A relational leadership perspective on unit-level safety climate.

PubMed

Thompson, Debra N; Hoffman, Leslie A; Sereika, Susan M; Lorenz, Holly L; Wolf, Gail A; Burns, Helen K; Minnier, Tamra E; Ramanujam, Rangaraj

2011-11-01

This study compared nursing staff perceptions of safety climate in clinical units characterized by high and low ratings of leader-member exchange (LMX) and explored characteristics that might account for differences. Frontline nursing leaders' actions are critical to ensure patient safety. Specific leadership behaviors to achieve this goal are underexamined. The LMX perspective has shown promise in nonhealthcare settings as a means to explain safety climate perceptions. Cross-sectional survey of staff (n = 711) and unit directors from 34 inpatient units in an academic medical center was conducted. Significant differences were found between high and low LMX scoring units on supervisor safety expectations, organizational learning-continuous improvement, total communication, feedback and communication about errors, and nonpunitive response to errors. The LMX perspective can be used to identify differences in perceptions of safety climate among nursing staff. Future studies are needed to identify strategies to improve staff safety attitudes and behaviors. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Effect of STOP technique on safety climate in a construction company.

PubMed

Darvishi, Ebrahim; Maleki, Afshin; Dehestaniathar, Saeed; Ebrahemzadih, Mehrzad

2015-01-01

Safety programs are a core part of safety management in workplaces that can reduce incidents and injuries. The aim of this study was to investigate the influence of Safety Training Observation Program (STOP) technique as a behavior modification program on safety climate in a construction company. This cross-sectional study was carried out on workers of the Petrochemical Construction Company, western Iran. In order to improve safety climate, an unsafe behavior modification program entitled STOP was launched among workers of project during 12 months from April 2013 and April 2014. The STOP technique effectiveness in creating a positive safety climate was evaluated using the Safety Climate Assessment Toolkit. 76.78% of total behaviors were unsafe. 54.76% of total unsafe acts/ at-risk behaviors were related to the fall hazard. The most cause of unsafe behaviors was associated with habit and unavailability of safety equipment. After 12 month of continuous implementation the STOP technique, 55.8% of unsafe behaviors reduced among workers. The average score of safety climate evaluated using of the Toolkit, before and after the implementation of the STOP technique was 5.77 and 7.24, respectively. The STOP technique can be considered as effective approach for eliminating at-risk behavior, reinforcing safe work practices, and creating a positive safety climate in order to reduction incidents/injuries.

Work-related injury factors and safety climate perception in truck drivers.

PubMed

Anderson, Naomi J; Smith, Caroline K; Byrd, Jesse L

2017-08-01

The trucking industry has a high burden of work-related injuries. This study examined factors, such as safety climate perceptions, that may impact injury risk. A random sample of 9800 commercial driver's license holders (CDL) were sent surveys, only 4360 were eligible truck drivers. Descriptive statistics and logistic regression models were developed to describe the population and identify variables associated with work-related injury. 2189 drivers completed the pertinent interview questions. Driving less-than-truckload, daytime sleepiness, pressure to work faster, and having a poor composite score for safety perceptions were all associated with increased likelihood of work-related injury. Positive safety perception score was protective for odds of work-related injury, and increased claim filing when injured. Positive psychological safety climate is associated with decreased likelihood of work-related injury and increased likelihood that a driver injured on the job files a workers' compensation claim. © 2017 Wiley Periodicals, Inc.

The relationship between safety climate and recent accidents: behavioral learning and cognitive attributions.

PubMed

Desai, Vinit M; Roberts, Karlene H; Ciavarelli, Anthony P

2006-01-01

The association between accidents and subsequent work unit safety perceptions was assessed to address cognitive and behavioral changes following accidents. Many studies attempt to predict accident rates using measures of work unit safety, but effects vary considerably. Conversely, this study examined whether recent accidents may be positively associated with work unit safety perceptions, as suggested by behavioral learning mechanisms (increases in safety investments following accidents) or cognitive mechanisms (defensive attributions regarding accident causality). Lagged squadron-level accident experience was correlated with work unit safety perceptions obtained through a 61-question safety climate survey administered to 6,361 individuals in U.S. Navy flight squadrons. Positive associations between minor or intermediately severe accidents and future safety climate scores were found, although no effect was found for major accidents. We suggest that accident history should be considered when examining work unit safety perceptions because recent accidents may be associated with higher safety climate scores. We did not find that this varies systematically with accident severity, and longitudinal research on additional samples is needed to further test this possibility. This research may be used to refine measurement of work unit safety and to examine impacts of accidents or safety violations on workers' cognitive processes and group behavioral changes.

Safety climate and its association with office type and team involvement in primary care.

PubMed

Gehring, Katrin; Schwappach, David L B; Battaglia, Markus; Buff, Roman; Huber, Felix; Sauter, Peter; Wieser, Markus

2013-09-01

To assess differences in safety climate perceptions between occupational groups and types of office organization in primary care. Primary care physicians and nurses working in outpatient offices were surveyed about safety climate. Explorative factor analysis was performed to determine the factorial structure. Differences in mean climate scores between staff groups and types of office were tested. Logistic regression analysis was conducted to determine predictors for a 'favorable' safety climate. 630 individuals returned the survey (response rate, 50%). Differences between occupational groups were observed in the means of the 'team-based error prevention'-scale (physician 4.0 vs. nurse 3.8, P < 0.001). Medical centers scored higher compared with single-handed offices and joint practices on the 'team-based error prevention'-scale (4.3 vs. 3.8 vs. 3.9, P < 0.001) but less favorable on the 'rules and risks'-scale (3.5 vs. 3.9 vs. 3.7, P < 0.001). Characteristics on the individual and office level predicted favorable 'team-based error prevention'-scores. Physicians (OR = 0.4, P = 0.01) and less experienced staff (OR 0.52, P = 0.04) were less likely to provide favorable scores. Individuals working at medical centers were more likely to provide positive scores compared with single-handed offices (OR 3.33, P = 0.001). The largest positive effect was associated with at least monthly team meetings (OR 6.2, P < 0.001) and participation in quality circles (OR 4.49, P < 0.001). Results indicate that frequent quality circle participation and team meetings involving all team members are effective ways to strengthen safety climate in terms of team-based strategies and activities in error prevention.

Perceived safety climate, job demands, and coworker support among union and nonunion injured construction workers.

