Safety Culture Research Research Articles

Assessing reliability and validity of food safety culture assessment tools

Since its recognition as a plausible direction to assure food safety, food safety culture research has evolved with several commercial and scientific assessment tools developed to evaluate the food safety culture in food businesses. However, existing research does not specify the validity and reliability checks required to demonstrate rigor in the tool development process and there is no unified methodology to confirm robustness of the tools to ensure trustworthiness and usefulness of findings and inferences generated. The purpose of the study was to develop a method to evaluate food safety culture assessment tools and to assess the reliability and validity of existing food safety culture assessment tools using the developed method. Eleven elements were found to be key in validating food safety culture assessment tools. Of the eight tools assessed, only one tool (CT2) was validated on each of the elements. The depth of validation strategies differed for each tool. Three out of the five commercial tools published peer reviewed publications that demonstrated the validation checks that were done. Face validation, and pilot testing were evident and appeared to be done the most. Whilst content, ecological, and cultural validity were the least validated for scientific tools, factor analysis and reliability checks were the least evaluated for commercial tools. None of the tools were assessed for postdictive validity, concurrent validity and the correlation coefficient relating to construct validity. Having an established science-based approach is key as it provides a way to determine the trustworthiness of established assessment tools against accepted methods.

Exploring safety culture research in the construction industry.

Despite numerous regulatory initiatives to improve health and safety in the construction industry, it still ranks as one of the most accident-prone industries worldwide. A dedicated focus on safety culture has been suggested as a complement to laws, regulations and management systems. This article explores safety culture research conducted in the construction industry, with the aim to provide insight into the specific themes that tend to be in focus as well as what theoretical and methodological approaches that tend to be favored. Searches in scientific databases were conducted twice. In a first attempt, searches resulted in 54 hits but only two articles fit the scope of the study. A revision of the search phrase resulted in 124 hits. Ultimately, 17 articles fit the scope of the study and were included. The content of the articles was analyzed and sorted thematically. The results show that four themes are prevalent in the existing literature: 1) unique challenges entail a need for situated applications, 2) models developed to operationalize safety culture, 3) measuring safety culture, and 4) safety management and leadership as key factors. Although research focusing on the construction industry has come to favor certain study designs and definitions of safety culture, further research may be enriched by broadening the theoretical and methodological perspectives. Specifically, researchers should conduct more in-depth qualitative studies that take the complexity of the industry into account, including the interpersonal relations between the actors involved.

Gender Equality Culture Measuring Attitudes Towards Gender Equality in the Transport Sector

The transport industry is dominated by men. Globally, woman constitute only a few per cent of those working on board ships. Calculating the distribution of gender, wages, and positions provides an insufficient basis from which to address this imbalance; rather, we need to study the attitudes and norms that constitute “gender equality culture”. These qualitative aspects emphasize men’s and women’s life conditions, values, and ideals that affect their opportunities to exert influence in the workplace and society. They influence research and industry and must be highlighted to put gender equality high on the agenda. Experience from safety culture research was used together with a literature review to identify indicators and develop questions for a survey tool to measure and evaluate gender equality culture. This survey has been tested in the maritime sector by 546 employees in the Swedish Maritime Administration responsible for matters such as fairway maintenance, pilotage, and road ferries. The results indicated an overall strong equality culture that nevertheless had some weak areas. Significant differences were found, with men believing to a greater extent than women that the workplace was sufficiently equal and that no one was excluded because of gender. Women believed to a greater extent than men that they had better knowledge of gender equality goals and strategy and they perceived that there was more talk about how to increase gender equality. The results indicated potential to identify strengths and weaknesses as a basis for activities and learning in order to achieve an improved equality culture.

