Perceptions Of Safety Culture Research Articles

Healthcare workers perceptions of patient safety culture in selected Ghanaian regional hospitals: a qualitative study

BackgroundPatient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers’ perceptions of patient safety culture in selected regional hospitals in Ghana.ObjectiveThis study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it.MethodIn-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes.ResultThe health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture.ConclusionsThis qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.

The Transparency in Nurses’ Work Environment and the Patient Safety

Transparency in nursing work environments is pivotal for enhancing patient safety and improving care quality. This study aims to identify work-related factors that influence nursing transparency and patient safety in a hospital setting. Employing a quantitative, non-experimental descriptive approach, this study surveyed 260 nurses from a pool of 800 at an educational hospital using an electronic questionnaire. The questionnaire assessed patient safety indicators, incident reporting transparency, work environment, and perceptions of patient safety culture. Data were analyzed using SPSS. The research highlights a significant correlation between work environments and transparency in incident reporting. Results indicated that better work environments are associated with higher levels of transparency and safety culture perception. The study also found that personal involvement in errors was underreported, suggesting a gap in the desired transparent culture. Enhancing the nursing work environment is crucial for improving transparency and patient safety, and strategic improvements in these areas can significantly bolster overall healthcare quality.

Enhancing patient safety culture and examining adverse events in intensive care units: a comparative analysis

Background and Purpose: The global emphasis on fostering a patient safety culture is a priority for many countries, including those in the Middle East. Hospitals worldwide are dedicated to enhancing the quality of patient care and safety, with an increasing recognition by hospital management of the role played by a robust patient safety culture. This study compares intensive care nurses' perceptions of patient safety culture and adverse events. Method: A comparative study was conducted in the intensive care units (ICUs) of four private and teaching hospitals utilizing The Hospital Survey on Patient Safety Culture (HSOPSC)-two in Riyadh and two in Cairo. Nonprobability sampling was employed across all registered nurses working in ICUs. Results: The study revealed that the highest percentage of errors occurred in patients' acquired infections (61.5%), while the lowest percentage was associated with patients' falls (7.8%). The strengths of the composites were continuous organizational learning improvement (85.9%) and management support for patient safety (81.4%). Areas for improvement were identified in composites such as handoffs and transitions (40.3%) and teamwork across units (49.5%). Notably, nurses in Cairo hospitals reported a higher frequency of adverse events compared to their counterparts in Riyadh hospitals. Implications for practice: The views of nurses working in both cities emphasized the importance of organizational learning to achieve ongoing improvement, teamwork within specific units, and managerial backing for ensuring patient safety. Moreover, the research emphasized the necessity for additional improvements in collaboration between different units, as well as in the processes of handoffs and transitions.

Comparing hospital leadership and front-line workers’ perceptions of patient safety culture: an unbalanced panel study

Background/aimThis article examines the relationships between workers’ hospital leadership status, hospital front-line status and patient safety culture in hospitals throughout the USA. By identifying possible disparities in perception, targeted interventions...

Evaluating the Effect of TeamSTEPPS on Teamwork Perceptions and Patient Safety Culture among Newly Graduated Nurses

BackgroundQuality healthcare delivery is contingent upon effective teamwork and a patient safety-focused culture. TeamSTEPPS offers an evidence-based framework that enhances these competencies. However, the impact of TeamSTEPPS on newly graduated nurses, who undergo a significant transitional phase, has yet to be comprehensively explored. Consequently, the objective of this study was to assess the influence of TeamSTEPPS on perceptions of teamwork and patient safety culture among newly graduated nurses.MethodsThis study employed a quasi-experimental pretest-posttest design with a single group, utilizing a convenience sample of 132 newly recruited nurses from a university hospital. The participants completed the hospital survey on patient safety culture and the TeamSTEPPS teamwork perceptions questionnaire at three different time points.ResultsThe impact of the TeamSTEPPS training program was found to be significant, as indicated by the substantial improvement in the mean scores of nurses’ perceptions regarding teamwork and the culture of patient safety across multiple assessments (p < 0.001). The effect size (η2p ≥ 0.14) suggests a large effect, further emphasizing the meaningful impact of the program on the measured outcomes.ConclusionsThe study underscores the effectiveness of TeamSTEPPS as a valuable framework for facilitating the seamless transition of newly graduated nurses into the healthcare field. Integrating TeamSTEPPS into nursing training programs can significantly enhance nurses’ perceptions of teamwork and the culture of patient safety. Therefore, it is crucial for nurse managers to implement TeamSTEPPS systematically, aiming to improve teamwork perception and cultivate a patient safety culture among nurses. Furthermore, they should establish mechanisms to ensure the consistent application of these skills over time.