PubMed

Gillen, Marion; Baltz, Davis; Gassel, Margy; Kirsch, Luz; Vaccaro, Diane

2002-01-01

This study evaluated injured construction workers' perceptions of workplace safety climate, psychological job demands, decision latitude, and coworker support, and the relationship of these variables to the injury severity sustained by the workers. Injury severity was assessed using the Health Assessment Questionnaire (HAQ), which evaluates functional limitations. Worker perceptions of workplace variables were determined by two instruments: (a) the Safety Climate Measure for Construction Sites and (b) the Job Content Questionnaire (JCQ). The overall model explained 23% of the variance in injury severity, with unique contributions provided by union status, the Safety Climate Score, and Psychological Job Demands. A positive significant correlation was found between injury severity and the Safety Climate Scores (r = .183, P = .003), and between the Safety Climate Scores and union status (r = .225, P < .001). There were statistically significant differences between union and nonunion workers' responses regarding perceived safety climate on 5 of the 10 safety climate items. Union workers were more likely than nonunion workers to: (a) perceive their supervisors as caring about their safety; (b) be made aware of dangerous work practices; (c) have received safety instructions when hired; (d) have regular job safety meetings; and (e) perceive that taking risks was not a part of their job. However, with regard to the 49-item JCQ, which includes Coworker Support, the responses between union and nonunion workers were very similar, indicating an overall high degree of job satisfaction. However, workers who experienced their workplace as more safe also perceived the level of management (r = -.55, P < .001) and coworker (r = -.31, P < .001) support as being higher. The findings of this study underscore the critical need for construction managers to alert workers to dangerous work practices and conditions more frequently, and express concern and praise workers for safe work in a

Safety climate in Swiss hospital units: Swiss version of the Safety Climate Survey

PubMed Central

Gehring, Katrin; Mascherek, Anna C.; Bezzola, Paula

2015-01-01

Abstract Rationale, aims and objectives Safety climate measurements are a broadly used element of improvement initiatives. In order to provide a sound and easy‐to‐administer instrument for the use in Swiss hospitals, we translated the Safety Climate Survey into German and French. Methods After translating the Safety Climate Survey into French and German, a cross‐sectional survey study was conducted with health care professionals (HCPs) in operating room (OR) teams and on OR‐related wards in 10 Swiss hospitals. Validity of the instrument was examined by means of Cronbach's alpha and missing rates of the single items. Item‐descriptive statistics group differences and percentage of ‘problematic responses’ (PPR) were calculated. Results 3153 HCPs completed the survey (response rate: 63.4%). 1308 individuals were excluded from the analyses because of a profession other than doctor or nurse or invalid answers (n = 1845; nurses = 1321, doctors = 523). Internal consistency of the translated Safety Climate Survey was good (Cronbach's alpha G erman = 0.86; Cronbach's alpha F rench = 0.84). Missing rates at item level were rather low (0.23–4.3%). We found significant group differences in safety climate values regarding profession, managerial function, work area and time spent in direct patient care. At item level, 14 out of 21 items showed a PPR higher than 10%. Conclusions Results indicate that the French and German translations of the Safety Climate Survey might be a useful measurement instrument for safety climate in Swiss hospital units. Analyses at item level allow for differentiating facets of safety climate into more positive and critical safety climate aspects. PMID:25656302

Defining and Measuring Safety Climate: A Review of the Construction Industry Literature.

PubMed

Schwatka, Natalie V; Hecker, Steven; Goldenhar, Linda M

2016-06-01

Safety climate measurements can be used to proactively assess an organization's effectiveness in identifying and remediating work-related hazards, thereby reducing or preventing work-related ill health and injury. This review article focuses on construction-specific articles that developed and/or measured safety climate, assessed safety climate's relationship with other safety and health performance indicators, and/or used safety climate measures to evaluate interventions targeting one or more indicators of safety climate. Fifty-six articles met our inclusion criteria, 80% of which were published after 2008. Our findings demonstrate that researchers commonly defined safety climate as perception based, but the object of those perceptions varies widely. Within the wide range of indicators used to measure safety climate, safety policies, procedures, and practices were the most common, followed by general management commitment to safety. The most frequently used indicators should and do reflect that the prevention of work-related ill health and injury depends on both organizational and employee actions. Safety climate scores were commonly compared between groups (e.g. management and workers, different trades), and often correlated with subjective measures of safety behavior rather than measures of ill health or objective safety and health outcomes. Despite the observed limitations of current research, safety climate has been promised as a useful feature of research and practice activities to prevent work-related ill health and injury. Safety climate survey data can reveal gaps between management and employee perceptions, or between espoused and enacted policies, and trigger communication and action to narrow those gaps. The validation of safety climate with safety and health performance data offers the potential for using safety climate measures as a leading indicator of performance. We discuss these findings in relation to the related concept of safety culture and

Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.

PubMed

Smith, Scott Alan; Yount, Naomi; Sorra, Joann

2017-02-16

A number of private and public companies calculate and publish proprietary hospital patient safety scores based on publicly available quality measures initially reported by the U.S. federal government. This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (Hospital SOPS) assesses provider and staff perceptions of hospital patient safety culture. Consumer Reports (CR), a U.S. based non-profit organization, calculates and shares with its subscribers a Hospital Safety Score calculated annually from patient experience survey data and outcomes data gathered from federal databases. Linking data collected during similar time periods, we analyzed relationships between staff perceptions of patient safety culture composites and the CR Hospital Safety Score and its five components using multiple multivariate linear regressions. We analyzed data from 164 hospitals, with patient safety culture survey responses from 140,316 providers and staff, with an average of 856 completed surveys per hospital and an average response rate per hospital of 56%. Higher overall Hospital SOPS composite average scores were significantly associated with higher overall CR Hospital Safety Scores (β = 0.24, p < 0.05). For 10 of the 12 Hospital SOPS composites, higher patient safety culture scores were associated with higher CR patient experience scores on communication about medications and discharge. This study found a relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases. As hospital managers allocate resources to improve patient safety culture within their organizations, their efforts may also indirectly improve consumer

The relationship between patient safety climate and occupational safety climate in healthcare - A multi-level investigation.