Towards a food safety culture improvement roadmap: diagnosis and gap analysis through a conceptual framework as the first steps

The food safety culture research field still remains limited in terms of the process needed to achieve food safety culture improvement. : This paper proposes a food safety culture diagnosis and gap analysis methodology, as the first two steps in the food safety culture improvement roadmap. The diagnosis identifies what dimensions are mature or underdeveloped, whilst the gap analysis reveals what caused some dimensions to obtain lower scores in the diagnosis. The assessment approach is different from previously described approaches that stop in the assessment phase, as it is specifically designed to form the basis for further food safety culture interventions. It includes all departments and hierarchical levels in a company, applies a multitude of different tools (subjective and objective, quantitative and qualitative) and is based on an encompassing conceptual framework, to be able to provide a credible, conceptually based, multilayered and multidimensional assessment of food safety culture maturity. The goal is not to obtain an estimation of the prevailing food safety culture maturity, but to achieve a detailed food safety culture analysis which includes the causes and reasons which led to the obtained maturity. A conceptual framework of food safety culture was developed by refining the model of De Boeck et al. (2017), using a mapping review. A mixed-method assessment was designed to evaluate a company's prevailing food safety culture (its building blocks and layers). Integration and interpretation of data collected in the mixed-method assessment was done through the proposed food safety culture gap analysis. The mixed-method assessment methodology and gap analysis were illustrated in a case study of a ready-to-eat meal producing company (SME, 73 employees, from which 13 managers). : The presented conceptual framework of food safety culture distinguishes three key building blocks, i.e. the food safety management system activities, the human-individual and the human-organizational building block, each containing multiple dimensions. The mixed-method assessment was designed as follows. A diagnostic tool was applied for the assessment of the food safety management system activities. The human-organizational building block was measured using the food safety climate self-assessment tool (De Boeck et al., 2015), a card-aided management interview and on-site evidence collection visits (observations, interviews and document analysis). The latter two tools are newly presented in this paper. The human-individual building block was assessed using validated self-assessment statements, complemented with four questions to evaluate employees' food safety knowledge objectively. The gap analysis based on the data collected in the mixed-method assessment revealed six important gaps in the prevailing food safety culture of the ready-to-eat meal producing company (case), relating to the following building blocks and embedded dimensions: FSMS activities: ‘control activities’, human-organizational building block: ‘commitment’, ‘adaptability’, ‘consistency’, ‘beliefs and values’ and ‘mission, vision and strategy’. This profound diagnosis methodology can be applied for the development of tailored improvement strategies (interventions), which is the next step in the improvement roadmap, to enhance the level of food safety culture. • A conceptual framework, diagnosis and gap analysis methodology are presented. • The assessment approach is designed to form the basis for interventions. • The diagnosis measures the dimensions' maturity through a mixed-method assessment. • The gap analysis reveals causes for lower scores obtained in the diagnosis phase. • The first two steps in the food safety culture improvement roadmap are completed.

A bibliometric analysis on safety culture maturity model

The effectiveness of the occupational health and safety management system came under criticism for its inability to reduce work accidents effectively. Consequently, a new approach, the safety culture approach, emerged. One noteworthy development in safety culture research is the safety culture maturity model. This study briefly overviews recent progress in the safety culture maturity model. To assess the model's current status and development trends, a bibliometric analysis approach was employed, utilizing journal articles listed in Scopus and Pubmed.The maturity model for safety culture is an evolving area of research, primarily focused on the construction sector but progressively extending to diverse industrial domains beyond high-risk companies. The predominant research involves the development of maturity models, with only a limited portion dedicated to assessing the model's validity and reliability, exploring connections between maturity measurements, safety performance, and overall organizational effectiveness. The multitude of safety culture definitions influences the use of diverse dimensions in assessing work culture. Typically, a five-level maturity scale with various labels is employed in these studies.

