Safety Leadership Research Articles

Patient safety in emergency departments: a problem for health care systems? An international survey.

Patient safety in healthcare is one of the cornerstones of quality of care. The emergency department (ED) is by its very nature a place where errors and safety issues are liable to occur. The aim of the study was to assess health professionals' perception of the level of safety in EDs and to identify in which work domains safety appears most at risk. Between 30 January and 27 February 2023, a survey addressing the main domains of safety was distributed to ED health care professionals through the European Society of Emergency Medicine contact network. It addressed five main domains: teamwork, safety leadership, physical environment and equipment, staff/external teams, and organisational factors and informatics, with a number of items for each domain. Further questions about infection control and team morale were added. The Cronbach's alpha measure was calculated to assure internal consistency. A score was developed for each domain by adding the question's value using the following ranking: never (1), rarely (2), sometimes (3), usually (4), and always (5) and was aggregated in three categories. The calculated sample size needed was 1000 respondents. The Wald method was used for analysis of the questions' consistency and X2 for the inferential analysis. The survey included 1256 responses from 101 different countries; 70% of respondents were from Europe. The survey was completed by 1045 (84%) doctors and 199 (16%) nurses. It was noted that 568 professionals (45.2%) had less than 10 years' experience. Among respondents, 80.61% [95% confidence interval (CI) 78.42-82.8] reported that monitoring devices were available, and 74.7% (95% CI 72.28-77.11) reported that protocols for high-risk medication and for triage (66.19%) were available in their ED. The area of greatest concern was the disproportionate imbalance between needs and the availability of staff at times of greatest flow, considered sufficient by only 22.4% (95% CI 20.07-24.69) of doctors and 20.7% (95% CI 18.41-22.9) of nurses. Other critical issues were overcrowding due to boarding and a perceived lack of support from hospital management. Despite these difficult working conditions, 83% of the professionals said they were proud to work in the ED (95% CI 81.81-85.89). This survey highlighted that most health professionals identify the ED as an environment with specific safety issues. The main factors appeared to be a shortage of personnel during busy periods, overcrowding due to boarding, and a perceived lack of support from hospital management.

Safety voice climate: A psychometric evaluation and validation

Introduction: Speaking up about safety issues, termed “safety voice,” is a proactive response where people across all levels of the organization express their concerns to prevent physical hazards. An understanding of safety voice requires insight into its antecedents. A perceived need to fit in with the organization and fear of consequences can trump the courage to speak out about safety concerns. Safety voice climate can be seen as a manifestation of the social exchanges in an organization and functions as a roadmap of which speaking out behaviors are encouraged and which behaviors are not. This study conceptualizes safety voice climate, presents the Safety Voice Climate Scale (SVCS) as a measurement tool, and gathers initial evidence for its validity. The study also assesses the associations between the SVCS and safety voice behavior. Method: The SVCS and the measurement of safety voice behavior were derived from the Trends in Risk Level in the Norwegian Petroleum Activity questionnaire. The SVCS includes the two theoretical dimensions Work colleagues’ encouragement of safety voice and Leaders’ attitudes towards safety voice. Psychometric properties were tested with a representative sample from the Norwegian petroleum sector (n = 7,624). Results: Confirmatory factor analyses supported the proposed two-factor model, and the internal consistency of the factors was good. Furthermore, a structural equation model including the SVCS as predictors of safety voice behavior showed a good fit, indicating acceptable criterion validity, although only the Work colleagues’ encouragement of safety voice variable was significantly associated with safety voice behavior. Conclusion and practical application: The SVCS can be used as a tool to detect some of the barriers and supporting elements relating to safety voice and guidance on the efforts needed to foster work climates that promote communication of safety issues.

Identification of Desired Qualifications for Construction Safety Personnel in the United States

Construction is a hazardous industry with a high number of injuries. Prior research found that many industry injuries can be prevented by implementing an effective safety plan if prepared and maintained by qualified safety personnel. However, there are no specific guidelines on how to select qualified construction safety personnel and what criteria should be used to select an individual for a safety position in the United States (US) construction industry. To fill this gap in knowledge, the study goal was to identify the desired qualifications of safety personnel in the US construction industry. To achieve the study goal, the Delphi technique was used as the main methodology for determining the desired qualifications for construction safety personnel. As a result, a panel of 15 subject-matter experts was selected, and 4 rounds of surveys were carried out. The findings of the study led to the identification of the desired qualifications for three construction safety positions (safety entry, safety professional, and safety manager). The present study contributes to the body of theoretical knowledge on construction safety and presents practical guidelines to assist industry stakeholders select qualified safety personnel for their projects. The selection of qualified safety personnel is expected to improve workplace safety performance and positively reflect on other project outcomes. Construction stakeholders should pay attention to three key aspects (namely, education, experience, and certification) when determining the qualifications for a safety leadership position and take into consideration the type of position intended to be filled. This study fills the gap in knowledge by identifying the desired qualifications and criteria on how to select safety personnel in the US construction industry.