PubMed

Pousette, Anders; Larsman, Pernilla; Eklöf, Mats; Törner, Marianne

2017-06-01

Patient safety climate/culture is attracting increasing research interest, but there is little research on its relation with organizational climates regarding other target domains. The aim of this study was to investigate the relationship between patient safety climate and occupational safety climate in healthcare. The climates were assessed using two questionnaires: Hospital Survey on Patient Safety Culture and Nordic Occupational Safety Climate Questionnaire. The final sample consisted of 1154 nurses, 886 assistant nurses, and 324 physicians, organized in 150 work units, within hospitals (117units), primary healthcare (5units) and elderly care (28units) in western Sweden, which represented 56% of the original sample contacted. Within each type of safety climate, two global dimensions were confirmed in a higher order factor analysis; one with an external focus relative the own unit, and one with an internal focus. Two methods were used to estimate the covariation between the global climate dimensions, in order to minimize the influence of bias from common method variance. First multilevel analysis was used for partitioning variances and covariances in a within unit part (individual level) and a between unit part (unit level). Second, a split sample technique was used to calculate unit level correlations based on aggregated observations from different respondents. Both methods showed associations similar in strength between the patient safety climate and the occupational safety climate domains. The results indicated that patient safety climate and occupational safety climate are strongly positively related at the unit level, and that the same organizational processes may be important for the development of both types of organizational climate. Safety improvement interventions should not be separated in different organizational processes, but be planned so that both patient safety and staff safety are considered concomitantly. Copyright © 2017 National Safety

Worksite health and safety climate: scale development and effects of a health promotion intervention.

PubMed

Basen-Engquist, K; Hudmon, K S; Tripp, M; Chamberlain, R

1998-01-01

Environmental influences on health and health behavior have an important place in research on worksite health promotion. We tested the validity and internal consistency of a new measure of organizational health and safety climate that was used in a large randomized trial of a worksite cancer prevention program (the Working Well Trial). The resulting scales then were applied to assess intervention effects. This study uses data from a subset of 40 worksites in the Working Well Trial. Employees at 20 natural gas pipeline worksite and 20 rural electrical cooperatives completed a cross-sectional questionnaire at baseline and 3-year follow-up. A factor analysis of this self-report instrument produced a two-factor solution. The resulting health and safety climate scales had good internal consistency (Cronbach's alpha = 0.74 and 0.82, respectively) and concurrent validity. The health climate scale was correlated more highly with organizational measures that were indicative of a supportive health climate than those indicating supportive safety climate, while the reverse was true of the safety climate scale. Changes in health climate were associated with the number of smoking and smokeless tobacco programs offered at the worksites at the time of the 3-year follow-up (r = 0.46 and 0.42, respectively). The scales were not correlated with most employee health behaviors. The health climate scores increased at intervention worksites, compared with scores at control worksites (F[1,36] = 7.57, P = 0.009). The health and safety climate scales developed for this study provide useful instruments for measuring organizational change related to worksite health promotion activities. The Working Well Intervention resulted in a significant improvement in worksite health climate.

Safety climate and attitude as evaluation measures of organizational safety.

PubMed

Isla Díaz, R; Díaz Cabrera, D

1997-09-01

The main aim of this research is to develop a set of evaluation measures for safety attitudes and safety climate. Specifically it is intended: (a) to test the instruments; (b) to identify the essential dimensions of the safety climate in the airport ground handling companies; (c) to assess the quality of the differences in the safety climate for each company and its relation to the accident rate; (d) to analyse the relationship between attitudes and safety climate; and (e) to evaluate the influences of situational and personal factors on both safety climate and attitude. The study sample consisted of 166 subjects from three airport companies. Specifically, this research was centered on ground handling departments. The factor analysis of the safety climate instrument resulted in six factors which explained 69.8% of the total variance. We found significant differences in safety attitudes and climate in relation to type of enterprise.

[Relationship between perceptions of safety climate at workplace and depressive disorders in manufacturing workers].

PubMed

Liu, Xu-hua; Xiao, Ya-ni; Huang, Zhi-xiong; Huang, Shao-bin; Cao, Xiao-ou; Guan, Dong-bo; Chen, Wei-qing

2013-04-01

To investigate the risk factors for depressive disorders in manufacturing workers and to provide a basis for developing health promotion measures at workplace. A questionnaire survey was performed in 8085 front-line production workers from 33 manufacturing enterprises in Nanhai District of Foshan, Guangdong Province, China. The questionnaire contained a survey of demographic characteristics, the Safety Climate Scale, the Center for Epidemiological Studies Depression Scale, etc. The multilevel logistic regression analysis was applied to investigate the risk factors for depressive disorders in workers. A total of 6260 workers completed the survey; their mean age was 31.1 ± 8.6 years, and 53.2% of them were males. The multilevel logistic regression analysis showed that after adjustment for sociodemographic factors such as age, sex, and martial status, more depressive disorders were reported in the enterprises with higher score of "production safety training" than in those with lower score (OR = 1.46, 95%CI = 1.07 ∼ 1.97); fewer depressive disorders were reported in the enterprises with higher score of "colleagues concerned about production safety" than in those with lower score (OR = 0.08, 95%CI = 0.03 ∼ 0.26); the relationships of "safety warnings and precautions" and "managers concerned about production safety" with workers' depressive disorders were not statistically significant (OR = 0.78, 95%CI = 0.48 ∼ 1.28; OR = 1.08, 95%CI = 0.68 ∼ 1.72). Depressive disorders in manufacturing workers are related to the safety climate at workplace, which indicates that a good safety climate at workplace should be created to prevent and control depressive disorders in workers.

Association of nurse work environment and safety climate on patient mortality: A cross-sectional study.

PubMed

Olds, Danielle M; Aiken, Linda H; Cimiotti, Jeannie P; Lake, Eileen T

2017-09-01

There are two largely distinct research literatures on the association of the nurse work environment and the safety climate on patient outcomes. To determine whether hospital safety climate and work environment make comparable or distinct contributions to patient mortality. Cross-sectional secondary analysis of linked datasets of Registered Nurse survey responses, adult acute care discharge records, and hospital characteristics. Acute care hospitals in California, Florida, New Jersey, and Pennsylvania. The sample included 600 hospitals linked to 27,009 nurse survey respondents and 852,974 surgical patients. Nurse survey data included assessments of the nurse work environment and hospital safety climate. The outcome of interest was in-hospital mortality. Data analyses included descriptive statistics and multivariate random intercept logistic regression. In a fully adjusted model, a one standard deviation increase in work environment score was associated with an 8.1% decrease in the odds of mortality (OR 0.919, p<0.001). A one-standard deviation increase in safety climate score was similarly associated with a 7.7% decrease in the odds of mortality (OR 0.923, p<0.001). However, when work environment and safety climate were modeled together, the effect of the work environment remained significant, while safety climate became a non-significant predictor of mortality odds (OR 0.940, p=0.035 vs. OR 0.971, p=0.316). We found that safety climate perception is not predictive of patient mortality beyond the effect of the nurse work environment. To advance hospital safety and quality and improve patient outcomes, organizational interventions should be directed toward improving nurse work environments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Civility norms, safety climate, and safety outcomes: a preliminary investigation.