Understanding safety culture and safety citizenship through the lens of social identity theory

There is considerable overlap between the concepts of culture and social identity. Here, in the context of organisational safety culture, we investigate the extent to which social identity processes can inform our understanding of organisational culture on safety citizenship behaviour. We test this relationship via two different social identity processes: (1) individuals’ organisational identity (a classically individual-level conceptualisation of social identity); and (2) individuals’ perceptions of others’ organisational identities (meta-identity; a social identity framing of culture). Safety culture survey data from 1,427 air traffic workers were analyses using a simple holdout cross-validation approach for model testing. We find that both identity processes mediate the link between safety culture and safety behaviour. The data also demonstrate that the strength of indirect effect of safety culture on safety citizenship via meta-identity is stronger with increasing levels of organisational identity. Moving forward, safety culture research and interventions may benefit from taking a social identity lens to understanding their culture (e.g. developing identity for safety and safe practice), which has implications for safety behaviour. Consideration of meta-identity has implications for behaviour change initiatives, as individuals who perceive strong group commitment in other group members may be more influenced by interventions that leverage group norms.

Measuring Safety Culture Using an Integrative Approach: The Development of a Comprehensive Conceptual Framework and an Applied Safety Culture Assessment Instrument.

An exponential amount of academic research has been dedicated to the safety culture concept, but still, no consensus has been reached on its definition and content. In general, safety culture research lacks an interdisciplinary approach. Furthermore, although the concept of safety culture is characterised by complexity and multifacetedness, the safety culture concept has been characterised by reductionism, where models and theories simplify the concept in order to better grasp it, leading to confined approaches. In this article, the multifacetedness of safety culture is acknowledged, and the topic is addressed from a safety science perspective, combining insights from multiple academic disciplines. An integrative and comprehensive conceptual framework to assess safety culture in organisations is developed, taking into account the limitations of existing models, as well as the needs of the work field. This conceptual framework is called the ‘Integrated Safety Culture Assessment’ (ISCA), where the ‘assessment’ refers to its practical usability. The practical rendition of ISCA can be used to map the safety culture of an organisation and to formulate recommendations in this regard, with the ultimate goal of bringing about a change towards a positive safety culture. The comprehensiveness of ISCA lies in the inclusion of technological factors, organisational or contextual factors and human factors interacting and interrelating with each other, and in considering both observable or objective safety-related aspects in an organisation, and non-observable or subjective safety-related aspects. When using ISCA, organisational safety culture is assessed in an integrative way by using a variety of research methods involving the entire organisation, and by taking into account the specific context of the organisation.

The landscape of safety management systems research: A scientometric analysis

Safety management systems (SMSs) are widely applied across many industrial sectors, and a large body of literature has been published addressing their design, implementation, effectiveness, and associated challenges. This article presents a high-level analysis of the SMS research domain, guided by a set of questions addressing the contents, structure, and evolution the research domain, its dominant themes and focus topics, the key scientific domains and journals contributing to its development, and the key publications serving as an intellectual basis for SMS related research. The results show a rapidly increasing volume of research outputs and a shift from research based in North America and Europe to Asia and Australia. There is only a limited number of institutions enduringly contributing to the field, and there are relatively few stable research collaborations, with the number of Chinese institutions publishing SMS related research fast expanding in recent years. The domain is strongly interdisciplinary and embedded in applied domains of science, with industrial engineering the most contributing category, as well as categories focusing on the industrial application domains. A temporal evolution of the research activity in different application domains is apparent, with an initial focus on occupational health and safety, followed by process safety, patient safety, food safety, and construction safety. SMS research has a strong relation to safety culture and safety climate research, and while safety and risk management concepts and theories form an important knowledge base for most application domains, the dominant views on accident causation differ between these. Research on SMS in the food industry is relatively separated from the other application domains. Based on the findings, various future research directions are discussed.

Conceptualizing the Contextual Dynamics of Safety Climate and Safety Culture Research: A Comparative Scientometric Analysis.