Joint Decision-Making and Team Outcomes: Examining Cross-Lagged Relationships and the Roles of Psychological Safety and Participative Leadership

ABSTRACT Despite increasing studies on team creativity, the relationship between joint decision-making and team creativity needs further exploration. Our study employs social exchange theory to investigate the potential bidirectional association between joint decision-making and team psychological safety while also exploring the role of participative leadership as a contextual constraint on this relationship. Through our analysis, we aim to shed light on the vital role of team psychological safety in mediating the moderating effect of participative leadership on the linkage between joint decision-making and team creativity. We test our hypotheses using a sample of 372 employees in 75 teams with a time-lagged research design. Our results demonstrated that joint decision-making is positively related to team psychological safety, and participative leadership strengthened the association between joint decision-making and team psychological safety and the association between joint decision-making and team creativity via team psychological safety. Overall, our findings suggest that team creativity could be improved if leaders can enhance their participative behaviors and identify appropriate channels for employees to feel psychologically safe in the workplace.

Development of process safety knowledge for senior operations leadership

AbstractClear and positive process safety leadership is at the core of managing high‐hazard businesses, and it is vital to ensure that risks are effectively managed. Cargill has designed a learning experience program for senior operations leadership in Latin America to provide leaders with an appropriate level of process safety knowledge that will support them taking better decisions, thereby reducing the likelihood of a process safety event at their manufacturing sites. The purpose of the program is to provide structural and focused learning of essential risk management practices and to allow the leaders time to discuss and learn about the risks and hazards on their sites. The program was designed to include kick‐off sessions, several learning experiences, and a final certification step. This program was deployed in Latin America in 2021 and, within 1 year, has certified 39 senior leaders for high‐hazard facilities. Several more certifications are expected to occur in the following months when all senior leaders would have gone through this learning program.

The role of safety leadership in nursing management during the pandemic

The role of safety leadership in nursing management during the pandemic

THE CONTRIBUTION OF LEADERSHIP TO SAFETY

Ineffective occupational safety and health leadership leads to inadequate safety requirements, poor safety supervision, ineffective training and poor safety attitudes. This can lead to a loss of productivity, reducing the economic benefits of the activity and, ultimately - and more importantly - leading to accidents, a negative impact on workers' health or even fatalities.

Safety Leadership, Covid-19 Risk Perception, and Safety Behavior: The Moderator Role of Work Pressure

Safety Leadership, Covid-19 Risk Perception, and Safety Behavior: The Moderator Role of Work Pressure

Adverse Patient Safety Events During the COVID-19 Epidemic.

A retrospective descriptive analysis of patient safety events related to COVID-19 was performed on data that were submitted in the Joint Patient Safety Event Reporting System and Root Cause Analysis databases to the VHA National Center for Patient Safety from March 2020 to February 2021. Events were coded for type of event, location, and cause of event. Delays in care and staff/patients exposed to COVID-19 were the most common types of patient safety events, followed by COVID-19-positive patients eloping, laboratory processing errors, and one wrong procedure. The most frequently cited locations where events took place were emergency departments, medical units, community living centers, and intensive care units. Confusion over procedures, care not provided because of COVID-19, and failure to identify COVID-positive patient before they exposed others to COVID were the most common causes for patient safety events. Our results are similar to other studies of patient safety during the first year of the COVID-19 pandemic. Based on these results, we recommend the following: (1) focus on patient safety culture, leadership, and governance; (2) proactively develop competency checklists, cognitive aids, and other tools for healthcare staff who are working in new or unfamiliar clinical settings; (3) augment or enhance communication efforts with patient safety huddles or briefings at all levels within a healthcare organization to proactively uncover risk and mitigate fear by explaining changes in policies and procedures; and (4) maximize the use of quality and patient safety experts who are knowledgeable in system and human factor theories as well as change management to assist in redesigning clinical workflows and processes.