Exploring Nursing Students' Perceptions of Patient Safety Culture in China

Exploring Nursing Students' Perceptions of Patient Safety Culture in China

The anatomy of safe surgical teams: an interview-based qualitative study among members of surgical teams at tertiary referral hospitals in Norway

BackgroundIn spite of the global implementation of surgical safety checklists to improve patient safety, patients undergoing surgical procedures remain vulnerable to a high risk of potentially preventable complications and adverse outcomes. The present study was designed to explore the surgical teams’ perceptions of patient safety culture, capture their perceptions of the risk for adverse events, and identify themes of interest for quality improvement within the surgical department.MethodsThis qualitative study had an explorative design with an abductive approach. Individual semi-structured in-depth interviews were conducted between 10/01/23 and 11/05/23. The participants were members of surgical teams (n = 17), general and orthopedic surgeons (n = 5), anesthesiologists (n = 4), nurse anesthetists (n = 4) and operating room nurses (n = 4). Middle managers recruited purposively from general and orthopedic surgical teams in two tertiary hospitals in Norway, aiming for a maximum variation due to gender, age, and years within the specialty. The data material was analyzed following Braun and Clarke’s method for reflexive thematic analysis to generate patterns of meaning and develop themes and subthemes.ResultsThe analysis process resulted in three themes describing the participants’ perceptions of patient safety culture in the surgical context: (1) individual accountability as a safety net, (2) psychological safety as a catalyst for well-being and safe performance in the operating room, and (3) the importance of proactive structures and participation in organizational learning.ConclusionsThis study provided an empirical insight into the culture of patient safety in the surgical context. The study highlighted the importance of supporting the individuals’ competence, building psychological safety in the surgical team, and creating structures and culture promoting a learning organization. Quality improvement projects, including interventions based on these results, may increase patient safety culture and reduce the frequency of adverse events in the surgical context.

Implementation of a patient safety training program in radiation oncology residency: A pilot study.

An educational program using Radiation Oncology-Incident Learning System (RO-ILS) was developed to improve safety culture and training for radiation oncology (RO) residents. The program included a pre-training assessment, interactive training, integration of residents into quality assurance meetings, and a post-training assessment over a 3 month rotation. Twelve residents completed the safety training program. Pre-training assessment mean scores (five-point scale) of experience with Incident Learning Systems (ILS), root-cause analysis (RCA), failure-mode and effect analysis (FMEA), safety training, and culture were 2.3, 2.8, 2.0, 4.0, and 4.4, respectively. Post-training assessment showed a significant increase in ILS 4.0 (p<0.001), RCA 3.8 (p=0.008), and FMEA 3.3 (p=0.006) and safety culture (4.8, p=0.043). Additionally, residents were anonymously surveyed ≥ 10 months after graduation to determine the long-term value of the program. The overall assessment from the graduated residents indicates that this education is valued by RO in many institutions. The majority of the residents are either currently utilizing or plan to utilize the information gained in this program in their new institutions. We report a successful implementation of a safety training program in a RO residency with significant improvements in self-reported confidence with the concepts of ILS, RCA, and FMEA and an improved perception of safety culture. This program can be implemented across all residency programs.