Safety climate and safety culture are important research domains in risk and safety science, and various industry and service sectors show significant interest in, and commitment to, applying its concepts, theories, and methods to enhance organizational safety performance. Despite the large body of literature on these topics, there are disagreements about the scope and focus of these concepts, and there is a lack of systematic understanding of their development patterns and the knowledge domains on which these are built. This article presents a comparative analysis of the literature focusing on safety climate and safety culture, using various scientometric analysis approaches and tools. General development patterns are identified, including the publication trends, in terms of temporal and geographical activity, the science domains in which safety culture and safety climate research occurs, and the scientific domains and articles that have primarily influenced their respective development. It is found that the safety culture and safety climate domains show strong similarities, e.g., in dominant application domains and frequently occurring terms. However, safety culture research attracts comparatively more attention from other scientific domains, and the research domains rely on partially different knowledge bases. In particular, while measurement plays a role in both domains, the results suggest that safety climate research focuses comparatively more on the development and validation of questionnaires and surveys in particular organizational contexts, whereas safety culture research appears to relate these measurements to wider organizational features and management mechanisms. Finally, various directions for future research are identified based on the obtained results.

Methodological aspects of patient safety culture research: A scoping Review

Investigating the safety culture has been relevant for more than two decades as a tool to improve the quality of patient care. This is a scope review of the last 20 years, whose objective is to investigate the type and prevalence of methodological approaches to patient safety culture and climate research. A review protocol was registered. The results were reported according to reports of preferred items for systematic reviews and extension of meta-analyzes for scope reviews (PRISMA-ScR). 107 studies were included. From the results, three major themes emerged for discussion, and the studies were classified into 1) Methodological approach and indeterminate use of concepts of climate and safety culture; 2) The isolated use of self-administered questionnaires in safety culture surveys and 3) A survey of the mixed methods approach in patient safety culture research. The quantitative approach was shown to be predominant, with the use of self-administered questionnaires for studies of the climate and culture of patient safety. The studies pointed out several limitations in the exclusive use of questionnaires, emphasizing the need to include multimethod research and the use of qualitative data collection techniques as an essential complement for the diagnosis of the patient safety culture.

AERODROM security climate: development and validation of the aerodrome security climate questionnaire (ADSECQ)

Large numbers of passengers and large amounts of goods are transported by air every year. This attracts the interest of terrorists, which poses high demands on aerodrome security. Technological solutions, and rules and regulations, have been widely implemented to detect security threats, but there is also a need for leading security indicators. Safety culture and climate have been identified as such leading indicators. The aim of this study was to develop and test a questionnaire instrument to measure aerodrome security climate. The development contained an expert focus group, expert panel, two pilot tests at four and five airports, respectively, and one full-scale study at nine Swedish commercial airports. The final instrument comprised 12 dimensions grounded in previous safety culture and climate research, and targeting three organizational levels. It had good psychometric properties and was validated against compliant as well as participative security behavior. We believe ADSECQ is suitable to evaluate the aerodrome security climate standard, pinpoint security climate areas for improvement, and evaluate the effect of interventions.

Adverse event notification analysis through patient safety culture research

Objetivo: a avaliação da cultura de segurança do paciente permite aos hospitais identificar e gerir prospectivamente questões relevantes de segurança em suas rotinas de trabalho. Método: estudo quantitativo, transversal e descritivo, ocorrida no ano de 2017 na Unidade de Terapia Intensiva Adulta em um hospital privado, localizado em Niterói/RJ. A população foram os profissionais médicos e equipe de enfermagem, utilizando análise estatística por meio de programa R, com a interface Rcmdr. Resultados: baseados nas respostas às perguntas sobre notificação de eventos aplicada com a Pesquisa de Cultura de Segurança do Paciente a 97 profissionais, com uma taxa de resposta de 85,6%, correspondendo a 83 profissionais. Menos de 45% dos participantes da pesquisa sempre notificam um erro, engano ou falha, que afete ou não o paciente, 59,0% não fizeram nenhuma notificação nos últimos 12 meses antecedentes à pesquisa e não houve diferença significativa na quantidade de notificação que destacasse uma categoria profissional, graduados ou não. Discussão: houve maior adesão à notificação de eventos pelos com maior tempo de hospital e com maior tempo naquela terapia intensiva. Não se encontrou correlação do número de notificações relatadas com o tempo de profissão e com a carga horária de trabalho. Conclusão: no que tange à conscientização de incrementar a adesão à notificação de eventos, a análise realizada contribuiu para a melhoria da segurança do paciente.