Demonstration of the Managing for Daily Improvement Quality Improvement Methodology in an Alcohol Withdrawal Protocol Audit.

The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is an assessment tool designed to standardize care and minimize the risk of complications in patients experiencing alcohol withdrawal. After discovering an increase in medication errors and late assessments under this protocol, pharmacists at a 218-bed community hospital performed an audit of protocol compliance using a performance improvement methodology known as Managing for Daily Improvement (MDI). A daily audit of CIWA-Ar protocol compliance was performed across all hospital units, followed by discussions with frontline nurses regarding barriers to compliance. The daily audit included assessments of appropriate monitoring frequency, medication administration, and medication coverage. Nurses caring for CIWA-Ar patients were interviewed to identify perceived barriers to protocol compliance. The MDI methodology provided a framework and tools to visualize audit results. The visual management tools used in the methodology include daily tracking of 1 or more discrete process measures, daily identification of barriers to perfect process performance at the patient and process level, and collaborative action plan tracking to resolve barriers. Forty-one audits were collected for 21 unique patients over 8 days. After conversations with multiple nurses across different units, the most commonly reported barrier to compliance was a lack of communication at shift handoff. The results of this audit were discussed with nurse educators, patient safety and quality leaders, and frontline nurses. Process improvement opportunities identified from this data included improved widespread nursing education, development of protocol auto-discontinuation criteria based on scores, and determination of downtime processes for the protocol. The MDI quality tool successfully assisted in identifying end-user barriers to and focused areas of improvement of compliance with a nurse-driven CIWA-Ar protocol. This tool is elegant in its simplicity and ease of use. It can be customized to cover any timeframe or monitoring frequency while providing visualization of progress over time.

Factors affecting safety behaviors of aircraft maintenance technicians: A study on Civil Aviation Industry in Turkey

Research over the years has drawn attention to the role of safety behaviors in determining safety outcomes. A good understanding of the predictors of safety behaviors is important for improving safety performance. Therefore, this study investigated factors affecting safety behaviors of aircraft maintenance technicians (AMTs). The effects of safety leadership and safety climate, which are considered as the main antecedents of safety behaviors, on safety compliance and safety citizenship behaviors were examined. Data was gathered from 359 AMTs employed in Turkish Civil Aviation industry through a questionnaire. The relationship between variables was tested by regression and path analysis. The results indicated that safety leadership and safety climate predict safety behaviors of AMTs. In addition, safety climate partially mediated the effects of safety leadership on safety behaviors. Furthermore, the whistleblowing dimension, which indicates to what extent maintenance team-induced unsafe acts is reported by AMTs, scored lower than expected. Group cohesion and collective nature of culture are considered as the causes of this underreporting problem and control practices of maintenance managers are suggested as a solution. Furthermore, controlling dimension of safety leadership is suggested for development of assertive safety behaviors among AMTs, which means acting in favor of safety without compromise. Lastly, considering the positive impact of the safety climate on various categories of safety behaviors, its role in building a high reliability organization for aircraft maintenance is highlighted.

Probability of Risk Factors Affecting Small-Scale LNG Supply Chain Activities in the Indonesian Archipelago

In Indonesia, the CoS for power supply increased from Rp. 1025 to Rp. 1334/KWh from 2016 to 2021, respectively; this indicates an inefficient process in electricity provision. One contributing factor to this inefficiency is the existence of many high speed diesel (HSD)-fueled power plants. These are distributed across the Indonesian archipelago with a supply chain that only uses sea transportation. The absence of an economical small-scale LNG (SS-LNG) supply chain also demonstrates the inadequate infrastructure for distributing LNG to refineries. This study aims to analyze the probability of risks that occur in SS-LNG supply chains in the Indonesian archipelago. The analytical methods used are descriptive statistical analysis and Delphi analysis through in-depth interviews and Focus Group Discussions (FGD) with experts. Results showed that the SS-LNG supply chain process in Indonesia includes LNG loading, unloading, shipping, picking, storage, regasification, and distribution. There are 30 risk indicators that may occur, with the highest risks including ship accidents, equipment damage, lack of transport ships, bad weather, earthquakes, tsunami, poor safety cultures, and low levels of safety leadership. These risk indicators can be used in implementing SS-LNG.

