Safety Voice Research Articles

A multi-criteria decision-making approach for prioritizing factors influencing healthcare workers' safety performance: A case of a women's hospital

This study was designed to examine the influence of organizational and individual-level factors on the safety performance of healthcare workers at a women's hospital. Healthcare workers in different occupational groups enrolled in the current study. A questionnaire was used for data collection, and the data were analyzed using an integrated multi-criteria decision-making (MCDM) approach. The entropy method was applied to prioritize influential factors, including safety climate, perceived organizational support for safety, perceived supervisor support for safety, safety voice, organizational resilience, and individual resilience, and the technique for order preference by similarity to an ideal solution (TOPSIS) was employed to rank the alternatives (healthcare workers in different occupational groups). The finding of the entropy method illustrated that perceived organizational support for safety and organizational resilience had the highest influence on healthcare workers' safety performance. The other most influential factor was individual resilience. Regarding safety performance components, safety compliance was more important than safety participation. TOPSIS results suggested that radiologists, nurses, and midwives experienced higher safety performance levels than the other occupational groups in the study women's hospital. The findings of this study demonstrated that organizational and individual-level factors such as safety climate, perceived organizational and supervisor support for safety, and resilience-related factors significantly influence healthcare workers' safety performance, and compliance with safety rules and procedures is essential to achieve better safety performance.

Getting away “Scott” (but not Susan) free: The effects of safety‐specific abusive supervision and supervisor gender on follower attributions and safety outcomes

SummaryWhile most research emphasizes the harmful effects of abusive supervision, we argue that certain contextual factors—specifically hazardous work environments and supervisor gender—may lead abusive supervision to be perceived as driven by performance promotion intentions as opposed to injury initiation intentions. We introduce the concept of Safety‐Specific Abusive Supervision (SSAS), which we define as the extent to which a supervisor's active response to safety incidents is perceived by employees as abusive. Drawing from event system theory and research on attributions of abusive supervision, we theorize that when supervisors engage in SSAS, employees are more likely to attribute their behavior to performance promotion rather than injury initiation, perceiving the supervisors' actions as a means to keep them safe rather than to cause harm. We predict that performance promotion attributions mediate the relationship between SSAS and safety performance outcomes, namely safety voice and perceived supervisor safety commitment. However, consistent with role congruity theory, we hypothesize that this relationship is only true for male supervisors and not for female supervisors. Across three studies (two experimental studies and one field study), we largely find support for our hypotheses.

Safety Listening in Organizations: An Integrated Conceptual Review

Failures of listening to individuals raising concerns are often implicated in safety incidents. To better understand this and theorize the communicative processes by which safety voice averts harm, we undertook a conceptual review of “safety listening” in organizations: responses to any voice that calls for action to prevent harm. Synthesizing research from disparate fields, we found 36 terms/definitions describing safety listening which typically framed it in terms of listeners’ motivations. These motivational accounts, we propose, are a by-product of the self-report methods used to study listening (e.g., surveys, interviews), which focus on listening perceptions rather than actual responses following speaking-up. In contrast, we define safety listening as a behavioral response to safety voice in organizational contexts to prevent harms. Influenced by cognitive, interactional, and environmental factors, safety listening may prevent incidents through enabling cooperative sensemaking processes for building shared awareness and understanding of risks and hazards.

The Differential Effects of Leader Food Safety Priority and Ethical Leadership on Food Safety Promotive and Prohibitive Voices: A Socially Desirable Responding Theory Perspective

ABSTRACT Studies on impact of different leadership styles on the promotive and prohibitive forms of food safety voices are limited. Therefore, drawing on socially desirable responding theory, this study examined the differential effects of leader food safety priority and ethical leadership on food handlers’ promotive and prohibitive forms of food safety voices. We found that leader food safety priority and ethical leadership influence employee voice through different mechanisms. Moreover, the indirect impact of leader food safety priority on promotive voices was stronger, while ethical leadership had a stronger indirect effect on prohibitive voice. Finally, leader – member exchange strengthened the indirect effects of leadership antecedents on both forms of food safety voices. This study provides theoretical and practical contributions to food safety voice literature.

