Development Of Safety Culture Research Articles

“What the Organization Has”: An Investigation of Situational Aspects of Safety Culture of Road Traffic Organization Using a Macroergonomic Approach

This research applied a reciprocal model to investigate the safety culture of road traffic organizations for motorcyclists’ safety. By focusing on the situational aspects, we applied the four steps of the macroergonomic approach to analyze a local government organization in Indonesia. We identified some weak elements of safety culture embedded in the sub-system level of the organization. The absence of proper education of motorcyclist candidates has led to failures in developing their skills and knowledge. In addition, we found that the existence of the item “if any” in the licensing registration procedure weakened the understanding of the importance of learning. Investigation of situational aspects revealed some critical issues regarding safety culture development by road traffic organizations.

Implementation of Coaching Approach to Formation, Maintenance and Development of Safety Culture at the «Rosatom» State Corporation Enterprises

The paper considers the possibility of using coaching as an innovative and effective technology for managerial interaction with personnel in the daily activities of the nuclear power plant leaders. The results of diagnostics of the development of management skills of managers at the Rostov nuclear power plant are presented. The obtained results of the study can be used as the basis for the strategy of forming and increasing leadership in matters of safety culture at the enterprises of the nuclear industry

A baseline assessment of patient safety culture and its associated factors from the perspective of critical care nurses: Results from 10 hospitals

IntroductionCritical care nurses are considered the key to patient safety improvement and play a vital role in enhancing quality of care in intensive care units (ICUs) where adverse events are frequent and have severe consequences. Moreover, there is recognition of the importance of the assessment and the development of patient safety culture (PSC) as a strategic focus for the improvement of patient safety and healthcare quality, notably in critical care settings. ObjectivesThis study aimed to assess critical care nurses' perception of PSC and to determine its associated factors. MethodsThis cross-sectional study was conducted among nurses working in the ICUs of the Tunisian centre (six Tunisian governorates). The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture questionnaire, comprising 10 dimensions and a total of 50 items. ResultsA total of 249 nurses from 18 ICUs participated in the study, with a participation rate of 87.36%. The dimensions scores ranged between 17.2% for the dimension “frequency of events reported” and 50.1% for the dimension “teamwork within units”. Multivariable logistic regression indicated that respondents who worked in private hospitals were five times more likely to have a developed PSC (adjusted odds ratio [AOR]: 5.34; 95% confidence interval [CI], [2.28, 12.51]; p < 10–3). Similarly, participants who worked in a certified hospital were two times more likely to have a more developed PSC than respondents who work in noncertified hospitals (AOR: 2.51; 95% CI, [.92–6.82]; p = 0.041). In addition, an increased nurse-per-patient ratio (i.e., reduced workload) increased PSC (AOR: 1.10; 95% CI, [1.02–1.12]; p = 0.018). ConclusionThis study has shown that the state of critical care nurses' PSC is critically low and these baseline results can help to form a plan of actions for improvements.

The Long and Winding Road to Developing a Patient Safety Culture.

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several recent reports on patient safety culture development in the NHS.

Assessing patient safety culture and its associated factors in 12 emergencies across Tunisia

Abstract Background Although the emergency departments (EDs) are the front line of the public health system, they are considered high-risk environments because of the shocking frequency of adverse events, within. Developing safety culture among EDs professionals, as a strategic focus, remains a priority. The purpose of this study is to measure safety culture in EDs and to determine its associated factors. Methods This is a cross-sectional and multicenter study, conducted among professionals from all the EDs of public and private healthcare institutions in central Tunisia. It was conducted from June to September 2017. The instrument tool used was the self-administered Hospital Survey On Patient Safety Culture questionnaire translated and validated by the CCECQA. Data entry and analysis were performed using SPSS 20.0 and Epi info 6. Also, ethical considerations were taken into account. Results In total, the study included 442 participants from 12 ED, with a participation rate of 80.35%. All the ten dimensions of safety culture were all to be improved. As for 'teamwork within units', it scored the highest with 46%, however, the lowest scores were attributed to 'the frequency of reported adverse events' (19.6%) followed by 'the non-punitive response to error' (19.8%). Private EDs have shown significantly higher scores regarding nine safety culture dimensions. Also, the size of the hospital was significantly associated with all dimensions of the safety culture. Conclusions This study has shown that the level of safety culture needs to be improved in public and private EDs and also underlines the importance of developing the safety culture and the implementation of safety and quality management systems. Key messages Patient safety culture is to be improved in Tunisian emergencies, although it is significantly more developed in private settings. A punitive culture still reigns in Tunisian healthcare context.

