0001], teamwork climate [51.19 (SD 18.55) vs 55.89 (SD 20.25), p=.031], safety climate [45.07 (SD 17.60) vs 50.36 (SD 19.65), p=.01], participation decision making [3 (SD 0.82) vs 3.65 (SD 0.87), p<.0001] and advancement in the organization [3.21 (SD 0.77) vs 4.04 (SD 0.77), p<.0001]. However, post-AASTRE scores were significantly worse in the domains workload and burnout climate.


The cross-cultural adaptation of the SCORE survey into Spanish is a useful tool for ICUs. The application of the AASTRE is associated with improvements in six SCORE domains, including the safety climate.

Intensive care medicine
Organizational change
Survey safety

Establecer una adaptación transcultural de la encuesta SCORE (Safety, Communication, Operational Reliability, and Engagement) y utilizar este instrumento para evaluar el impacto de una intervención en seguridad.


Adaptación transcultural y análisis pre/post de la encuesta después de la intervención.


Cinco UCI.


Médicos residentes, médicos adjuntos y enfermeras.


Adaptación de la encuesta SCORE al castellano. La encuesta adaptada se utilizó para medir el efecto en la organización (antes y un año después) de la utilización de una herramienta de seguridad, los análisis aleatorios de seguridad en tiempo real (AASTRE).

Medidas principales

La adaptabilidad de la versión española en el entorno de la UCI y la evaluación del efecto AASTRE en sus dominios.


La adaptación intercultural fue adecuada. Las puntuaciones medias postintervención fueron mejores en los dominios, media (desviación estándar [DE]): entorno de aprendizaje (50,55 [DE 20,62] vs. 60,76 [DE 23,66], p<0,0001), percepción del liderazgo (47,98 [DE 23,57] vs. 62,82 [DE 27,46], p<0,0001), clima de trabajo en equipo (51,19 [DE 18,55] vs. 55,89 [DE 20,25], p=0,031), clima de seguridad (45,07 [DE 17,60] vs. 50,36 [DE 19,65]), participación en toma de decisiones (3 [DE 0,82] vs. 3,65 [DE 0,87], p<0,0001) y crecimiento dentro de la organización (3,21 [DE 0,77] vs. 4,04 [DE 0,77], p<0,0001). En postintervención fueron peores los dominios: carga de trabajo y clima de burnout.


La adaptación transcultural de la encuesta SCORE es un instrumento útil. La aplicación del AASTRE se asocia con mejoras en 6 dominios del SCORE, incluido el clima de seguridad.

Palabras clave:
Medicina intensiva
Cambio organizacional
Encuesta de seguridad


These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC ( )and click the link to the magazine.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe to

Medicina Intensiva (English Edition)

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Medicina Intensiva (English Edition)

Subscribe to our newsletter

Article options
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?