Comparison of hygiene standards and food safety practices between sole-proprietor and corporate-managed restaurants in Lebanon

PurposeThe objectives of this study were to compare the hygiene standards and food handling practices between sole-proprietor and the corporate-managed restaurants in Lebanon and to determine whether the variations between both groups are explained by and directly related to the type of management.Design/methodology/approachAn in-depth observation assessment of food safety environment and practices was conducted on a convenient sample of 50 food businesses in Beirut, which are typical of foodservice outlets in Lebanon and in many countries of the Middle East. The observation assessment checklist comprised six constructs of 2–7 components for analysis. It covered all areas including documentation and record-keeping requirements, which are crucial parts of a food safety system.FindingsThere was a significant difference in the visual assessment score between sole-proprietor (77.9 ± 18.4) and corporate group (48.5 ± 12.8). Food handlers' behavior and hygiene standards were significantly associated with the type of management. However, there were still critical gaps in the food safety performance of the corporate group suggesting other underlying factors than the type of management.Practical implicationsAdditional elements were drawn from this study for future food safety culture research. Understanding the food safety attitudes and perception of risks of the management representatives, leaders, or food business owners is vital to develop appropriate food safety interventions and foster a positive food safety culture in the foodservice industry.Originality/valueTo the authors’ knowledge, this is the first study not only in Lebanon (or MENA) but also in other regions to measure the association of management type, that is, sole-proprietor management and corporate management, with the food hygiene standards and food safety practices in the foodservice establishments. This paper presents new findings that will be of value for researchers in food safety and will complement the existing literature on food safety culture in the foodservice industry.

An intercontinental analysis of food safety culture in view of food safety governance and national values

Taking food safety culture into account is a promising way to improve food safety performance in the food industry. Food safety culture (FS-culture) research is expanding from an organisational perspective to include characteristics of the internal and external company environment. In this study, the prevailing food safety culture in 17 food companies from four countries on three continents (Africa, Asia and Europe) was assessed in view of food safety governance and national values. The internal environment characteristics, i.e. food safety vision, food safety program and food production system vulnerability, were also assessed. Statistical analysis revealed little variation in FS-culture scores between the companies within the same country. Overall the FS-culture for Greek and Zambian companies was scored proactive, while for Chinese and Tanzanian companies an active score was achieved. Both the internal and external company environment seemed to influence the prevailing FS-culture. Cluster analysis showed that Tanzanian and Zambian companies exhibited similarities in the implementation of food safety programs, and in their national values and food safety governance as compared to Greece and China. Food safety governance was reflected in the food safety programs and supportiveness of the organisation to food safety and hygiene. All cultural dimensions were correlated with risk perceptions, with masculinity and long-term orientation also significantly correlated with the enabling conditions and attitude. Understanding how national values and food safety governance approaches differently influence food safety culture is expected to enable formulation of best approaches tailored for companies operating in countries with different company environments, to improve food safety performance.

Informing Healthcare Team Performance: Integrating Data to Improve Quality and Safety

A worldwide rising demand for health care means increasing resource investment in health systems, with the concomitant requirement for greater accountability. Greater accountability requires the generation of more and more data and information. Health care is frequently described as fragmented or siloed, and this is reflected in how data is captured, managed, and shared throughout the system. Data relating to business performance, quality, and patient safety is extracted from different systems, and its primary use is to inform senior decision makers about organizational-level performance. Meanwhile, health care teams at a local level when asked if they are performing well in relation to quality and safety are often unable to answer this question. This policy brief summarizes the results of a study undertaken as part of the Collective Leadership for Safety Culture research program to codesign a suite of quality and safety performance indicators to assist acute hospital health care teams to monitor and improve their quality and safety performance. Recommendations are presented for senior decision makers in the acute hospital setting to inform policy on the gathering and management of Quality and Safety data.