Assessment of patient safety culture in intensive care units and factors affecting it

Abstract Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals participated in the study with a participation rate of 81.94%, spread over 10 hospitals and 18 units. All dimensions were to be improved. The overall perception of safety was 32.35%. The most developed dimension was teamwork within units with a score of 47.87% and the least developed dimension was the non-punitive response to error (18.6%). The patient safety culture was significantly more developed in private hospitals in seven of the 10 dimensions. Participants working in small units had a significantly higher patient safety culture. It has been shown that when workload is reduced the patient safety culture was significantly increased. Conclusions This study has shown that the patient safety culture still needs to be improved and allowed a clearer view of the safety aspects requiring special attention. Thus, improving patient safety culture. by implementing the quality management and error reporting systems could contribute to enhance the quality of healthcare provided to patients. Key messages The culture of culpability is the main weakness in the study. Encouraging event reporting and learning from errors s should be priorities in hospitals to enhance patient safety and healthcare quality.

Assessing patient safety culture and its associated factors in Tunisian primary healthcare centers

Abstract Background Primary healthcare centers provide the first contact for patients and it goes without saying that quality and patient safety in these facilities are vital goals and challenges. In fact, it has been identified that a significant proportion of safety incidents caught in hospitals had originated in the earlier levels of care, and some studies have found that errors in primary care can result in severe consequences. Hence why, a developed Patient Safety Culture is a component key to improve patient safety and healthcare quality in these settings. Thus, this study aimed to assess patient safety culture in Tunisian primary healthcare centers and to explore its associated factors. Methods It is a cross-sectional descriptive multicenter study, conducted from January to April 2016 in all the 30 primary healthcare settings of the Tunisian center, partners of the Faculty of Medicine of Sousse. The measurement instrument used was the validated French version of the Hospital Survey on Patient Safety Culture Questionnaire. The data analysis was conducted using the Statistical Package for Social Sciences (SPSS 20.0) and Epi info 6.04d for windows. Results A total of 214 professionals participated in the study, corresponding to a response rate of 85%. The “Teamwork within units” dimension had the highest score (71.5%). The lowest scores were for the dimensions related to “Frequency of events reported” and the “Non-punitive response to errors” (31.4% and 35.4% respectively). Additionally, the “Frequency of reported events” dimension was significantly higher among professionals involved in risk management committees (p = 0.01). Conclusions This study demonstrates that the level of patient safety culture needs to be improved in primary healthcare centers in Tunisia. Strategies to nurture patient safety culture should focus upon building leadership capacity that supports open communication, blame-free environment, teamwork and continuous organizational learning. Key messages Patient safety culture in primary healthcare settings is not as strong to ensure the provision of safe care. A well-designed patient safety initiatives, with organizational policies, must be integrated in order to enhance patient safety and quality of care.

Baseline Patient Safety Culture in Cameroon: Setting a Foundation for Trauma Quality Improvement

BackgroundTrauma quality improvement (QI) has resulted in decreased trauma mortality and morbidity in high-income countries and has the potential to do the same in low- and middle-income countries. Effective implementation of QI programs relies on a foundational culture of patient safety; however, studies on trauma-related patient safety culture in Sub-Saharan Africa remain scarce. This study assesses baseline patient safety culture in Cameroon to best identify opportunities for improvement. Materials and methodsOver a 3-week period, the Hospital Survey on Patient Safety Culture was administered in three hospitals in the Littoral region of Cameroon. Percentages of positive responses (PPRs) were calculated across 42 items in 12 survey dimensions. A mixed-effects logistic regression model was used to summarize dimension-level percentages and confidence intervals. ResultsA total of 179 trauma-related hospital personnel were surveyed with an overall response rate of 76.8%. High PPRs indicate favorable patient safety culture. Of the 12 dimensions evaluated by the Hospital Survey on Patient Safety Culture, nine had a PPR below 50%. Dimensions particularly pertinent in the context of QI include Nonpunitive Response to Errors with a PPR of 25.8% and Organization Learning—Continuous Improvement with a PPR of 64.7%. ConclusionsThe present study elucidates an opportunity for the development of trauma patient safety culture in Cameroon. Low PPR for Nonpunitive Response to Errors indicates a need to shift cultural paradigms from ascribing individual blame to addressing systemic shortcomings of patient care. Moving forward, data from this study will inform interventions to cultivate patient safety culture in partnering Cameroonian hospitals.