PubMed

McGonagle, Alyssa K; Walsh, Benjamin M; Kath, Lisa M; Morrow, Stephanie L

2014-10-01

Working environments that are both civil and safe are good for business and employee well-being. Civility has been empirically linked to such important outcomes as organizational performance and individuals' positive work-related attitudes, yet research relating civility to safety is lacking. In this study, we link perceptions of civility norms to perceptions of safety climate and safety outcomes. Drawing on social exchange theory, we proposed and tested a model in 2 samples wherein civility norms indirectly relate to safety outcomes through associations with various safety climate facets. Our results supported direct relationships between civility and management safety climate and coworker safety climate. Additionally, indirect effects of civility norms on unsafe behaviors and injuries were observed. Indirect effects of civility norms on unsafe behaviors were observed through coworker safety climate and work-safety tension. Indirect effects of civility norms on injuries were observed through management safety climate and work-safety tension for full-time employees, although these effects did not hold for part-time employees. This study provides initial evidence that researchers and practitioners may want to look beyond safety climate to civility norms to more comprehensively understand the origins of unsafe behaviors and injuries and to develop appropriate preventive interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

The predictive validity of safety climate.

PubMed

Johnson, Stephen E

2007-01-01

Safety professionals have increasingly turned their attention to social science for insight into the causation of industrial accidents. One social construct, safety climate, has been examined by several researchers [Cooper, M. D., & Phillips, R. A. (2004). Exploratory analysis of the safety climate and safety behavior relationship. Journal of Safety Research, 35(5), 497-512; Gillen, M., Baltz, D., Gassel, M., Kirsch, L., & Vacarro, D. (2002). Perceived safety climate, job Demands, and coworker support among union and nonunion injured construction workers. Journal of Safety Research, 33(1), 33-51; Neal, A., & Griffin, M. A. (2002). Safety climate and safety behaviour. Australian Journal of Management, 27, 66-76; Zohar, D. (2000). A group-level model of safety climate: Testing the effect of group climate on microaccidents in manufacturing jobs. Journal of Applied Psychology, 85(4), 587-596; Zohar, D., & Luria, G. (2005). A multilevel model of safety climate: Cross-level relationships between organization and group-level climates. Journal of Applied Psychology, 90(4), 616-628] who have documented its importance as a factor explaining the variation of safety-related outcomes (e.g., behavior, accidents). Researchers have developed instruments for measuring safety climate and have established some degree of psychometric reliability and validity. The problem, however, is that predictive validity has not been firmly established, which reduces the credibility of safety climate as a meaningful social construct. The research described in this article addresses this problem and provides additional support for safety climate as a viable construct and as a predictive indicator of safety-related outcomes. This study used 292 employees at three locations of a heavy manufacturing organization to complete the 16 item Zohar Safety Climate Questionnaire (ZSCQ) [Zohar, D., & Luria, G. (2005). A multilevel model of safety climate: Cross-level relationships between organization and group

Hospital safety climate surveys: measurement issues.

PubMed

Jackson, Jeanette; Sarac, Cakil; Flin, Rhona

2010-12-01

Organizational safety culture relates to behavioural norms in the workplace and is usually assessed by safety climate surveys. These can be a diagnostic indicator on the state of safety in a hospital. This review examines recent studies using staff surveys of hospital safety climate, focussing on measurement issues. Four questionnaires (hospital survey on patient safety culture, safety attitudes questionnaire, patient safety climate in healthcare organizations, hospital safety climate scale), with acceptable psychometric properties, are now applied across countries and clinical settings. Comparisons for benchmarking must be made with caution in case of questionnaire modifications. Increasing attention is being paid to the unit and hospital level wherein distinct cultures may be located, as well as to associated measurement and study design issues. Predictive validity of safety climate is tested against safety behaviours/outcomes, with some relationships reported, although effects may be specific to professional groups/units. Few studies test the role of intervening variables that could influence the effect of climate on outcomes. Hospital climate studies are becoming a key component of healthcare safety management systems. Large datasets have established more reliable instruments that allow a more focussed investigation of the role of culture in the improvement and maintenance of staff's safety perceptions within units, as well as within hospitals.

Job characteristics and safety climate: the role of effort-reward and demand-control-support models.

PubMed

Phipps, Denham L; Malley, Christine; Ashcroft, Darren M

2012-07-01

While safety climate is widely recognized as a key influence on organizational safety, there remain questions about the nature of its antecedents. One potential influence on safety climate is job characteristics (that is, psychosocial features of the work environment). This study investigated the relationship between two job characteristics models--demand-control-support (Karasek & Theorell, 1990) and effort-reward imbalance (Siegrist, 1996)--and safety climate. A survey was conducted with a random sample of 860 British retail pharmacists, using the job contents questionnaire (JCQ), effort-reward imbalance indicator (ERI) and a measure of safety climate in pharmacies. Multivariate data analyses found that: (a) both models contributed to the prediction of safety climate ratings, with the demand-control-support model making the largest contribution; (b) there were some interactions between demand, control and support from the JCQ in the prediction of safety climate scores. The latter finding suggests the presence of "active learning" with respect to safety improvement in high demand, high control settings. The findings provide further insight into the ways in which job characteristics relate to safety, both individually and at an aggregated level.

Safety Climate Survey: reliability of results from a multicenter ICU survey.

PubMed

Kho, M E; Carbone, J M; Lucas, J; Cook, D J

2005-08-01

It is important to understand the clinical properties of instruments used to measure patient safety before they are used in the setting of an intensive care unit (ICU). The Safety Climate Survey (SCSu), an instrument endorsed by the Institute for Healthcare Improvement, the Safety Culture Scale (SCSc), and the Safety Climate Mean (SCM), a subset of seven items from the SCSu, were administered in four Canadian university affiliated ICUs. All staff including nurses, allied healthcare professionals, non-clinical staff, intensivists, and managers were invited to participate in the cross sectional survey. The response rate was 74% (313/426). The internal consistency of the SCSu and SCSc was 0.86 and 0.80, respectively, while the SCM performed poorly at 0.51. Because of poor internal consistency, no further analysis of the SCM was therefore performed. Test-retest reliability of the SCSu and SCSc was 0.92. Out of a maximum score of 5, the mean (SD) scores of the SCSu and SCSc were 3.4 (0.6) and 3.4 (0.7), respectively. No differences were noted between the three medical-surgical and one cardiovascular ICU. Managers perceived a significantly more positive safety climate than other staff, as measured by the SCSu and SCSc. These results need to be interpreted cautiously because of the small number of management participants. Of the three instruments, the SCSu and SCSc appear to be measuring one construct and are sufficiently reliable. Future research should examine the properties of patient safety instruments in other ICUs, including responsiveness to change, to ensure that they are valid outcome measures for patient safety initiatives.

