High Safety Culture Research Articles

Выбор работниками горнодобывающих предприятий вариантов соблюдения требований охраны труда и промышленной безопасности

The reduction of occupational injuries at Russian mining enterprises is significantly hampered by mass and constantly repeated violations of requirements of occupational and industrial safety by employees. The problem is being addressed at all levels of enterprise, company, and industry management and involves trade unions and state supervision authorities. The international and Russian best practices for the formation of a high-safety culture have been actively adopted. Coal-mining companies and ore mining and processing plants organize training for risk management, and development of skills of safe behavior in the production environment for their personnel on a constant basis, which provided some results; however, the problem has not been resolved completely. The suggested approach to deal with the issue aims at the identification of those behavioral options to comply with requirements of occupational and industrial safety during production activities that are preferred by employees. Based on questionnaires filled by personnel of coal mining enterprises, the outcome of each option selected by employees has been analyzed. As a processing database of the questionnaire results, a game theory has been proposed: an employee is considered a «player» interacting with «nature», i.e., the working environment, whereas the comprehensive assessment based on criteria of Laplace, Wald, Savage, and Hurwitz has been used as a toolset. A set of potential strategies (options) adopted by an employee in order to comply with requirements of occupational and industrial safety has been established; the distinctive features of options have been presented. As a result of a questionnaire survey among employees, the information data has been collected to determine the expected outcome of a chosen strategy. The obtained information has been mathematically processed; the dominant strategy has been identified, and the probabilities of use of the other strategies have been calculated. The study results can be used to develop justified managing solutions by the enterprise's top-management in order to reduce repeated and mass violations of safety requirements, which will facilitate sustainable improvement of the occupational safety at mining enterprises.

On the issue of creating an algorithm for assessing safety culture in modern healthcare institutions

Healthcare institutions with a high culture of patient safety are characterized by the appropriate level of mutual trust of employees, a general understanding of the importance of patient safety issues, the presence of an effective system of preventive measures to ensure the safety of both medical personnel and the patient, which has been implemented. Moreover, maintaining a high safety culture requires an understanding of certain norms of behavior and attitude towards the patient from the stand point of ensuring his maximum safety, which contributes to compliance with treatment standards and the development of safe behavior. The aim of the study was to create and scientifically substantiate an algorithm for analytical assessment of the level of safety culture in modern healthcare institutions. The research was conducted on the basis of the Dental Medical Center of Bogomolets National Medical University. Hygienic and medical-sociological methods and methods of expert assessment and statistical analysis were used in the work. Expert assessment maps of the leading components of safety culture served as the material of the conducted research. The organizational and target structure of the scientific work provided for the determination of the structural features of the leading components of safety culture and the development of a scoring scale for their assessment, the implementation of an expert evaluation of the specified components and the establishment of the degree of consistency of the opinions of experts, the calculation of the weighting coefficients of the influence of various components on the formation of a certain level of safety culture and the justification of objective statistical approaches to assessing the level of safety culture. In the course of the conducted research, a high degree of consistency of experts’opinions was revealed and the values of weighting coefficient swere calculated, which made it possible to develop generalized formulas for determining the values of indicators of the level of safety culture provision in modern healthcare institutions from the standpoint of assessing the degree of influence on the level of safety culture of the leading characteristics of dangerous actions of a person (doctor, specialist, etc.) (Component No. 1), identifying the degree of influence on the level of safety culture of both strengths and weaknesses in creating a safe medical environment (Component No. 2) and establishing the degree of influence on the level of safety culture of dangerous production factors inherent for medical environment (Component No. 3). It is sub­stantiated that the process of creating an algorithm for analytical assessment of the level of safety culture in modern healthcare institutions should involve the implementation of the following stages: establishing the degree of expression of the leading indicators that are components of each of its main components, using special scales (1ststage), determining the values indicators of ensuring the level of patient safety culture for each of the components using the appropriate generalized formulas (2ndstage), evaluation and meaningful interpretation of the values of indicators of the level of safety culture based on quantitative criteria (3rdstage), determination of collective, group or personalized, according to the content, strategies application of preventive measures aimed at increasing the level of safety culture in each specific case (4thstage).