Safe Surgery Checklist Implementation: Associations of Management Practice and Safety Culture Change.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

Intern nursing students' perceptions of patient safety culture and their experiences with factors affecting the safety of care in hospital settings: A mixed method study

BackgroundPatient safety culture is a globally studied subject as it plays a significant role in preventing and reducing errors. There is limited mixed-method research into the in-depth investigation of intern nurses' views on patient safety in hospital settings and the factors affecting it. ObjectiveThis study was conducted to determine intern nursing students' perceptions of patient safety culture and their experiences with exploring factors affecting the safety of care in hospital settings. Design and methodsA convergent mixed-method design was used. The study group was selected using the purposive sampling method. STROBE and COREQ checklists were followed. The quantitative phase was descriptive and correlational, and the qualitative phase was phenomenological. Quantitative data were collected using a “Personal Information Form” and “Patient Safety Culture Scale” and qualitative data using a “Semi-Structured Interview Form.” Mean ± standard deviation, median (min-max), frequency, percentage values, Shapiro-Wilk, and Mann-Whitney U tests were employed to evaluate quantitative data. The inductive content analysis method was used to analyze qualitative data. Setting and participantsThe study consisted of intern nursing students from a university in the 2020–2021 academic year. The quantitative phase of the research was conducted with 38 and the qualitative phase with nine intern nursing students. In the qualitative phase, the saturation point was taken as a basis. ResultsIn the study, nursing students' perceptions of patient safety culture were high (3.24 ± 0.49; min = 1.88 and max = 4). The results of the qualitative data analysis indicated that the factors affecting patient safety in hospital settings consisted of three themes, namely “health professionals, care environment, and patients and caregivers” and nine subthemes. ConclusionsIntern nursing students had high perceptions of patient safety culture and had highly significant experiences with the factors affecting safe care in hospital settings.

Employees’ Perceptions of Workplace Safety Culture: A Case Study of a Polyester Company

Safety culture is a crucial component of ensuring workplace safety and preventing accidents. This study aimed to assess the safety leadership and safety culture of a polyester company in Thailand. Data gathering was conducted utilizing survey forms developed by the study team, including the 360-degree safety leadership survey and the 36-question safety culture survey. The sample group, comprising 1,286 individuals, consisted of management, employees, and independent contractors from a polyester company with four business units. Both the safety leadership and the safety culture perception surveys were provided with average values, thorough descriptions, graphical representations, and visuals. The study revealed that the perceptions of safety leadership and safety culture among the employees aligned with the standard level. However, certain issues, including off-the-job safety, communicating about safety, empowering other employees, setting safety standards and expectations, and promoting safety improvements and sharing, placed the organization’s safety culture at the foundational level, requiring management commitment and awareness development. For further actions, the company should emphasize the value of strategic workers' involvement in programs that empower employees, such as visible safety leadership for all management levels, notification and reporting programs, and safety sharing among business partners, to establish a world-class safety culture as the company's goal. Doi: 10.28991/ESJ-2024-08-01-017 Full Text: PDF

Assessment of Patient Safety Culture in Midwives

Although there may be different definitions in national and international literature, patient safety, in general terms, encompasses all the precautions taken by healthcare professionals in healthcare institutions to prevent harm to individuals as a result of care delivery. It is an indispensable component of quality healthcare services. Patient safety, crucial in all healthcare services, becomes even more significant during the pivotal period of pregnancy, which is a physiological process but also involves a delicate balance between health and illness. Therefore, it is expected that midwives working in the delivery room, in particular, handle patient safety with utmost care. In recent years, with the increase in studies related to the culture of patient safety, the quality, satisfaction, and safety of care provided by midwives have also become subjects of investigation. This thesis aims to assess the levels of patient safety culture perception among midwives working in the delivery room, as well as to evaluate their opinions regarding patient safety and identify the behaviors influencing these opinions. The population of the study consists of midwives working in the delivery rooms of Muş and Bitlis provinces. The sample selection was not applied; all midwives who wished to participate in the study were included. Data analysis was conducted using the computer-assisted SPSS 22.0 software package. Percentage distributions were used in statistical evaluation, and for group comparisons, the significance was determined by the "Chi-square (X2) test" for categorical variables, the "t-test" for comparing means between two groups, and the "one-way ANOVA test" for evaluating the significance of differences among more than two group means. The level of statistical significance was accepted as p&lt; 0.05 for all tests. Midwives' perceptions of patient safety culture were rated as moderate with 57%, and their patient safety ratings were determined to be "very good" with 44.4%. Within the scope of the hospital survey, among the 12 sub-areas of patient safety culture, "teamwork within units" had the highest positive response rate at 79.7%, while "non-punitive response to error" stood out with the lowest positive response percentage at 27.4%. The highest percentage of positive responses in the hospital survey regarding patient safety culture was determined to belong to the statement 'We work together as a team when there is a lot of work that needs to be done urgently, with 85.6%. The lowest percentage of positive responses was for the statement 'We work in crisis mode when there is a lot of work to be done and it needs to be done very quickly,' which was 12.2%." In the conducted comparisons, a significant relationship was found between midwives' working province, age groups, marital status, duration of employment in the institution, duration of work in the unit, professional experience, weekly working hours, and employment status parameters with the percentages of positive responses given to the sub-areas of the hospital survey on patient safety culture. When evaluating patient safety practices in the delivery room, factors affecting working conditions, adequacy of staff numbers, and patient safety should also be taken into consideration. In order for patient safety practices to be carried out comprehensively, regular training, involvement of midwives in the process, and active participation are required.