Safety climate practice in Korean manufacturing industry.

PubMed

Baek, Jong-Bae; Bae, Sejong; Ham, Byung-Ho; Singh, Karan P

2008-11-15

Safety climate survey was sent to 642 plants in 2003 to explore safety climate practices in the Korean manufacturing plants, especially in hazardous chemical treating plants. Out of 642 plants contacted 195 (30.4%) participated in the surveys. Data were collected by e-mail using SQL-server and mail. The main objective of this study was to explore safety climate practices (level of safety climate and the underlying problems). In addition, the variables that may influence the level of safety climate among managers and workers were explored. The questionnaires developed by health and safety executive (HSE) in the UK were modified to incorporate differences in Korean culture. Eleven important factors were summarized. Internal reliability of these factors was validated. Number of employees in the company varied from less than 30 employees (9.2%) to over 1000 employees (37.4%). Both managers and workers showed generally high level of safety climate awareness. The major underlying problems identified were inadequate health and safety procedures/rules, pressure for production, and rule breaking. The length of employment was a significant contributing factor to the level of safety climate. In this study, participants showed generally high level of safety climate, and length of employment affected the differences in the level of safety climate. Managers' commitment to comply safety rules, procedures, and effective safety education and training are recommended.

Organizational culture and climate for patient safety in Intensive Care Units.

PubMed

Santiago, Thaiana Helena Roma; Turrini, Ruth Natalia Teresa

2015-02-01

Objective To assess the perception of health professionals about patient safety climate and culture in different intensive care units (ICUs) and the relationship between scores obtained on the Hospital Survey on Patient Safety Culture (HSOPSC) and the Safety Attitudes Questionnaire (SAQ). Method A cross-sectional study conducted at a teaching hospital in the state of São Paulo, Brazil, in March and April 2014. As data gathering instruments, the HSOPSC, SAQ and a questionnaire with sociodemographic and professional information about the staff working in an adult, pediatric and neonatal ICU were used. Data analysis was conducted with descriptive statistics. Results The scales presented good reliability. Greater weaknesses in patient safety were observed in the Working conditions andPerceptions of management domains of the SAQ and in the Nonpunitive response to error domain of the HSOPSC. The strengths indicated by the SAQ wereTeamwork climate and Job satisfactionand by the HSOPC, Supervisor/manager expectations and actions promoting safety and Organizational learning-continuous improvement. Job satisfaction was higher among neonatal ICU workers when compared with the other ICUs. The adult ICU presented lower scores for most of the SAQ and HSOPSC domains. The scales presented moderate correlation between them (r=0.66). Conclusion There were differences in perception regarding patient safety among ICUs, which corroborates the existence of local microcultures. The study did not demonstrate equivalence between the SAQ and the HSOPSC.

Consensus achievement of leadership, organisational and individual factors that influence safety climate: Implications for nursing management.

PubMed

Fischer, Shelly A; Jones, Jacqueline; Verran, Joyce A

2018-01-01

To validate a framework of factors that influence the relationship of transformational leadership and safety climate, and to enable testing of safety chain factors by generating hypotheses regarding their mediating and moderating effects. Understanding the patient safety chain and mechanisms by which leaders affect a strong climate of safety is essential to transformational leadership practice, education, and research. A systematic review of leadership and safety literature was used to develop an organising framework of factors proposed to influence the climate of safety. A panel of 25 international experts in leadership and safety engaged a three-round modified Delphi study with Likert-scored surveys. Eighty per cent of participating experts from six countries were retained to the final survey round. Consensus (>66% agreement) was achieved on 40 factors believed to influence safety climate in the acute care setting. Consensus regarding specific factors that play important roles in an organisation's climate of safety can be reached. Generally, the demonstration of leadership commitment to safety is key to cultivating a culture of patient safety. Transformational nurse leaders should consider and employ all three categories of factors in daily leadership activities and decision-making to drive a strong climate of patient safety. © 2017 John Wiley & Sons Ltd.

Safety in numbers: the development of Leapfrog's composite patient safety score for U.S. hospitals.

PubMed

Austin, J Matthew; D'Andrea, Guy; Birkmeyer, John D; Leape, Lucian L; Milstein, Arnold; Pronovost, Peter J; Romano, Patrick S; Singer, Sara J; Vogus, Timothy J; Wachter, Robert M

2014-03-01

To develop a composite patient safety score that provides patients, health-care providers, and health-care purchasers with a standardized method to evaluate patient safety in general acute care hospitals in the United States. The Leapfrog Group sought guidance from a panel of national patient safety experts to develop the composite score. Candidate patient safety performance measures for inclusion in the score were identified from publicly reported national sources. Hospital performance on each measure was converted into a "z-score" and then aggregated using measure-specific weights. A reference mean score was set at 3, with scores interpreted in terms of standard deviations above or below the mean, with above reflecting better than average performance. Twenty-six measures were included in the score. The mean composite score for 2652 general acute care hospitals in the United States was 2.97 (range by hospital, 0.46-3.94). Safety scores were slightly lower for hospitals that were publicly owned, rural in location, or had a larger percentage of patients with Medicaid as their primary insurance. The Leapfrog patient safety composite provides a standardized method to evaluate patient safety in general acute care hospitals in the United States. While constrained by available data and publicly reported scores on patient safety measures, the composite score reflects the best available evidence regarding a hospital's efforts and outcomes in patient safety. Additional analyses are needed, but the score did not seem to have a strong bias against hospitals with specific characteristics. The composite score will continue to be refined over time as measures of patient safety evolve.

Safety climate and mindful safety practices in the oil and gas industry.

PubMed

Dahl, Øyvind; Kongsvik, Trond

2018-02-01

The existence of a positive association between safety climate and the safety behavior of sharp-end workers in high-risk organizations is supported by a considerable body of research. Previous research has primarily analyzed two components of safety behavior, namely safety compliance and safety participation. The present study extends previous research by looking into the relationship between safety climate and another component of safety behavior, namely mindful safety practices. Mindful safety practices are defined as the ability to be aware of critical factors in the environment and to act appropriately when dangers arise. Regression analysis was used to examine whether mindful safety practices are, like compliance and participation, promoted by a positive safety climate, in a questionnaire-based study of 5712 sharp-end workers in the oil and gas industry. The analysis revealed that a positive safety climate promotes mindful safety practices. The regression model accounted for roughly 31% of the variance in mindful safety practices. The most important safety climate factor was safety leadership. The findings clearly demonstrate that mindful safety practices are highly context-dependent, hence, manageable and susceptible to change. In order to improve safety climate in a direction which is favorable for mindful safety practices, the results demonstrate that it is important to give the fundamental features of safety climate high priority and in particular that of safety leadership. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Railway safety climate: a study on organizational development.