I Speak Up Because You Care: A Meta-Analytic Review of Safety Voice as a Social Exchange

I Speak Up Because You Care: A Meta-Analytic Review of Safety Voice as a Social Exchange

For the sake of safety: A time-lagged study investigating the relationships between perceived leadership behaviors and employee safety behaviors

BackgroundThe construction industry is affected by severe occupational accidents, and site managers’ leadership has been identified as critical in relation to safety. Most research in this field is cross-sectional and concerns broadly defined meta-categories of behaviors. AimsBy investigating the relationships between perceived specific leadership behaviors (i.e., planning, safety commitment, safety positive feedback, and active listening) and employee safety behaviors (i.e., compliance, participation, and voice), both cross-sectionally and across time (including exploration of reciprocal effects) this study aims to A) identify specific leadership behaviors of relevance for employee safety behaviors and B) further elucidate the time-lagged, prospective, relationship between managers’ safety-related leadership behaviors and employees’ safety behaviors. MethodConstruction site employees rated their managers’ leadership behaviors and their own safety behaviors on two occasions with a 4-month time lag (T1 and T2), using electronic questionnaires. Three cross-lagged panel models, one for each category of employee safety behaviors, were tested for cross-sectional, time-lagged and reciprocal effects. ResultsThe cross-sectional results support positive associations between all measured categories of perceived leadership behaviors and employee safety behaviors, with bivariate correlation coefficients ranging between 0.25 and 0.55. When controlling for respondents’ levels on the constructs at T1, the time-lagged data does not support prospective influence of planning, safety-specific positive feedback, or active listening leadership behaviors on employee safety behaviors, but does support prospective positive influence of safety commitment leadership behaviors on employee safety voice behaviors (ß = 0.34, p =.05). Reversed causality was found Employee safety compliance behaviors had a prospective positive influence on perceived active listening leadership behaviors (β = 0.20, p =.05) indicating that managers with employees that display high degrees of safety compliance behaviors show higher degrees of active listening behaviors 4 months later. ConclusionsThis study contributes with specific information about what kind of day-to-day leadership behaviors are associated with employee safety behaviors in the construction industry. Furthermore, the time-lagged data supports prospective influence of perceived safety commitment leadership behaviors on employee safety voice behaviors, suggesting that construction site managers should be trained and supported in consistently encouraging safe behaviors and in interrupting risk behaviors, in congruence with the safety information provided. Reversed causality was found, implying the existence of reciprocity in the leader-employee relationship.

Safety Management System for Lone Working Person in Industry

The purpose of this study was to investigate the risk of working alone (lone working) in the home industry and the benefits of implementing safety voice (speaking up behavior), to identify opportunities for effective intervention, with the goal to retain satisfied Industries. It is without a doubt that the employer must protect and take care of its employees by providing necessary facilities and ensuring the workstation is safe. Significant concepts emerged from this literature review on lone workers: risk perception of lone Industries workers; employee safety voice; organizations preventive and protective strategies for lone Industries employees; and focus groups of home visiting health care providers. All have substantial years of practical experience in delivering home health care to young patients and the aged communities. The participant’s responses to the interview and survey question revealed the safety concerns, occupational hazards at the patient’s home, and the need for employers to assess risk management on patients’ home before these workers visit the homes.

An integrative systematic review of employee silence and voice in healthcare: what are we really measuring?

The history of inquiries into the failings of medical care have highlighted the critical role of communication and information sharing, meaning that speaking up and employee silence have been extensively researched. However, the accumulated evidence concerning speaking-up interventions in healthcare indicates that they achieve disappointing outcomes because of a professional and organizational culture which is not supportive. Therefore, there is a gap with regard to our understanding of employee voice and silence in healthcare, and the relationship between withholding information and healthcare outcomes (e.g., patient safety, quality of care, worker wellbeing) is complex and differentiated. The following integrative review is aimed at addressing the following questions; (1) How is voice and silence conceptualized and measured in healthcare?; and (2) What is the theoretical background to employee voice and silence?. An integrative systematic literature review of quantitative studies measuring either employee voice or employee silence among healthcare staff published in peer-reviewed journals during 2016-2022 was conducted on the following databases: PubMed, PsycINFO, Scopus, Embase, Cochrane Library, Web of Science, CINAHL and Google Scholar. A narrative synthesis was performed. A review protocol was registered on the PROSPERO register (CRD42022367138). Of the 209 initially identified studies for full-text screening, 76 studies met the inclusion criteria and were selected for the final review (N = 122,009, 69.3% female). The results of the review indicated the following: (1) concepts and measures are heterogenous, (2) there is no unifying theoretical background, and (3) there is a need for further research regarding the distinction between what drives safety voice versus general employee voice, and how both voice and silence can operate in parallel in healthcare. Limitations discussed include high reliance on self-reported data from cross-sectional studies as well as the majority of participants being nurses and female staff. Overall, the reviewed research does not provide sufficient evidence on the links between theory, research and implications for practice, thus limiting how research in the field can better inform practical implications for the healthcare sector. Ultimately, the review highlights a clear need to improve assessment approaches for voice and silence in healthcare, although the best approach to do so cannot yet be established.