Workforce safety culture, job stress and job satisfaction in an automotive industry

Safety culture as an organizational factor has an essential role in preventing occupational injuries and diseases. In this descriptive-analytical study, the relationship between organizational safety culture, job stress and satisfaction has been investigated to have a better understanding of the effect of this organizational factor on employee job stress and satisfaction. Three valid tools, including the Safety culture questionnaire, standard job stress questionnaire (JSQ), and Standard Minnesota Job Satisfaction Questionnaire, were used. The study population consisted of 210 workers working in 13 production halls of an automotive industry who were selected by a simple random sampling method. After data collecting, SPSS software version 22 was used for data analysis, and AMOS software version 24 was used for confirmatory factor analysis. The results show a significant relationship between trained and untrained groups and safety culture (p = 0.002), job stress and education level (p = 0.006), and job satisfaction and education level (p = 0.011). Safety culture score was significantly different in trained and untrained groups (p = 0.002). Factor analysis showed that a workplace with higher safety culture could lead to less job stress and more job satisfaction in employees. Based on the results, safety culture affects job satisfaction and job stress. Also, we found safety and health education is one of the factors affecting safety culture, job satisfaction, and stress. Safety culture could result in less job stress and more job satisfaction in employees. Improving it will improve the safety and health situation and ultimately increase job satisfaction and reduce job stress.

The limits of soft safety regulation: Does successful work with safety culture require SMS implementation?

The Swedish Transport Agency defined contributing to a high safety culture in transport companies as a key element in its regulatory strategy. This study examines how the safety culture strategy was received and enacted by regulators and companies within each transport sector, and factors influencing this. We discuss what a regulatory agency can accomplish through a safety culture strategy, and the extent to which it is bounded by the safety management maturity level in each sector. A key question is whether safety management requires a sequential, or evolutionary development, where companies must implement well-functioning safety management systems (SMS) before being organisationally mature enough to work successfully with safety culture. Our results seem to support this assertion, as we find that transport sectors with legal SMS requirements focus on safety culture, and work with safety culture elements (e.g. reporting/just culture, continuous improvement, involvement) to ensure that the SMS is a living system. Sectors without SMS requirements (i.e. road) do not focus on safety culture. Without SMS, it seems that safety culture work equals focusing on safety commitment among managers and employees. We identify additional factors influencing organisational maturity level and safety culture focus, limiting soft safety regulation, e.g. business structure, maintaining equal conditions for competition.

Moderating effect of safety culture on the association inter work schedule and driving performance using the theory of situation awareness

The adverse effects of work schedule on driving performance are relatively common. Therefore, it is necessary to fully understand an organisation’s safety culture to improve driver performance in order to avoid road crashes. This study aims to investigate the moderating role of safety culture in the relationship between driver work schedules and driving performance. The study developed a conceptual framework based on the literature review of existing studies, which is supported by situation awareness theory that explains the model’s relationships and supports the study’s hypotheses. Three hundred four questionnaires were collected from oil and gas truck drivers then Structural equation modelling (SEM) was applied to test the study hypotheses. Derived from the findings, the outer loading for all items was above the threshold of 0.70 unless two items were deleted. The latent exogenous variables of safety culture and work schedule explained 59.1% of driving performance. Besides, work schedule and safety culture significantly impact driving performance. In addition, the results show that safety culture moderates the unfavourable work schedule impact on driving performance with an effect size of 23%. Therefore, this study showed strong evidence that safety culture acts as a critical moderator in reducing the negative impact of work schedule on driving performance in the energy transportation sector. Drivers with high safety culture can manage and reduce the effect of work schedule disorder on driving performance through their safety attitude and patterns compared to those drivers with low safety culture. Consequently, the improvement in driving performance will be noticed among drivers with a high awareness of safety culture.