PubMed

Cheng, Yung-Hsiang

2017-09-07

The safety climate of an organization is considered a leading indicator of potential risk for railway organizations. This study adopts the perceptual measurement-individual attribute approach to investigate the safety climate of a railway organization. The railway safety climate attributes are evaluated from the perspective of railway system staff. We identify four safety climate dimensions from exploratory factor analysis, namely safety communication, safety training, safety management and subjectively evaluated safety performance. Analytical results indicate that the safety climate differs at vertical and horizontal organizational levels. This study contributes to the literature by providing empirical evidence of the multilevel safety climate in a railway organization, presents possible causes of the differences under various cultural contexts and differentiates between safety climate scales for diverse workgroups within the railway organization. This information can be used to improve the safety sustainability of railway organizations and to conduct safety supervisions for the government.

Associations between safety climate and safety management practices in the construction industry.

PubMed

Marín, Luz S; Lipscomb, Hester; Cifuentes, Manuel; Punnett, Laura

2017-06-01

Safety climate, a group-level measure of workers' perceptions regarding management's safety priorities, has been suggested as a key predictor of safety outcomes. However, its relationship with actual injury rates is inconsistent. We posit that safety climate may instead be a parallel outcome of workplace safety practices, rather than a determinant of workers' safety behaviors or outcomes. Using a sample of 25 commercial construction companies in Colombia, selected by injury rate stratum (high, medium, low), we examined the relationship between workers' safety climate perceptions and safety management practices (SMPs) reported by safety officers. Workers' perceptions of safety climate were independent of their own company's implementation of SMPs, as measured here, and its injury rates. However, injury rates were negatively related to the implementation of SMPs. Safety management practices may be more important than workers' perceptions of safety climate as direct predictors of injury rates. © 2017 Wiley Periodicals, Inc.

Job characteristics and work safety climate among North Carolina farmworkers with H-2A visas.

PubMed

Arcury, Thomas A; Summers, Phillip; Talton, Jennifer W; Nguyen, Ha T; Chen, Haiying; Quandt, Sara A

2015-01-01

ABSTRACT Migrant farmworkers are a vulnerable population. Migrant farmworkers with H-2A visas are the only agricultural workers with temporary work permits. Little research has directly focused on the job characteristics and work safety of workers with H-2A visas. This analysis (1) describes their personal and job characteristics, job hazards, and stressors; (2) describes their perceived work safety climate; and (3) examines associations of perceived work safety climate with job characteristics, job hazards, and stressors. Data are from a cross-sectional component of a larger study of farmworker pesticide exposure; in 2012 interviews were conducted with 163 migrant farmworkers with H-2A visas in North Carolina. The sample was limited to men aged 30 to 70 years. Migrant farmworkers with H-2A visas experience the same hazards as do other farmworkers. Their mean score on the Perceived Work Safety Climate Scale 25.5 (SD = 3.7) is similar to that of other farmworkers and other immigrant workers. Perceived work safety climate is associated with hours worked per week (P = .02), precarious employment (P < .001), planting and cultivating (P = .002), topping tobacco (P = .0012), and stress (P = .02). Perceived work safety climate is particularly important for migrant farmworkers with H-2A visas because their labor contracts limit their options to change employers. Additional research on the status of work safety climate among agricultural workers is needed, as well as on the factors that affect work safety climate and on the safety characteristics that are affected by work safety climate. Policy changes that lead to improved work safety climate should be considered.

Job Characteristics and Work Safety Climate among North Carolina Farmworkers with H-2A Visas

PubMed Central

Arcury, Thomas A.; Summers, Phillip; Talton, Jennifer W.; Nguyen, Ha T.; Chen, Haiying; Quandt, Sara A.

2016-01-01

Migrant farmworkers are a vulnerable population. Migrant farmworkers with H-2A visas are the only agricultural workers with temporary work permits. Little research has directly focused on the job characteristics and work safety of workers with H-2A visas. This analysis (1) describes their personal and job characteristics, job hazards, and stressors; (2) describes their perceived work safety climate; and (3) examines associations of perceived work safety climate with job characteristics, job hazards, and stressors. Data are from a cross-sectional component of a larger study of farmworker pesticide exposure; in 2012 interviews were conducted with 163 migrant farmworkers with H-2A visas in North Carolina. The sample was limited to men aged 30 to 70 years. Migrant farmworkers with H-2A visas experience the same hazards as do other farmworkers. Their mean score on the perceived work safety climate scale 25.5 (SD=3.7) is similar to that of other farmworkers and other immigrant workers. Perceived work safety climate is associated with hours worked per week (p=0.02), precarious employment (p<0.001), planting and cultivating (p=0.002); topping tobacco (p=0.0012), and stress (p=0.02). Perceived work safety climate is particularly important for migrant farmworkers with H-2A visas because their labor contracts limit their options to change employers. Additional research on the status of work safety climate among agricultural workers is needed, as well as on the factors that affect work safety climate and on the safety characteristics that are affected by work safety climate. Policy changes that lead to improved work safety climate should be considered. PMID:25635744

Development and validation of safety climate scales for mobile remote workers using utility/electrical workers as exemplar.

PubMed

Huang, Yueng-Hsiang; Zohar, Dov; Robertson, Michelle M; Garabet, Angela; Murphy, Lauren A; Lee, Jin

2013-10-01

The objective of this study was to develop and test the reliability and validity of a new scale designed for measuring safety climate among mobile remote workers, using utility/electrical workers as exemplar. The new scale employs perceived safety priority as the metric of safety climate and a multi-level framework, separating the measurement of organization- and group-level safety climate items into two sub-scales. The question of the emergence of shared perceptions among remote workers was also examined. For the initial survey development, several items were adopted from a generic safety climate scale and new industry-specific items were generated based on an extensive literature review, expert judgment, 15-day field observations, and 38 in-depth individual interviews with subject matter experts (i.e., utility industry electrical workers, trainers and supervisors of electrical workers). The items were revised after 45 cognitive interviews and a pre-test with 139 additional utility/electrical workers. The revised scale was subsequently implemented with a total of 2421 workers at two large US electric utility companies (1560 participants for the pilot company and 861 for the second company). Both exploratory (EFA) and confirmatory factor analyses (CFA) were adopted to finalize the items and to ensure construct validity. Reliability of the scale was tested based on Cronbach's α. Homogeneity tests examined whether utility/electrical workers' safety climate perceptions were shared within the same supervisor group. This was followed by an analysis of the criterion-related validity, which linked the safety climate scores to self-reports of safety behavior and injury outcomes (i.e., recordable incidents, missing days due to work-related injuries, vehicle accidents, and near misses). Six dimensions (Safety pro-activity, General training, Trucks and equipment, Field orientation, Financial Investment, and Schedule flexibility) with 29 items were extracted from the EFA to

Concept analysis of safety climate in healthcare providers.