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.

How does subjective invulnerability impact young workers’ safety voice?

Introduction: Young workers are at risk of workplace injuries for numerous reasons. One contentious yet untested theory is that subjective invulnerability to danger—a sense of indestructability in the face of physical hazards—can affect some young workers’ reactions to workplace hazards. This study contends that subjective invulnerability can affect these reactions in two ways: (a) perceptions of physical hazards at work generate less fear of injury among those who perceive themselves as more invulnerable and/or; (b) fear of injury does not motivate speaking up about safety concerns (safety voice) among those who perceive themselves as more invulnerable. Method: This paper tests a moderated mediation model in which higher perceptions of physical hazards at work are related to higher safety voice intentions via higher fear of injury, but that subjective invulnerability reduces the extent to which: (a) perceptions of physical hazards at work are associated with fear of injury and/or; (b) fear of injury is associated with safety voice. This model is tested in two studies of young workers (Study 1 on-line experiment: N = 114, M age = 20.67, SD = 1.79; range = 18–24 years; Study 2 field study using three waves of data collected at monthly intervals: N = 80, M age = 17.13, SD = 1.08, range = 15–20 years). Results: Contrary to expectations, the results showed that young workers who feel more invulnerable to danger are more likely to speak up about safety when experiencing higher fear of injury, and that perceptions of physical hazards–safety voice relationship is mediated by fear of injury for those who perceive themselves to be more invulnerable to danger. Conclusions/Practical Applications: Rather than subjective invulnerability silencing safety voice as predicted, the current data suggest that subjective invulnerability may serve to accelerate how fear of injury motivates safety voice.

The Influence Mechanism of Political Skill on Safety Voice Behavior in High-Risk Industries: The Mediating Role of Voice Efficacy

As an important indicator to measure the adaptability and development potential of individuals in an organization, political skill is rarely considered as an antecedent variable in the field of safety voice. This study is based on impression management theory and social cognitive theory. From the perspective of employee self-service-oriented safety voice motivation, we took political skill as a predictor of safety voice behavior and introduced voice efficacy as an intermediary variable to construct a theoretical model of the relationship between political skill, voice efficacy, and safety voice behavior. We used the method of questionnaire to collect data from employees in high-risk industries. SPSS and AMOS software were used as analysis tools to examine the relationship between political skill, voice efficacy, and safety voice behavior. The study results show that: (1) political skill has a significant positive impact on safety voice behavior; and (2) voice efficacy plays a mediating role in the relationship between political skill and safety voice behavior. In this study, a new predictor of safety voice behavior and its mediation mechanism were obtained. Political skill can not only reflect the psychological cognitive ability of individuals in dangerous work environments, but it is also an important manifestation of the social exchanges between employees and organizations. In the special organizational context where China generally values "guanxi", political skill has a stronger ability to predict and explain safety voice behavior. This research can help organizations obtain safety-related suggestions from employees in a timely manner and realize the sustainable development of safety management.