Occupational risk assessment based on employees’ knowledge and awareness of hazards in mining

Analyses and assessments of hazards occurring in work processes are carried out by teams, in which there is usually one representative of the personnel, as the embodiment of the active participation of employees in the assessment of occupational risks. This is why the article presents research on all employees’ knowledge and awareness about risks in their work environment. The research was carried out in the form of an employee survey in one of the open-pit mines, at workstations dealing with the loading and transporting of excavated material. The survey included a list of 40 hazards divided into four groups: (1) hazards related to machines and equipment used, (2) hazards related to exposure, (3) hazards with an impact extending beyond the workstation and (4) hazards of an ergonomic nuisance nature, where employees were required to indicate which hazards apply to their workplaces and determine their level of significance, probability of occurrence and the scale of possible effects. In this way, a hierarchical identification of threats occurring at the analyzed workplaces was made, and the obtained results were used to determine the amount of occupational risk both for specific workstations and for the whole technological process. The measures of the magnitude of occupational risk obtained using the proposed method have showed that, according to the respondents, greatest risks at the workstation are associated with moving machines and vehicles and with mobile equipment. Equally important risks, which were often mentioned by employees, were those directly related to their health, i.e., related to ergonomic nuisance and exposure. Threats resulting from geological and mining conditions, considered typical for mining, were important for the surveyed miners but they were not the most important owing to proper prevention, good organization of work and high safety culture The active involvement of the crew in the process of assessing occupational hazards allowed to identify the significance of each hazard, in the opinion of the personnel working at various places and to use this ranking for determining occupational risk levels in the mining company concerned. The research has also outlined another goal to be achieved: a comparison of the relative significance of hazards identified by the employees and of the hazards listed in occupational risk assessment matrices used by mines.

The Safety Culture Among the Employees of the Operational Units of South Zagros Oil & Gas Production Company, Iran

Background: Safety plays a significant role in the oil & gas industries, where there are many risk factors that can cause accidents. This study aims to evaluate the level of safety culture among the employees of the operational units of South Zagros Oil & Gas Production Company (SZOGPC). Materials and Methods: In this descriptive-analytical study, a standardized safety culture questionnaire with 50 items and five domains of education, workplace, safety priority, information exchange, and management commitment was used. All employees in the operational units of the SZOGPC were selected as samples (n=260). They answered the questions based on Five-point Likert scales. After collecting the data, their were entered into SPSS software, v. 23. Results: The mean safety culture score in Parsian operational unit was higher than in other operational units. The lowest level of safety culture was related to the operational unit of Sarkhun & South Gashu. The Mean±SD of total safety culture score was 19.03±0.248. Among the safety culture domains, safety priority had the highest score, while the workplace had the lowest score. Conclusion: The safety culture among the employees of the operational units of the SZOGPC is at moderate level. The managers of this company should improve the safety culture among their employees; a positive and high safety culture among employees can facilitate the organization’s movement to achieve higher safety standards.

Peran Pedoman Safety Management System pada Perguruan Tinggi Dalam Negeri dalam Menghadapi Ancaman Pandemi Virus

The COVID-19 pandemic has changed the shape of the world of work. This change makes 100% of universities in Indonesia conduct online learning, but some academic administrative activities are still carried out on campus. With this condition, higher education management faces two things that must be considered, namely the health of employees who are still working on campus, and teaching staff who work at home. The purpose of this study is to make the right size in measuring the Safety Management System in Higher Education in dealing with the threat of the virus and to examine the role of Management Commitment to the implementation of the Safety Management System and to examine the role of Safety Culture in the implementation of the Safety Management System. This research is a survey research using a questionnaire, with data analysis method using Path Analysis and Binomial Regression and validity test using Confirmatory Factor Analysis. From the results of this study, it can be seen that a high Safety Culture cannot improve Safety Performance in Higher Education during the pandemic, which is different from Management Commitment and the Safety Management System which are the main determinants of employee Safety Performance during the pandemic. Management's commitment can indeed improve employee Safety Performance during a pandemic, but in improving Safety Performance during a pandemic, performance will be higher if the management commitment pushes the Safety Management System first, then it will increase the organization's Safety Performance with the virus pandemic.