PubMed

Lin, Ying-Siou; Lin, Yen-Chun; Lou, Meei-Fang

2017-06-01

To report an analysis of the concept of safety climate in healthcare providers. Compliance with safe work practices is essential to patient safety and care outcomes. Analysing the concept of safety climate from the perspective of healthcare providers could improve understanding of the correlations between safety climate and healthcare provider compliance with safe work practices, thus enhancing quality of patient care. Concept analysis. The electronic databases of CINAHL, MEDLINE, PubMed and Web of Science were searched for literature published between 1995-2015. Searches used the keywords 'safety climate' or 'safety culture' with 'hospital' or 'healthcare'. The concept analysis method of Walker and Avant analysed safety climate from the perspective of healthcare providers. Three attributes defined how healthcare providers define safety climate: (1) creation of safe working environment by senior management in healthcare organisations; (2) shared perception of healthcare providers about safety of their work environment; and (3) the effective dissemination of safety information. Antecedents included the characteristics of healthcare providers and healthcare organisations as a whole, and the types of work in which they are engaged. Consequences consisted of safety performance and safety outcomes. Most studies developed and assessed the survey tools of safety climate or safety culture, with a minority consisting of interventional measures for improving safety climate. More prospective studies are needed to create interventional measures for improving safety climate of healthcare providers. This study is provided as a reference for use in developing multidimensional safety climate assessment tools and interventional measures. The values healthcare teams emphasise with regard to safety can serve to improve safety performance. Having an understanding of the concept of and interventional measures for safety climate allows healthcare providers to ensure the safety of their

Exploring Typical and Atypical Safety Climate Perceptions of Practitioners in the Repair, Maintenance, Minor Alteration and Addition (RMAA) Sector in Hong Kong.

PubMed

Hon, Carol K H; Liu, Yulin

2016-09-22

The safety of repair, maintenance, minor alteration and addition (RMAA) work is an under-explored area. This study explored the typical and atypical safety climate perceptions of practitioners in the RMAA sector in Hong Kong, based on a self-administered questionnaire survey of 662 local practitioners in the industry. Profile analysis, via multidimensional scaling of the respondents' scores of three safety climate scales, identified one typical perception: high in management commitment to occupational health and safety (OHS) and employee involvement, low in applicability for safety rules and regulations, and low in responsibility for OHS. The respondents were clustered into typical and atypical perception groups according to their safety climate scores' match to the typical perception. A comparison of demographics between the two groups with logistic regression found that work level and direct employer significantly affect their classification. A multivariate analysis of variance of safety performance measures between the two groups indicated that the typical group had a significantly higher level of safety compliance than the atypical group, with no significant difference in safety participation or injury. The significance of this study lies in revealing the typical safety climate perception profile pattern of RMAA works and offering a new perspective of safety climate research.

Safety climate and firefighting: Focus group results.

PubMed

DeJoy, David M; Smith, Todd D; Dyal, Mari-Amanda

2017-09-01

Firefighting is a hazardous occupation and there have been numerous calls for fundamental changes in how fire service organizations approach safety and balance safety with other operational priorities. These calls, however, have yielded little systematic research. As part of a larger project to develop and test a model of safety climate for the fire service, focus groups were used to identify potentially important dimensions of safety climate pertinent to firefighting. Analyses revealed nine overarching themes. Competency/professionalism, physical/psychological readiness, and that positive traits sometimes produce negative consequences were themes at the individual level; cohesion and supervisor leadership/support at the workgroup level; and politics/bureaucracy, resources, leadership, and hiring/promotion at the organizational level. A multi-level perspective seems appropriate for examining safety climate in firefighting. Safety climate in firefighting appears to be multi-dimensional and some dimensions prominent in the general safety climate literature also seem relevant to firefighting. These results also suggest that the fire service may be undergoing transitions encompassing mission, personnel, and its fundamental approach to safety and risk. These results help point the way to the development of safety climate measures specific to firefighting and to interventions for improving safety performance. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Variations in patient safety climate and perceived quality of collaboration between professions in out-of-hours care

PubMed Central

Klemenc-Ketis, Zalika; Deilkås, Ellen Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2017-01-01

Purpose To get an overview of health care workers perceptions of patient safety climates and the quality of collaboration in Slovenian out-of-hours health care (OOHC) between professional groups. Materials and methods This was a cross-sectional study carried out in all (60) Slovenian OOHC clinics; 37 (61.7%) agreed to participate with 438 employees. The questionnaire consisted of the Slovenian version of the Safety Attitudes Questionnaire – Ambulatory Version (SAQ-AV). Results The study sample consisted of 175 (70.0%) physicians, nurse practitioners, and practice nurses. Practice nurses reported the highest patient safety climate scores in all dimensions. Total mean (standard deviation) SAQ-AV score was 60.9±15.2. Scores for quality of collaboration between different professional groups were high. The highest mean scores were reported by nurse practitioners on collaboration with practice nurses (4.4±0.6). The lowest mean scores were reported by practice nurses on collaboration with nurse practitioners (3.8±0.9). Conclusion Due to large variations in Slovenian OOHC clinics with regard to how health care workers from different professional backgrounds perceive safety culture, more attention should be devoted to improving the team collaboration in OOHC. A clearer description of professional team roles should be provided. PMID:29184416

Safety climate and safety behaviors in the construction industry: The importance of co-workers commitment to safety.

PubMed

Schwatka, Natalie V; Rosecrance, John C

2016-06-16

There is growing empirical evidence that as safety climate improves work site safety practice improve. Safety climate is often measured by asking workers about their perceptions of management commitment to safety. However, it is less common to include perceptions of their co-workers commitment to safety. While the involvement of management in safety is essential, working with co-workers who value and prioritize safety may be just as important. To evaluate a concept of safety climate that focuses on top management, supervisors and co-workers commitment to safety, which is relatively new and untested in the United States construction industry. Survey data was collected from a cohort of 300 unionized construction workers in the United States. The significance of direct and indirect (mediation) effects among safety climate and safety behavior factors were evaluated via structural equation modeling. Results indicated that safety climate was associated with safety behaviors on the job. More specifically, perceptions of co-workers commitment to safety was a mediator between both management commitment to safety climate factors and safety behaviors. These results support workplace health and safety interventions that build and sustain safety climate and a commitment to safety amongst work teams.