The influence of learning-oriented leadership for promoting future-directed workplace safety in the mining industry

Learning-oriented behaviour is important for risk identification and safety management, especially in high-risk industries. Yet, its effect in relation to employee safety citizenship behaviour (SCB) has not been systematically investigated. This study aims at: (a) examining the impact of safety learning behaviour on SCB; (b) examining the relationship between job risk assessment, safety training and safety learning; and (c) examining the mediating effect of safety learning on the relationship between job risk assessment, safety training and SCB. Data were collected from a sample of 316 employees of six large-scale gold mining companies in Ghana, and analysed using the partial least squares-structural equation analysis. The results showed positive significant associations between safety learning and employee-safety voice and safety stewardship behaviours. Job risk assessment, safety training and safety learning were also associated positively with each other. The results showed further that safety learning mediates the relationship between safety training and employee safety voice and safety stewardship behaviours. Our findings provide implications for theory and practice as it points out the critical influence of learning-oriented supervisors behaviour for promoting future-directed workplace safety.

Ethical leadership supports safety voice by increasing risk perception and reducing ethical ambiguity: Evidence from the COVID-19 pandemic.

Misconduct by business and political leaders during the pandemic is feared to have impacted people's adherence to protective measures that would help to safeguard against the spread of COVID-19. Addressing this concern, this article theorizes and tests a model linking ethical leadership with workplace risk communication-a practice referred to as 'safety voice' in the research literature. Our study, conducted with 511 employees from UK companies, revealed that ethical leadership is positively associated with greater intention to engage in safety voice regarding COVID-19. We also find that this association is mediated by relations with the perceived health risk of COVID-19 and ambiguity about ethical decision making in the workplace. These findings therefore underscore the importance of good ethical conduct by leaders for ensuring that health and safety risks are well understood and communicated effectively by organizational members particularly during crises. We discuss the theoretical and practical implications of our study and highlight further opportunities for future research to address the ethical dimensions of leadership, risk management, and organizational risk communication.

Upward safety communication in the workplace: How team leaders stimulate employees’ voice through empowering and monitoring supervision

The importance of employees’ voice for workplace safety management is receiving growing attention. The present contribution focuses on three different categories of safety-specific voice behaviours and their links with complementary safety supervision styles: promotive voice (i.e. offering original suggestions to improve safety in work practices), preventive voice (i.e. raising personal concerns for potential risks), and proscriptive voice (i.e. speaking up against violations of safety standards). The first aim of the study is to provide evidence of the differential validity of the three categories of safety voice. Second, it intends to investigate how team leaders can stimulate these different kinds of employees’ voice. A survey investigation was conducted in a multinational chemical industry (N = 192). The statistical results of the study unveil that only empowering supervision affected promotive and preventive voices, whereas proscriptive voice was found to be affected by both empowering and monitoring supervision. Overall, the findings seem to indicate a substantial conceptual independence between the three categories of safety voice. At the same time, the study suggests that distinct supervision actions may affect these different expressions of employees’ safety voice in different ways, underlining the importance of a differential approach to these constructs, not only for research advancement, but also for the design of appropriate organisational programs aimed at stimulating open safety communication in the workplace, and to develop a more articulated approach to safety supervision, in order to support employees’ propensity to engage in appropriate safety voice actions, in accordance with their working situations.

How Safety Climate Impacts Safety Voice-Investigating the Mediating Role of Psychological Safety from a Social Cognitive Perspective.

Safety voice has become a popular research topic in the organizational safety field because it helps to prevent accidents. A good safety climate and psychological safety can motivate employees to actively express their ideas about safety, but the specific mechanisms of safety climate and psychological safety, on safety voice, are not yet clear. Based on the “environment-subject cognition-behavior” triadic interaction model of social cognitive theory, this paper explores the relationship between safety climate and safety voice, and the mediating role of psychological safety. We collected questionnaires and conducted data analysis of the valid questionnaires using analytical methods such as hierarchical regression, stepwise regression, and the bootstrap sampling method. We found that safety climate significantly and positively influenced safety voice, and psychological safety played a mediating role between safety climate and safety voice, which strengthened the positive relationship between them. From the research results, it was clear that to stimulate employees to express safety voice behavior, organizations should strive to create a good safety climate and pay attention to building employees’ psychological safety. The findings of this paper provide useful insights for the management of employee safety voice behavior in enterprises.