Prevalence of work-related musculoskeletal pain in masonry apprentices

The construction industry, specifically masonry, reports more work-related musculoskeletal disorders (WMSD) rates than the general industry. Masonry apprentices are assumed to be healthy, yet may have WMSDs. The purpose of this study was to evaluate the prevalence of musculoskeletal symptoms (MSS), time loss, and healthcare use among apprentices. 183 brick and block masonry apprentices completed surveys on demographics, work history, MSS, and functional well-being. The prevalence of MSS was calculated by body region, time loss, and healthcare use. The relationship between MSS, and perceived global physical and mental health was assessed. Approximately 78% of apprentices reported MSS, most in several body regions. Low back and wrists/hands were most prevalent, although few missed work or sought healthcare. Lower functional health and well-being was reported. Apprentices reported MSS comparable to previous studies of journey-level masons. Apprenticeship programmes could integrate ergonomics education to help apprentices develop safety culture early in their careers. Practitioner Summary: New masonry workers (apprentices) are assumed to be healthy yet work-related musculoskeletal symptoms (MSS) may be common early in their career. The prevalence of MSS was assessed among apprentices. Approximately 78% of apprentices reported MSS, most in several body regions, comparable to journey-level masons. Abbreviations: WMSD: work-related musculoskeletal disorders; MSS: musculoskeletal symptoms; SAVE: SAfety voice for ergonomics; MNQ: modified nordic questionnaire; FTE: full-time equivalent; SF-12: short from-12v2

Exploring the role of managers in the development of a safety culture in seven French healthcare facilities: a qualitative study

BackgroundNumerous studies have been conducted over the past 15 years to assess safety culture within healthcare facilities; in general, these studies have shown the pivotal role that managers play in its development. However, little is known about what healthcare managers actually do to support this development, and how caregivers and managers represent managers’role. Thus the objectives of this study were to explore: i) caregivers and managers’ perceptions and representations of safety, ii) the role of managers in the development of safety culture as perceived by themselves and by caregivers, iii) managers’ activities related to the development of safety culture.MethodsAn exploratory, multicentre, qualitative study was conducted from May 2014 to March 2015 in seven healthcare facilities in France. Semi-structured interviews were conducted with managers (frontline, middle and top level) and caregivers (doctors, nurses and nurse assistants) and on-site observations of two managers were carried out in all facilities. A thematic analysis of semi-structured interviews was performed. Observed activities were categorised using Luthans’ typology of managerial activities.ResultsParticipants in semi-structured interviews (44 managers and 21 caregivers) expressed positive perceptions of the level of safety in their facility. Support from frontline management was particularly appreciated, while support from top managers was identified as an area for improvement. Six main categories of safety-related activities were both observed among managers and regularly expressed by participants. However, caregivers’ expectations of their managers and managerial perceptions of these expectations only partially overlapped.ConclusionsThe present study highlights current categories of managerial activities that foster safety culture, and points out an important gap between caregivers’ expectations of their managers, and managerial perceptions of these expectations. The findings underline the need to allow more time for managers and caregivers to talk about safety issues. The results could be used to develop training programs to help healthcare managers to understand their role in the development of safety culture.