Association of Implementation and Social Network Factors With Patient Safety Culture in Medical Homes: A Coincidence Analysis.

The patient-centered medical home (PCMH) may provide a key model for ambulatory patient safety. Our objective was to explore which PCMH and patient safety implementation and social network factors may be necessary or sufficient for higher patient safety culture. This was a cross-case analysis study in 25 diverse U.S. PCMHs. Data sources included interviews of a clinician and an administrator in each PCMH, surveys of clinicians and staff, and existing data on the PCMHs' characteristics. We used coincidence analysis, a novel method based on set theory and Boolean logic, to evaluate relationships between factors and the implementation outcome of patient safety culture. The coincidence analysis identified 5 equally parsimonious solutions (4 factors), accounting for all practices with higher safety culture. Three solutions contained the same core minimally sufficient condition: the implementation factor leadership priority for patient safety and the social network factor reciprocity in advice-seeking network ties (advice-seeking relationships). This minimally sufficient condition had the highest coverage (5/7 practices scoring higher on the outcome) and best performance across solutions; all included leadership priority for patient safety. Other key factors included self-efficacy and job satisfaction and quality improvement climate. The most common factor whose absence was associated with the outcome was a well-functioning process for behavioral health. Our findings suggest that PCMH safety culture is higher when clinicians and staff perceive that leadership prioritizes patient safety and when high reciprocity among staff exists. Interventions to improve patient safety should consider measuring and addressing these key factors.

Safety culture, safety management and accident risk in trucking companies

The Safety ladder for goods transport describes an approach with an increasing prevalence of safety structural measures at four Safety ladder levels in trucking companies. This paper validates the Safety ladder approach in empirical research by comparing safety structure, safety culture and accident risk for trucking companies. The study has four aims: 1) To map the safety structure at the different levels of the Safety ladder, 2) Examine whether safety culture is improved with increased structural measures at each Safety ladder level, 3) Examine whether the accident risk decreases at each Safety ladder level, and 4) Discuss practical implications. The study is based on survey data (N = 533) from 17 companies at different levels of the Safety ladder, a Reference sample, and qualitative interviews (N = 30) with management and employee representatives in the companies. Based on the interviews, we describe the safety structural measures at each level of the Safety ladder. Survey results indicate increasing safety culture scores at each level of the Safety ladder, while the accident risk decreases. The safety culture level was 12 points higher at Level 4, than in the Reference sample, and the accident risk at Level 4 was half the risk of Level 2. We conclude by suggesting the concrete management practices related to each level. Thus, the current study identifies and describes management practices in trucking companies that are associated with high safety culture scores and low accident risk.

Analysing and Assessing the State of Safety Culture at the Mining Industry Facilities in the Irkutsk Region

Safety at work is an important factor in the successful operation of an enterprise. In practice, it is quite difficult to achieve safety at work, but there exist all necessary conditions for this. The article considers the role of the systematic management of an enterprise, which helps to ensure safety at all stages of the production life cycle. In the paper, we discuss the system of organizational culture that supports the management system, the concept of safety culture and how it can be implemented. Also in this study, we discuss the history of systematic safety management drawing on the experience of mining enterprises in the Irkutsk Region. The article contains practical research and calculated data on the evaluation of safety culture at such enterprises as Angasolsky Crushed Stone Plant, Pereval Quarry, and the stone-cutting production of Baikalquartzsamotsvety OJSC. The article concludes with a discussion of how to achieve high safety culture at these enterprises taking into account the regulatory environment that can encourage the development of the systematic safety culture management without this being a burden for organizations.