Development and validation of employee safety voice scale in the Chinese organizational context

AbstractSafety voice helps organizations to identify safety issues timely and is critical to the long-term growth of the organization. Safety voice has become a hot research topic in organizational safety, and different scales have been developed. However, the unique cultural context in China has led to the need to redevelop safety voice measurement tools. In this paper, we developed an initial scale of safety voice for employees in Chinese organizational contexts fusing in-depth interviews and mature scales. The initial scale based on two samples (n1 = 205,n2 = 420) was revised and validated using item analysis, exploratory factor analysis, confirmatory factor analysis, and reliability analysis to finalize the final scale. We finally found that the safety voice scale in Chinese organizational contexts contains two dimensions: promotive safety voice and prohibitive safety voice. The scale developed in this paper is a reliable tool to measure safety voice behavior of Chinese employees.

Workers' relational identification with supervisors influences safety behaviour in construction projects

PurposeThis research aims to examine the influence of workers' identification with their supervisors on safety behaviour in construction projects.Design/methodology/approachEmploying the job demands–resources theory, this research tested the relationships among relational identification as a personal resource, respectful engagement as a job resource, employee safety voice as a positive work behaviour and safety behaviour as the outcome. Partial least squares structural equation modelling (PLS-SEM) was used to analyse 120 quantitative data collected using a questionnaire survey.FindingsRelational identification, which reflects workers' identification with their supervisors, is a significant predictor of safety behaviour. Furthermore, respectful engagement and employee safety voice sequentially mediate the relationship between relational identification and safety behaviour.Research limitations/implicationsThe internalisation of safety norms, values and practices in construction projects is contingent on the identification of workers with their supervisors.Originality/valueSafety behaviour of workers is a significant predictor of safety performance in construction projects. Research on numerous antecedents of safety behaviour points out that leadership is a significant predictor of construction workers' safe behaviour. Contributing to research on construction safety leadership, this research found that leader-subordinate relationship is key to make construction workers more psychologically ready to internalise the importance of safety behaviours at work.

Ethical Leadership Supports Safety Voice by Increasing Perceived Risk and Reducing Ethical Ambiguity

Drawing on social exchange theory, this paper theorizes and tests a model linking ethical leadership with workplace communication of health and safety risks by employees – termed ‘safety voice’ – regarding the dangers posed by COVID-19. Our study, conducted with 511 employees from UK companies, revealed that ethical leadership encourages safety voice through increasing the perceived health risk of COVID-19 and reducing ambiguity associated with making ethical decisions in the workplace. Our findings thereby underscore the importance of good ethical conduct by leaders for ensuring health and safety risks are managed and communicated effectively within organizations during crises. We discuss the theoretical and practical implications of our study, and highlight further opportunities for future research to address the ethical dimensions of leadership and organizational risk management and communication.

The Effects of Safety-Related Abusive Supervision and Gender on Attributions and Safety Outcomes

While most research implies the harmful effects of abusive supervision, we argue that there are specific contextual factors where abusive supervision is more likely to be attributed to performance promotion intentions as opposed to injury initiation ones. We present the concept of Safety-Specific Abusive Supervision, which we define as perceptions of abusive supervisory behaviors related to safety that occur in hazardous work environments. We theorize that leaders who engage in Safety-Specific Abusive Supervision are more likely to have their behaviors attributed to performance promotion motives such that their actions are perceived to keep employees safe and motivate safety performance. We suspect that those performance promotion attributions act as a mediator between safety-specific abusive supervision and safety performance outcomes, namely safety voice and safety climate. However, we predict that this relationship is only true for male supervisors and not female supervisors. Across three studies (two experimental studies and one field study), we largely find support for our hypotheses. We conclude with a discussion of the importance of examining contextual factors for examining the attributions of abusive supervision and implications for managers of work safety relevant environments.

When and for whom organizational identification is more effective in eliciting safety voice: an empirical study from the construction industry perspective

Safety voice (SV) is a form of voice in which employees express opinions or concerns about organizational safety. It plays an important role in preventing accidents and promoting safety performance. The purpose of this study is to reveal the emotional factors and boundary conditions behind employee engagement in SV, especially in the construction context. This study, therefore, investigated how organizational identification (OID) drove construction project participants’ SV using a three-way interaction model of perceived insider status (PIS) as an individual difference and safety climate (SC) as an organizational contextual difference. The proposed model was tested using a sample of 357 participants in different construction projects. The results showed that OID was positively correlated with SV. The interaction effect of OID and PIS on SV depended on SC, with PIS enhancing the identification–voice relationship at a low level of SC and weakening it at a high level of SC.