Development of Safety and Health Culture of Construction Project Through Academic Institution and Industry Linkages on TVET Platform: A Proposed Study

The increasing trend of occupational accident due to unsafe behavior and unsafe act especially in construction site suggests the need for more effective assessment model or framework towards a more proactive measure. The objective of this study is to development of safety and health culture of construction project through academic institution and industry linkages through Technical and Vocational Education and Training (TVET) platform. The cooperation of employers and employees, together with the government agencies, Academic institution, public –private networking and the Construction Industry Development Board (CIDB) of Malaysia towards excellence safety culture and sustainable development. The review on construction industry and related issues, Institutional perspectives on safety climate, a systems approach to workforce development and Malaysia’s TVET developments is the key element of study and it is combination of several approaches. The framework of the study and flowchart were present to ensure the proposed study is ready to execute.

LCB approach for construction safety

The unsafe behavior that is seen everywhere on construction sites is the biggest challenge for further improvement of construction safety performance. Focusing on the “human” related issues in construction safety, this paper reviews the research and practices of safety management and comes up with three key elements to look at, namely safety leadership, safety culture, and safety behavior. Through systematic exploration on the connotation of and interaction between safety leadership, safety culture, and safety behavior, a Leadership-Culture-Behavior (LCB) approach for construction safety is proposed with the kernel - leadership driven culture development and behavior control. The LCB approach emphasizes the role of safety leadership to not only directly reduce unsafe behavior but also to fundamentally change the causes of unsafe behavior through safety culture development, ultimately achieving the goal of reducing unsafe behaviors sustainably and preventing accidents. The LCB approach has been implemented in a number of railway and building projects in mainland and Hong Kong SAR, China, and Singapore. Significant improvement of L/C/B has been observed. Taking a high-speed railway project in China as an example, safety leadership, safety culture, and safety behavior of the project stakeholders at all levels were significantly improved. In the end, based on LCB, new directions and potential areas for future research of construction safety are discussed.

Test of a safety culture model from a management perspective

Purpose – The importance of developing theoretical models and their empirical validation, capable of explaining safety performance within organizations, has been pointed out by the scientific community. Fernandez-Muniz, Montes-Peon, and Vazquez-Ordaz (2007) proposed a model that integrates dimensions considered as determinants of safety culture to explain safety performance, which was tested with Occupational Health and Safety technicians of Spanish companies. This study aims to verify if that theoretical model obtains empirical support in the Portuguese context, considering the supervisors’ perspective. In addition, it also aims to contribute to the adaptation of the measurement instrument, which allowed for the empirical test of the model in the Portuguese context. Design/methodology/approach – The study conducted is quantitative with a cross-sectional study design. In total, 174 supervisors at different levels of supervision, in different Portuguese companies from different activity sectors, participated in the study. Data were gathered through the Portuguese version of the instrument developed by the authors of the model (Fernandez-Muniz et al., 2007). Findings – The results partially confirm the proposed model wherein supervisors play a determinant role in the development of safety culture and thus in the safety performance of organizations. Originality/value – This study addresses one of the demands present in the literature, having empirically tested a model that aims to explain the safety performance of organizations, expanding its application to the management perspective and to a different national context. The results emphasize the role supervisors may play in the development of safer organizations.

Structural equation model of construction safety culture dimensions in foreign company in Indonesia

The level of work accidents in one project is greatly influenced by the level maturity of safety culture are founded by some structural elements. In Indonesia, the construction industry is growing up and many foreign construction companies come and expand their business in Indonesia, which well-known for having better maturity. The aim of this research is to know the safety culture dimensions in foreign construction companies in Indonesia and the relationship model of those structural elements. Methodology of this research survey respondent and the analysis was conducted using SMART PLS application software to obtain the results of relationships between dimensions. The results are ten safety culture dimensions in foreign construction companies in Indonesia and 16 relationships that are significant relationship in developing safety culture in foreign construction company. The most influential dimensions are leadership and the value of safety among the workers to developing safety culture and expected to be applied to public and private companies in Indonesia.