The state of mental health training in basic police curricula: A national level examination

ABSTRACT Police officers are front-line mental health responders who make daily decisions regarding persons with mental illness. However, little is known about what mental health training (MHT) states require from their future police officers. This study aims to evaluate the emphasis placed on MHT for police recruits across the United States. Specifically, we ask: 1) What (if any) are the minimum MHT hours police recruits must complete in the basic training academy? 2)What are the characteristics of state-mandated MHT in basic police academies? Our findings show that, on average, states devote 1.1% (7.28 hours) of their basic training curricula to MHT. We also identify four major contextual themes that depict MHT in police basic training. In this study, we offer public safety leaders, policymakers, and curriculum designers up-to-date data on the current state of MHT in basic police academies and recommendations for how it can be improved.

COVID-19 and Food Delivery Employees’ Workplace Safety

With the global pandemic of COVID-19 in recent years, food delivery employees’ workplace safety has been severely threatened and challenged. Thus, this study hopes to understand their real work safety and its impact. Based on the perspective of human resource development, broaden-and-build theory, and internal and external marketing activities, the study examines the relationships between safety leadership, safety training, employee well-being, service quality, and customer citizenship behavior. The results using three-wave and 498 valid employee-customer pairs (498 food delivery employees and 600 customers) from 2 food delivery companies in Taiwan showed that: (1) Safety leadership positively affects employee well-being; (2) Safety training positively affects employee well-being; (3) Employee well-being positively affects service quality; (4) Employee well-being positively affects customer citizenship behavior; (5) Employee well-being mediates the relationship between safety leadership and customer citizenship behavior, and (6) Safety training moderates the relationship between safety leadership and employee wellbeing. Research and managerial implications are discussed.

Mental health of public safety personnel: Developing a model of operational, organizational, and personal factors in public safety organizations.

The work of public safety personnel (PSP) such as police officers, firefighters, correctional officers, and paramedics, as well as other PSP, makes them vulnerable to psychological injuries, which can have profound impacts on their families and the communities they serve. A multitude of complex operational, organizational, and personal factors contribute to the mental health of PSP; however, to date the approach of the research community has been largely to explore the impacts of these factors separately or within single PSP professions. To date, PSP employers have predominantly focused on addressing the personal aspects of PSP mental health through resiliency and stress management interventions. However, the increasing number of psychological injuries among PSPs and the compounding stressors of the COVID-19 pandemic demonstrate a need for a new approach to the study of PSP mental health. The following paper discusses the importance of adopting a broader conceptual approach to the study of PSP mental health and proposes a novel model that highlights the need to consider the combined impacts of operational, organizational, and personal factors on PSP mental health. The TRi-Operational-Organizational-Personal Factor Model (TROOP) depicts these key factors as three large pieces of a larger puzzle that is PSP mental health. The TROOP gives working language for public safety organizations, leaders, and researchers to broadly consider the mental health impacts of public safety work.

Construction of a Bayesian Network Based on Leadership-Culture-Behavior Model to Improve Owner Safety Management Behavior

The positive influence of owners’ safety management on the safety performance of construction projects has gained significant attention. Considerable research has been performed to examine the relationship of owners’ safety leadership (SL), safety culture (SC), and safety management behavior (SMB). However, there is a lack of understanding of the mechanisms of influence of owners’ leadership–culture behavior (LCB) and recommendations to improve owners’ safety management behavior. This study developed the influence mechanism of owner LCB and explored the optimal intervention plan to improve owners’ SMB. First, a longitudinal survey was undertaken, which included more than 2,000 construction projects across China, to collect data. Subsequently, a Bayesian network (BN) was constructed to characterize the influence mechanism of owner LCB. Finally, the effects of different intervention plans on SMB were compared. The results proved that the owners’ SL had considerable effects on behavioral improvement when SL and SC were at low levels, whereas SC became prominent when SL and SC were at medium or high levels. This shows that safety leadership and safety culture successively play a role in behavior improvement. Additionally, the combined improvement of role modeling and safety training achieved the best improvement effect on SMB in case projects, which reveals that a combination of safety leadership and safety culture plays a greater role in behavior improvement. This study contributes to the LCB approach and proposes a selection scheme for intervention measures to improve owners’ safety management behavior.

Giant Tongue Hemangioma - A Rare Case Report

In various industries, the importance and evolution of process safety leadership and culture have been stressed by several studies. Nevertheless, the palm oil milling industry remains an understudied domain. This paper undertakes a critical review of the most recent developments in the palm oil milling process and unit operations that trigger concerns about process safety to leaders in the palm oil milling industry with guidelines about the requisite process safety leadership and culture to be understood with a view to enhancing safety outcomes. In addition, the paper explores the principle of 3C for explicating constant accidents along with the four-level safety culture in the palm oil milling industry. To do so, the author presents case studies of two Malaysian key palm oil companies.