Impacto de la adecuación del protocolo de preparación prequirúrgica en la incidencia de infección de localización quirúrgica en cirugía cervical

BackgroundSurgical wound infection is one of the leading causes of healthcare-associated infections. One of the most common measures for its reduction is the pre-surgical preparation. The aim of this study was to evaluate the adequacy to the pre-surgical protocol in patients undergoing neck surgery and the relationship with the incidence of surgical wound infection. Material and methodsObservational cohort study, conducted from January 2011 to December 2017. Variables related to patient, pre-surgical preparation and infection were collected. Infection rate was calculated after a maximum period of 30days after surgery. The effect of the pre-surgical preparation's adequacy and infection was evaluated. ResultsThe study included 131 patients. The global adequacy of the pre-surgical protocol was 84.7%, being the main cause of inadequacy the application of the mouthwash (7.6% of the interventions). The overall incidence of surgical wound infection during the follow-up period was 4.6% (95%CI: 1.0%-8.2%). No relationship between the adequacy to the protocol and the presence of infection was found (P=.59). ConclusionsAdequacy of the pre-surgical preparation in our hospital was high and the incidence of surgical wound infection was low, and no relationship was found between the two. The results show a high safety culture in this surgery. However, there is still room for improvement in the quality of care of our patients.

The Association Between Professional Burnout and Engagement With Patient Safety Culture and Outcomes: A Systematic Review.

In the last 20 years, there have been numerous successful efforts to improve patient safety, although recent research still shows a significant gap. Researchers have begun exploring the impact of individual level factors on patient safety culture and safety outcomes. This review examines the state of the science exploring the impact of professional burnout and engagement on patient safety culture and safety outcomes. A systematic search was conducted in CINAHL, PubMed, and Embase. Studies included reported on the relationships among burnout or engagement and safety culture or safety outcomes. Twenty-two studies met inclusion criteria. Ten studies showed a relationship between both safety culture and clinical errors with burnout. Two of 3 studies reported an association between burnout and patient outcomes. Fewer studies focused on engagement. Most studies exploring engagement and safety culture found a moderately strong positive association. The limited evidence on the relationship between engagement and errors depicts inconsistent findings. Only one study explored engagement and patient outcomes, which failed to find a relationship. The burnout/safety literature should be expanded to a multidisciplinary focus. Mixed results of the relationship between burnout and errors could be due to a disparate relationship with perceived versus observed errors. The engagement/safety literature is immature, although high engagement seems to be associated with high safety culture. Extending this science into safety outcomes would be meaningful, especially in light of the recent focus on an abundance-based approach to safety.

Lessons from Chernobyl and Fukushima and Advanced Control Concepts for Severe Accidents

The year 2016 marks the 30th anniversary of the accident in the No. 4 unit of the Chernobyl NPP and the 5th anniversary of the accident at the Fukushima NPP in Japan. The Chernobyl accident substantially changed the public’s attitude toward severe accidents at NPPs, promoting on the one hand modernization and improvement of safety systems and on the other hand a higher safety culture by harmonization of standards and regulations, and adoption of deeply echeloned protection and a scientifically validated approach to the analysis of accidents. The Fukushima accident revealed a new class of accidents – extreme actions caused by naturally occurring cataclysms and/or different external actions, which actually are identical to loss of a large part or all of the means for controlling an accident. The present article examines the main lessons on accidents in terms of understanding the phenomenology of the events occurring during severe accidents and confirms the importance of the deterministic component of the safety concept. At the same time, it emphasizes that special attention must be given to hydrogen safety, systems for prolonged removal of residual heat, emergency readiness, and emergency response under the extreme conditions of severe accidents. The computational means used to develop accident counter-measures must be properly set to take account of the design features of the reactor facility, the containment of the NPP, and the adjoining territories in order to determine the time required to implement the procedures for controlling accidents and mitigating the consequences.