Perception of Hospital Food Service Workers Regarding Patient Safety Culture and Patient Identification Practice

Implementing the 'Patient Identification' procedure during food distribution will ensure the right diet is served to the right patient. This study explored the perception of patient safety culture and its association with patient identification practices among hospital food service workers. We conducted a mixed method research in a Joint Commission International (JCI)-accredited hospital in Yogyakarta. Food service workers who received patient safety training and were responsible for distributing food in adult inpatient wards (n=76) participated in this study. Perception of patient safety culture was measured using a validated questionnaire and in-depth interview, whereas patient identification practice was observed directly using a checklist. Descriptive statistics and chi-square tests were employed. More than half (55.3%) of the subjects perceived overall patient safety culture well. However, 34.2% of the subjects performed substandard practice verifying the patient's identity (name, address, or medical record number) when delivering food. There was an insignificant association between the perception of patient safety and patient identification practice by food service workers (p0.05), as some considered that patient identification was more appropriate to be performed by other health professions instead of food service workers. Nevertheless, nearly all (98,68%) food service workers perceived their duty to match the patient's name with the label on the food tray as important.

Perception Of Patient Safety Culture At The Primary Care Level: The Case Of The Community Health Centre Ljubljana.

Patient safety is a crucial element of quality healthcare, and endeavours to enhance it are vital for attaining universal health coverage and improving patient outcomes. This study aimed to evaluate the perception of patient safety culture among staff at the Community Health Centre Ljubljana (CHCL). A cross-sectional study was conducted in December 2022. All CHCL staff (N=1,564) from different professional groups were invited to participate in an anonymous electronic survey using the validated Slovenian version of the "Medical Office Survey on Patient Safety Culture" (MOSPSC). Mean percent positive scores for all items in each composite were calculated. The final sample included 377 participants (response rate, 24.1%), most of whom were women (91.5%, N=345) with different professional profiles. The mean age of the participants was 44.5 years (SD 11.1) with a mean work experience of 20.1 years (SD 12.1). The percentage of positive overall MOSPSC composite scores was 59.6%. A strong patient safety culture perception was identified in the following dimensions: Information exchange with other settings (93.5%), Organisational learning (90.2%), List of patient safety and quality issues (88.1%), Patient care tracking/follow-up (76.2 %) and Teamwork (75.0%). Weak patient safety culture was identified in the dimensions of Work pressure and pace (10.7%), Leadership support for patient safety (27.1%), Communication openness (40.9%), Office processes and standardisation (48.2%) and Overall ratings on quality and patient safety (49.4%). CHCL leadership should address weaknesses, redesign processes, and implement strategies to reduce patient safety incidents. Establishing a just culture that encourages employees to report errors fosters transparency and facilitates learning from errors.