Development and Implementation of Methods for Behavioral Safety Audit Conducting in the Fuel and Energy Complex

The analysis of the accident and industrial injury statistics shows that the majority of accidents and industrial accidents (more than 70%) are caused by the mistakes of the operational personnel servicing the hazardous production facilities connected with violation of requirements of the organization and production of hazardous works. One of the priority directions of the state policy of the Russian Federation in the field of industrial safety till 2025 is the development of industrial safety culture, awareness of personal responsibility for a condition of industrial safety, formation of the intolerant relation to violations of safety requirements, in particular, due to implementation of scientific and technical achievements and the best practices. This study proposed a new approach to ensuring safety on objects of fuel and energy complex establishing rules of conducting the behavioral safety audit (BSA), assessment of identified hazardous actions and use of preventive measures. Within approbation of this new approach to safety ensuring we have made the procedure of mathematical processing of results of 264 conducted BSA on one of gas transmission companies. Implementation of approach boosts safety culture of production, prevention of the industrial accidents and accidents caused by unsafe behaviour and actions of workers.

Developing Safety Culture Framework for the Malaysian Port Industries

Developing Safety Culture Framework for the Malaysian Port Industries

The Venus model for integrating practitioner-led workforce transformation and complex change across the health care system.

The aim of this paper is to present the Venus model for workforce transformation, demonstrating its research origins, theoretical foundations, and practical application for enabling individuals, teams, and services to sustain transformation in the workplace. The paper provides a brief synopsis of how the Venus model was generated from four large-scale mixed-method studies embracing workforce transformation, safety culture, integrated facilitation, and continuous professional development. The Venus model has five stems and identifies key integrated skill sets pivotal to successful transformation, which are interdependent: Being able to facilitate an integrated approach to learning, development, improvement, knowledge translation, inquiry, and innovation-drawing on the workplace itself as an influential resource; Being a transformational and collective leader building relationships that encourage curiosity, creativity, and harnessing the talents of all not just a few; Being a skilled practice developer focused on achieving the key values of being person-centred, and the ways of working that are collaborative, inclusive, and participative; Applying improvement skills that enable small step change using measurement wisely to focus on measuring what is valued as well as evaluating positive progress; and, finally Facilitating culture change at the micro-systems level while being attuned to the organizational and systems enablers required to support this. The paper concludes with consideration of implications for implementation of the model and its relevance for practice, policy, education, and future research as well as outlining potential limitations and conclusions.

Organizational structure and safety culture: Conceptual and practical challenges

This essay argues that:(1.)The concepts of both “safety” and “safety culture” are under-developed in organizational analysis. This has led to ambiguity and confusion in our understanding of the causal connection of both to specific elements of organizational structure.(2.)There is more complexity in the link between structure and safety culture as features of organization than might be supposed. The actual content of structural elements such as roles and rules, functional lines and limits of authority, accountability and communication – can themselves require closely supporting cultural norms of acceptance to actually function as formally described. Otherwise a formal organization chart can be a highly misleading picture, as they often are, of actual transactions occurring within a functioning organization.(3.)But the relationship between structure and safety culture can be different in the different phases of (1) the initial change of cultural or sub-culture features that undermine safety, (2) safety culture development and finally, (3) the challenge of the continued maintenance of a safety culture over time in an organization.(4.)Both specific safety management structures and a reinforcing safety culture are essential within an organization to reach across the scope of activities and time frames necessary for reliable safety performance.The implications of these points are explored for both future safety research and regulatory practice concerning organizational structure and safety culture and, ultimately, to connecting both to the improvement of safety performance.

Can Teamwork Promote Safety in Organizations?

In this review, we conceptualize teamwork as the linchpin driving safety performance throughout an organization. Safety is promoted by teams through various mechanisms that interact in a complex and dynamic process. We press pause on this dynamic process to organize a discussion highlighting the critical role played by teamwork factors in the engagement of safe and unsafe behavior, identifying five team-level emergent states that enable effective teamwork and safety: psychological safety, team trust, collective efficacy, shared mental models, and situation awareness. Additionally, we consider foundational conditions that support team-driven safety, the development of safety culture, and the importance of team safety climate in shaping performance. We discuss leveraging teams to generate safety and identify directions for future research investigating the relationship between teamwork and safety. Overall, we submit that researchers and practitioners would benefit from taking a systems perspective of safety by integrating principles of team science to better understand and promote safety in organizations.

Development of Safety Culture

Development of Safety Culture