Review of concepts and Trends in Safety culture research of construction Industry

Review of concepts and Trends in Safety culture research of construction Industry

Safety culture research and practice: A review of 30 years of research collaboration

Safety culture is a prevalent construct in industrial safety management and arguably one of the most important developments in industrial safety in recent history. This paper aims to provide insight into how an undefined term coined in 1986 has become a major area of collaborative research. This paper also intends to discuss how the construct of safety culture is a positive example of collaborative research and knowledge translation. A literature search was conducted to identify all peer‐reviewed journal articles that included the term “safety culture” in the title in the database. The relevant publications are compared with the use of safety culture by industry and governments to illustrate the intertwined relationship between research and practice. An initial literature search yielded 1,253 article findings. After refining search results, 420 relevant peer‐reviewed articles from 1986 until 2016 remained. Safety culture research has been conducted in response to industry interest in the concept. This industry interest has not only resulted in excellent knowledge translation but also may have contributed to the fragmentation of the research area.

Safety culture and power: Interactions between perceptions of safety culture, organisational hierarchy, and national culture

Practices that involve power dynamics are integral to maintaining organisational safety (e.g. speaking-up, challenging poor behaviour, admitting error, communicating on safety), and staff engagement in these is assumed to be shaped by perceptions of safety culture. These perceptions, in-turn, are associated with (1) positions within an organisational hierarchy (which makes power-related acts more or less threatening), and (2) societal values for power distance (e.g. challenging authority). With a sample of 13,573 of air traffic control staff (controllers, engineers, administrative, and management) from 21 national air traffic providers, we reconfirm the observation that managers perceive safety culture more positively than frontline staff (hypothesis 1), and that workers in countries with established values for hierarchy and power report safety culture as less positive than those from countries with low power distance (hypothesis 2). We then, for the first time, examine the interaction between these two factors, and establish that differences in safety culture perceptions between those higher in the hierarchy (management) and those lower in the hierarchy (air traffic controllers and administrative staff) are exacerbated by national contexts for large power distance (hypothesis 3). The study contributes to the literature by theorising the role of power in safety culture theory, and its influence upon safety culture perceptions. Moving forward, safety culture research and interventions may benefit from considering how power exists and manifests at the level of superior-subordinate dynamics.

Patient safety culture in care homes for older people: a scoping review

BackgroundIn recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes.MethodsA scoping review was undertaken to describe the availability of evidence related to care homes’ patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review.ResultsTwenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base.ConclusionsSafety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.

Researching safety culture: deliberative dialogue with a restorative lens

Safety culture is a key component of patient safety. Many patient safety strategies in health care have been adapted from high-reliability organizations (HRO) such as aviation. However, to date, attempts to transform the cultures of health care settings through HRO approaches have had mixed results. We propose a methodological approach for safety culture research, which integrates the theory and practice of restoration science with the principles and methods of deliberative dialogue to support active engagement in critical reflection and collective debate. Our aim is to describe how these two innovative approaches in health services research can be used together to provide a comprehensive effective method to study and implement change in safety culture. Restorative research in health care integrates socio-ecological theory of complex adaptive systems concepts with collaborative, place-sensitive study of local practice contexts. Deliberative dialogue brings together all stakeholders to collectively develop solutions on an issue to facilitate change. Together these approaches can be used to actively engage people in the study of safety culture to gain a better understanding of its elements. More importantly, we argue that the synergistic use of these approaches offers enhanced potential to move health care professionals towards actionable strategies to improve patient safety within today's complex health care systems.