Assessment of radiation safety culture among radiological technologists in medical imaging departments in Saudi Arabia

This study aimed to evaluate the perception of radiation safety culture among medical radiological technologists (MRTs) in the Kingdom of Saudi Arabia. The study was performed from June 2022 to February 2023 and involved MRTs from various hospitals and medical centres in Saudi Arabia. A cross-sectional study was conducted using a self-administered and previously validated radiation safety culture survey instrument in medical imaging departments. The survey comprises 11 determinants of radiation safety culture, including personal accountability, teamwork in imaging, teamwork across imaging stakeholders, questioning attitude, feedback loops, organisational learning, leadership actions, non-punitive response, error reporting, radiation policy and overall perception of radiation safety. A total of 496 MRTs participated in this study. Results showed that most of the MRTs were male (75.0%), between 25 and 44 yr old (71.0%), with a bachelor’s degree (53.2%) and had less than 5 yr of experience (41.1%). The highest mean scores were for personal accountability (4.43 ± 0.62) and teamwork in imaging (4.22 ± 0.91), while the lowest mean score was for non-punitive response (2.94 ± 1.01). The majority of the MRTs reported good perception for the personal accountability (71.8%), teamwork in imaging (56.5%) and organisational learning (46%) scales; moderate perception for the teamwork across imaging stakeholders (53.2%), questioning attitude (71%), feedback loops (47.6%), leadership actions (74.2%), error reporting (53.2%), radiation policy (54.8%) and overall perception of radiation safety (62.1%) scales; and poor perception for the non-punitive response scale (45.2%). Individual and organisational interference are warranted to adhere to a strong radiation safety culture with continuing education. Moreover, repeated measures are necessary to assess for categorical improvement associated with the relevant determinants that are also important to support a positive radiation safety culture.

중소종합병원의 간호·간병통합서비스 병동과 일반병동 간호사간의 환자안전문화와 환자참여문화 인식 비교

Purpose : This study aimed to improve patient safety and nursing quality by comparing nurse's perceptions of patient safety culture and patient participation culture in comprehensive service and general ward. Methods : The research included 171 nurses from four general hospitals, with 87 working in comprehensive service wards and 84 in general wards. Data was collected through self-reporting questionnaires between September 21 and October 6, 2020. The collected data was then analyzed using SPSS/WIN 25.0 for descriptive analysis, t-test, ANOVA, Scheffé test, and Cronbach's alpha. Results : There was no significant difference in nurse's perceptions of patient safety culture between comprehensive service and general wards. However there was a statistically significant difference in their perceptions of patient participation culture. Conclusion : This findings show nurses in comprehensive service ward have more cooperative relationships with patients indicating that their attitude toward patient participation is more positive.

Evolución de la percepción de la cultura de seguridad de los profesionales sanitarios en una urgencia pediátrica

Background and aimSafety culture (SC) is a fundamental tool for minimizing adverse events and improving safety and quality of care. Our objective, therefore was to analyze the evolution of the SC of healthcare professionals in a pediatric emergency department (PED) after the implementation of a risk management system for patient safety based on the UNE:EN:ISO 179003 Standard and the execution of new safe practices for Joint Commission International accreditation. At the same time describe the current strengths and weaknesses. MethodsQuasi-experimental, single-center study. All PED professionals participated in the study. An initial measurement of SC was performed through the Hospital Survey on Patient Safety Culture (HSOPS) questionnaire of the Agency for Healthcare Research and Quality adapted to Spanish in 2014. Pro-patient safety strategies were implemented between 2015 and 2022. A subsequent measurement was performed in 2022. ResultsThe response rate in 2014 was 55% and 78% in 2022. On both occasions the group with the highest participation was nurses with 35.1% and 34.8%, respectively.Five dimensions improved after the interventions: frequency of adverse events (25.2%, p<0.001), organizational learning (25%, p<0.001), feedback and communication about errors (22.3%, p<0.001), non-punitive response to errors (6.5%, p = 0.176), and management support (4%, p = 0.333). ConclusionsThe actions carried out had a positive influence on organizational learning and the frequency of adverse events reported and communication within the team. In contrast, the perception of SC did not increase.

Perceptions of Patient Safety Culture among Triage Nurses in the Emergency Department: A Cross-Sectional Study.

