Weaknesses In Safety Culture Research Articles

Оцінка культури безпеки у вітчизняній охороні здоров’я: триангуляційний підхід

The aim of the study. To evaluate the safety culture in domestic health care using a mixed approach, that is, using a questionnaire survey, document analysis, as well as an analysis of the state of safety of patients and medical personnel. Materials and methods. The evaluation of safety culture in Ukrainian healthcare has been carried out based on the methodology of the IAEA (International Atomic Energy Agency), specifically employing a triangulation approach involving questionnaire surveys, document analysis, as well as an analysis of patient and medical personnel safety conditions. Our analysis and assessment of the regulatory framework for safety provision in the hospital environment from 1994 to 2020, as well as the safety status of patients from 2003 to 2020 and medical personnel from 2002 to 2018, formed the basis of the material used in this study. Additionally, the evaluation of safety culture was conducted through a questionnaire survey involving 199 healthcare professionals from various healthcare facilities. Research results. The study revealed that safety culture in domestic healthcare facilities is at an early stage of formation and requires systematic improvement. Developing a more comprehensive methodology for assessing safety culture in the medical field is an important and promising direction for future research. The results of our study confirmed the effectiveness of employing a triangulation approach to assess the level of safety culture excellence in healthcare facilities. Conclusions. Strengthening the identified weaknesses in safety culture within the domestic medical industry can become the goal and foundation of a future strategy to create a safe hospital environment based on improving and enhancing safety culture.

Perception of medical-surgical wards’ patients from safety culture: A cross-sectional and multicenter study

Background and aims: Identifying the strengths and weaknesses of safety culture in hospitals can be the basis for developing plans to improve the safety status of patients. This study aimed to determine the level of patient safety culture (PSC) from their view in medical-surgical wards of five teaching hospitals in Zanjan. Methods: This cross-sectional study was performed on 245 patients admitted to medical-surgical wards of five teaching hospitals in the Zanjan, Iran, from 2020-Agust-22 to 2020-November-21. Poisson time sampling method was used. Data collection was performed using a demographic information questionnaire and PSC scale. The data were analyzed using SPSS 18 and descriptive statistics, independent t test, and one-way analysis of variance. Results: The mean of total PSC was 3.63±0.60 out of 5. The highest mean of PSC was related to organizing and planning for care (3.87±0.71) and communication and teamwork (3.80±0.70). The lowest mean was related to information dissemination (3.31±0.60). Conclusion: Safety culture or, in other words, patients’ perception of the safety situation prevailing in studied wards and hospitals was moderate. Therefore, it needs to be upgraded and improved. Among the various dimensions of patient-perceived safety, the manner and extent of information sharing was worse. It is suggested that plans be made to direct actions to improve the patient’s safety culture in general and in the field of information dissemination in particular.

Analysis of Safety Culture Weaknesses in Chemical Safety Board Investigation Reports

The U.S. Chemical Safety Board (CSB), an independent, non-regulatory federal agency that investigates the root causes of major chemical incidents, has firstly analyzed safety culture as an important element to maintain process safety in the investigation report of “BP America Refinery Explosion” in 2007. On the same year, the Center for Chemical Process Safety (CCPS) published Risk Based Process Safety (RBPS) in which process safety culture was newly added as an element. The author found six CSB reports which analyzed the weaknesses of safety culture and related them to the essential features of process safety culture in RBPS. Discussions are made on the results of the relations.

Repeated assessment of process safety culture in major hazard industries in the Rotterdam region (Netherlands)

In 2018, safety culture assessments were carried out in the Rotterdam region in nineteen major hazard companies. Four industrial sectors were involved: refineries, (petro) chemical industry, bulk storage, and chemical warehousing and logistics. Fourteen companies had participated in a similar evaluation in 2012. The assessment methodology developed in 2012 was both pragmatic (with a focus on fourteen dimensions) and normative (using a scale of 1–5 for safety culture maturity). A score of 3.0 was regarded as the minimum acceptable score for major hazards companies. The safety culture maturity scores compiled in this study allowed benchmarking of the safety cultures among the companies and sectors. The refineries had the highest ratings. In two chemical warehousing and logistics companies the safety culture maturity was below acceptable. Strengths and weaknesses of safety culture were identified at company and sector levels, and each company recognized and acknowledged the outcomes. The consistency in safety culture levels was shown to be an important factor, inconsistency blurring the borders between predefined levels of safety culture.The study is the first to present results of repeated safety culture maturity assessments. Comparing the 2012 and 2018 results in fourteen companies showed that consistently good or excellent scores in 2012 were a good predictor for an adequate safety culture six years later. The results showed that it is possible to improve the safety culture in six years from below acceptable (2.5) to good (4.0). However, no evidence was found for the ‘maturing process’ suggested in the theory. The interventions that were likely to have contributed to improvements in safety culture were education and training, launching a safety culture improvement program, realizing concrete safety improvements, and strengthening the involvement of the personnel.

Psychometric model for safety culture assessment in nuclear research facilities

A safe and reliable operation of nuclear power plants depends not only on technical performance, but also on the people and on the organization. Organizational factors have been recognized as the main causal mechanisms of accidents by research organizations through USA, Europe and Japan. Deficiencies related with these factors reveal weaknesses in the organization’s safety culture. A significant number of instruments to assess the safety culture based on psychometric models that evaluate safety climate through questionnaires, and which are based on reliability and validity evidences, have been published in health and ‘safety at work’ areas. However, there are few safety culture assessment instruments with these characteristics (reliability and validity) available on nuclear literature. Therefore, this work proposes an instrument to evaluate, with valid and reliable measures, the safety climate of nuclear research facilities. The instrument was developed based on methodological principles applied to research modeling and its psychometric properties were evaluated by a reliability analysis and validation of content, face and construct. The instrument was applied to an important nuclear research organization in Brazil. This organization comprises 4 research reactors and many nuclear laboratories. The survey results made possible a demographic characterization and the identification of some possible safety culture weaknesses and pointing out potential areas to be improved in the assessed organization. Good evidence of reliability with Cronbach's alpha coefficient of 0.951 was obtained. Validation method was based on Exploratory Factor Analysis (EFA), using Principal Components Analysis (PCA) and Varimax orthogonal factor rotation. The results confirmed the unidimensionality of the items and, almost entirely, the conceptual framework of the safety culture proposed for the instrument. However, the results also suggested that some adjustments to the conceptual framework of the instrument must be performed in case of a new application.

Assessing the Safety Culture of an Organisation

ABSTRACTThis paper describes a method for assessing the safety culture of an Organisation. The method is based on the key characteristics of world class safety performance. The article includes a questionnaire that can be used in surveys to assess the status of safety culture in an Organisation. The use of leading indicators designed to detect latent weaknesses in safety culture is described. Information on the balance among the dimensional elements of safety culture (psychological safety management and behavioural) can also be obtained. Results of a field trial of the method are given.