An ecological study of the burden of road traffic crashes in the Middle East and North Africa

Road traffic injuries (RTIs) and deaths constitute a serious preventable global public health problem. To analyse time trends of age-standardized mortality rates and disability-adjusted life years (DALYs) caused by RTIs in 23 Middle East and North Africa (MENA) countries; and to assess the correlation between national implementation of best practice for road safety recommended by the World Health Organization, national income level, and RTI burden. Time trend analysis over 17 years (2000-2016) was conducted using Joinpoint regression. An overall score was calculated for each country to assess implementation of best practice for road safety. Mortality decreased significantly (P < 0.05) in Islamic Republic of Iran, Jordan, Kuwait, Lebanon, Morocco, Oman, Qatar, and Tunisia. In most MENA countries, DALYs increased but they significantly decreased in the Islamic Republic of Iran. The score calculated varied widely among the MENA countries. In 2016, no correlation was identified between the overall score and mortality and DALYs. National income was not associated with RTI mortality or the calculated overall score. Countries in the MENA region had varying levels of success in reducing the burden from RTIs. During the Decade of Action for Road Safety 2021-2030, MENA countries can achieve optimal road safety by implementing measures that are customized for the local context, such as law enforcement and public education. Other focus areas for improving road safety are building capacity in sustainable safety management and leadership, improving vehicle standards, and addressing gaps in areas such as use of child restraint.

The relationship among safety leadership, risk perception, safety culture, and safety performance: Military volunteer soldiers as a case study.

Safety is fundamental to any organization; if not based on safety, organizational decision-making and management would be meaningless. For a country, soldiers are responsible for national security; they serve as a barrier that defends a country against external invasive forces, thus assuming great missions and responsibilities on their shoulders. To ensure soldiers fulfill their duties of protecting the country and the people, they should gain clear risk perception, which should be instilled into them during their daily combat readiness training. Only when their performances meet safety criteria can they become a strong fighting force. This study recruited military volunteer soldiers as its research participants and employed convenience sampling to distribute questionnaires. In total, this research collected 725 valid copies, of which the data were used to explore the relationship among safety leadership, risk perception, safety culture, and safety performance. To achieve this goal, this study proposed some research hypotheses based on literature review. The hypotheses were all verified via latent variable modeling and multiple hierarchical regression analysis after the reliability and validity of each construct had been tested via confirmatory factor analysis. The research results showed that the more deeply military volunteer soldiers sense safety leadership, the clearer their risk perception will be and the more helpful it would be in achieving safety performance. It is worth mentioning that risk perception can serve as a mediator while safety culture can mediate the relationship between safety leadership and safety performance. Lastly, the research proposes suggestions in the section of conclusions, which provides reference to the combat readiness training and daily tasks of soldiers.

PENGARUH SAFETY LEADERSHIP DAN SAFETY CLIMATE MELALUI SAFETY BEHAVIOR TERHADAP KECELAKAAN KERJA PADA KESEHATAN KARYAWAN

Work accidents in the construction sector are still a work safety problem both in the world and in Indonesia that require attention from various parties. Safety behavior will make employees avoid the risk of accidents and create a sense of security at work so as to increase employee productivity. Several studies conducted by researchers found that safety behavior is influenced by leadership and company climate. The safety leadership approach can be one of the solutions to promote occupational safety and health more comprehensively.&#x0D; This study aims to determine the effect of safety leadership and safety climate through safety behavior on work accidents at PT Enseval Putera Megatrading Batam employees. The research design used in this research is descriptive and verification method using path analysis. With a sample of 52 respondents at PT Enseval Putera Megatrading Batam. The results showed that there was a significant influence between safety behavior on the work accident variable with a path value of 0.889, there was a significant influence between safety leadership on the Safety behavior variable with a path value of 0.550, there was a significant influence between safety leadership on the work accident variable with a path value paths of 0.530. Indirectly, safety leadership through safety behavior has no effect on work accidents because the test results are smaller than the direct value. There is a significant influence between safety climate on the safety behavior variable with a path value of 0.447. The path value is 0.478. Indirectly, safety climate through safety behavior has no effect on work accidents because the test results are smaller than the direct value.It is recommended to carry out more intense programs in the field of K3 by conducting trainings and scientific development