The patient safety culture is key to ensuring patient safety in healthcare organizations. The triage environment is inherently demanding for patient safety and is characterized by high stress, rapid decision-making, and quick action. In several countries, including Slovenia, there is a lack of studies on the patient safety culture among triage nurses. This study aimed to assess the perceptions of the patient safety culture among triage nurses. A cross-sectional survey design was used. The Emergency Medical Services-Safety Attitudes Questionnaire, distributed to triage nurses, was used to collect data. A total of 201 triage nurses participated in this study. The results revealed that the overall average perception of the patient safety culture was 57.27% (SD = 57.27), indicating that the perception of the patient safety culture among triage nurses in the emergency department was non-positive and requires improvement. "Job Satisfaction" received the highest score (63.18%; SD = 17.19), while "Working Conditions" received the lowest (49.91%; SD = 17.37). The perception of positive and negative safety culture responses was statistically significant for age (χ2 (3) = 17.750, p ≤ 0.001), education (χ2 (2) = 6.957, p = 0.031) and length of working experience (χ2 (3) = 8.875, p = 0.031). The findings emphasize the significance of improving the safety culture in relation to several areas of patient care during the triage process. This research serves as a crucial foundation for enhancing patient safety in triage, providing quality care, and reducing adverse events.

사업장의 안전보건교육 경험에 따른 불안전한 행동이 안전보건문화에 미치는 영향에 관한 연구

Safety and health education at the workplace is an important way to prevent industrial accidents, and is a basic matter in which workers can participate, and is the employer's obligation. Although the importance of safety training in the workplace is recognized, there is much controversy about its effectiveness in improving on-site operability. Accordingly, this study aims to understand the actual status of safety and health education and determine the impact of unsafe behavior on safety and health culture according to safety and health education experience. It was conducted for the purpose of using basic data to verify and activate the effectiveness of safety and health education in the future. This study conducted a survey of workers at about 150 manufacturing plants from August to December 2022, and 300 people were selected for final analysis. The survey questions were designed to fit the study using questions used in the Occupational Safety and Health Trend Survey(2015) conducted by the Korea Occupational Safety and Health Agency and the risk assessment of safety management consulting organizations. The collected data were subjected to frequency analysis, factor analysis, and multiple regression analysis using SPSS 21.0 program. As a result, workers were aware of the obligation to provide safety and health education, and the experience of regular safety and health education was the highest among safety education. Those who experienced safety education showed that inappropriate management or supervision, negligence during work, unreasonable actions and movements, inappropriate use of equipment and tools, unsafe work performance, and unreasonable work influenced the perception of safety and health culture. For inexperienced people, inadequate management or supervision appeared to affect safety and health culture. Through this study, it was confirmed that awareness of unsafe behavior is formed through education and is a factor that influences safety and health culture. In the future, it will be necessary to provide an opportunity to form a safety and health culture by linking safety and health education to activation within the workplace and field operability. In addition, it seems that more management is needed to make safety and health education a reality and continuously implement it.

Safety culture as competitive advantage for slovenian natural health resorts

BACKGROUND: Many studies are focused on safety culture. There is no study on employees’ perceptions of safety culture in natural health resorts. OBJECTIVE: This study aims to examine the concept of safety culture from the perspective of the employees in natural health resorts in Slovenia. METHODS: The survey was administered to a sample of 268 employees in six Slovenian natural health resorts to measure the attitudes, practices/behaviors, knowledge, and training of employees. RESULTS: The results of the survey did not show a statistical correlation between the employees’ safety attitudes and their age, their level of education and their position within the organization. However, this study revealed significant differences in understanding of the safety measures and selected safety attitudes across six resorts. Similarly, the study revealed significant differences in knowledge and understanding of the safety protocols across six resorts. The results are reflecting higher management safety awareness in selected resorts what could result in an important competitive advantage for a selected organization. CONCLUSIONS: The research provides an in-depth insight into the concept of safety culture, presented through the attitudes, practices/behaviors, knowledge, and training of employees in natural health resorts in Slovenia. Findings contribute to the development of conceptual knowledge in safety science.