METHODOLOGICAL APPROACH TO SAFETY CULTURE ASSESMENT IN MEDICAL ORGANISATION

Безопасность пациента является важнейшим компонентом качества медицинской деятельности. Литературные данные показывают, что если у организации развита культура безопасности, это способствует правильному соблюдению стандартов безопасности, высокому уровню сообщений о медицинских ошибок и развитию безопасного поведения. Целью настоящего исследования является определение оптимального метода исследования культуры безопасности в многопрофильной клинике г. Москвы. Дана сравнительная характеристика – HSPSC и SAQ. Были проанализированы преимущества и недостатки каждого из опросников, включая удобство заполнения, время для заполнения, возможность сравнения полученных результатов с другими клиниками, основные фокусы данных опросников. В результате сделан вывод о целесообразности использования опросника HSPSC для исследования культуры безопасности в многопрофильной клинике г. Москвы с учетом культурных, социальных и экономических факторов.

Journey Toward High Reliability: A Comprehensive Safety Program to Improve Quality of Care and Safety Culture in a Large, Multisite Radiation Oncology Department.

High-reliability organizations (HROs) focus on continuous identification and improvement of safety issues. We sought to advance a large, multisite radiation oncology department toward high reliability through the implementation of a comprehensive safety culture (SC) program at the University of Pennsylvania Department of Radiation Oncology. In 2011, with guidance from safety literature and experts in HROs, we designed an SC framework to reduce radiation errors. All state-reported medical events (SRMEs) from 2009 to 2016 were retrospectively reviewed and plotted on a control chart. Changes in SC grade were assessed using the Agency for Healthcare Research and Quality Hospital Survey. Outcomes measured included the number of radiation treatment fractions and days between SRMEs, as well as SC grade. Multifaceted safety initiatives were implemented at our main academic center and across all network sites. Postintervention results demonstrate increased staff fundamental safety knowledge, enhanced peer review with an electronic system, and special cause variation of SRMEs on control chart analysis. From 2009 to 2016, the number of days and fractions between SRMEs significantly increased, from a mean of 174 to 541 days (P < .0075) and 21,678 to 113,104 fractions (P < .0028) preintervention and postintervention, respectively. Agency for Healthcare Research and Quality results demonstrate a high patient SC grade over time. Our journey toward becoming an HRO has led to the development of a robust SC through a comprehensive safety framework. Our multifaceted initiatives, focusing on culture and system changes, can be successfully implemented in a large academic radiation oncology department to yield measurable improvements in SC and outcomes.

What do surgical trainees think about patient safety culture, and is this different from their consultants?

Introduction Little is known about the patient safety culture within surgical departments in UK hospitals. What has been done to date is to survey only permanent senior staff opinion of the safety culture in their institution. This study surveyed both consultant and trainee views on perceived patient safety and compared the results between these two groups. Material and methods The previously validated Team Work and Safety Climate Questionnaire was configured in Survey Monkey format and sent to all surgical trainees and consultant surgeons in the South West Strategic Health Authority. Two reminders were sent to achieve as high a return rate as possible. Results Two hundred and ninety-six replies were received. Forty-four percent of trainees and 30% of consultants responded to the survey. Consultants consistently rated a higher safety culture than surgical trainees. Only 2.9% of trainees believe their patient safety concerns would be acted upon by hospital management. There is notable variation in perceived patient safety culture between hospitals. Conclusion This study has suggested that the patient safety culture in hospitals, within a Strategic Health Authority, is variable and sub-optimal when viewed by surgical trainees and their consultants. This study also provides some evidence that the perception of patient safety in an organization varies according to clinical experience. As trainees deliver a great deal of clinical care, surveys of safety culture should include this group. As perceived patient safety culture is correlated to clinical outcomes, validated safety surveys might form part of the assessment of a hospital's performance, along with outcome and patient satisfaction.