Do Leadership Style, Unit Climate, and Safety Climate Contribute to Safe Medication Practices?

PubMed

Farag, Amany; Tullai-McGuinness, Susan; Anthony, Mary K; Burant, Christopher

2017-01-01

This study aims at: examining if leadership style and unit climate predict safety climate; and testing the direct, indirect, and total effect of leadership style, unit climate, and safety climate on nurses' safe medication practices. The Institute of Medicine and nursing scholars propose that safety climate is a prerequisite to safety practices. However, there is limited empirical evidence about factors contributing to the development of safety climate and about the association with nurses' safe medication practices. This cross-sectional study used survey data from 246 RNs working in a Magnet® hospital. Leadership style and unit climate predicted 20% to 50% of variance on all safety climate dimensions. Model testing revealed the indirect impact of leadership style and unit climate on nurses' safe medication practices. Our hypothesized model explained small amount of the variance on nurses' safe medication practices. This finding suggests that nurses' safe medication practices are influenced by multiple contextual and personal factors that should be further examined.

Examination of the relationship between management and clinician perception of patient safety climate and patient satisfaction.

PubMed

Mazurenko, Olena; Richter, Jason; Kazley, Abby Swanson; Ford, Eric

2017-04-25

The aim of this study was to explore the relationship between managers and clinicians' agreement on deeming the patient safety climate as high or low and the patients' satisfaction with those organizations. We used two secondary data sets: the Hospital Survey on Patient Safety Culture (2012) and the Hospital Consumer Assessment of Healthcare Providers and Systems (2012). We used ordinary least squares regressions to analyze the relationship between the extent of agreement between managers and clinicians' perceptions of safety climate in relationship to patient satisfaction. The dependent variables were four Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores: communication with nurses, communication with doctors, communication about medicines, and discharge information. The main independent variables were four groups that were formed based on the extent of managers and clinicians' agreement on four patient safety climate domains: communication openness, feedback and communication about errors, teamwork within units, and teamwork across units. After controlling for hospital and market-level characteristics, we found that patient satisfaction was significantly higher if managers and clinicians reported that patient safety climate is high or if only clinicians perceived the climate as high. Specifically, manager and clinician agreement on high levels of communication openness (β = 2.25, p = .01; β = 2.46, p = .05), feedback and communication about errors (β = 3.0, p = .001; β = 2.89, p = .01), and teamwork across units (β = 2.91, p = .001; β = 3.34, p = .01) was positively and significantly associated with patient satisfaction with discharge information and communication about medication. In addition, more favorable perceptions about patient safety climate by clinicians only yielded similar findings. Organizations should measure and examine patient safety climate from multiple perspectives and be aware that individuals

Safety climate and culture: Integrating psychological and systems perspectives.

PubMed

Casey, Tristan; Griffin, Mark A; Flatau Harrison, Huw; Neal, Andrew

2017-07-01

Safety climate research has reached a mature stage of development, with a number of meta-analyses demonstrating the link between safety climate and safety outcomes. More recently, there has been interest from systems theorists in integrating the concept of safety culture and to a lesser extent, safety climate into systems-based models of organizational safety. Such models represent a theoretical and practical development of the safety climate concept by positioning climate as part of a dynamic work system in which perceptions of safety act to constrain and shape employee behavior. We propose safety climate and safety culture constitute part of the enabling capitals through which organizations build safety capability. We discuss how organizations can deploy different configurations of enabling capital to exert control over work systems and maintain safe and productive performance. We outline 4 key strategies through which organizations to reconcile the system control problems of promotion versus prevention, and stability versus flexibility. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Patient Safety Climate: A Study of Southern California Healthcare Organizations.

PubMed

Avramchuk, Andre S; McGuire, Stephen J J

2018-01-01

Human error remains the most important factor in unnecessary deaths and suffering in U.S. hospitals. Human error results from healthcare providers' attitudes and behaviors toward patients in different settings. Therefore, taking periodic snapshots of the attitudes and behaviors prevalent in an organization and manifested in its patient safety climate (PSC) is essential.We developed and tested a short survey instrument intended as an organization-level measure of PSC with good psychometric properties that can be used in hospitals, clinics, or other healthcare provider settings. Analysis of data from 61 Southern California healthcare organizations resulted in a PSC model with four distinct, reliable factors: (1) Assistance From Others and the Organization, (2) Leadership Messages of Support in Policy and Behavior, (3) Resources and Work Environment, and (4) Error Reporting Behavior. A PSC score, ranging from 0 to 100, was generated for each organization.For a subsample of hospitals in our study, preliminary results indicate a predictive quality of the model. The higher the PSC score, the lower the number of violations detected by the Centers for Medicare & Medicaid Services in complaint inspections, and the fewer the safety problems reported by The Leapfrog Group.Given the association between PSC and health outcomes, we urge healthcare leaders to use various means, such as our survey, to monitor the degree to which their organizations maintain a climate that fosters patient safety and use such data to pinpoint areas for improvement.

An overview of patient safety climate in the VA.

PubMed

Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M

2008-08-01

To assess variation in safety climate across VA hospitals nationally. Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data were collected using an anonymous survey design. We received 4,547 responses (49 percent response rate). The percent problematic response--lower percent reflecting higher levels of patient safety climate--ranged from 12.0-23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement.

Evaluation of safety climate and employee injury rates in healthcare.

PubMed

Cook, Jacqueline M; Slade, Martin D; Cantley, Linda F; Sakr, Carine J

2016-09-01

Safety climates that support safety-related behaviour are associated with fewer work-related injuries, and prior research in industry suggests that safety knowledge and motivation are strongly related to safety performance behaviours; this relationship is not well studied in healthcare settings. We performed analyses of survey results from a Veterans Health Administration (VHA) Safety Barometer employee perception survey, conducted among VHA employees in 2012. The employee perception survey assessed 6 safety programme categories, including management participation, supervisor participation, employee participation, safety support activities, safety support climate and organisational climate. We examined the relationship between safety climate from the survey results on VHA employee injury and illness rates. Among VHA facilities in the VA New England Healthcare System, work-related injury rate was significantly and inversely related to overall employee perception of safety climate, and all 6 safety programme categories, including employee perception of employee participation, management participation, organisational climate, supervisor participation, safety support activities and safety support climate. Positive employee perceptions of safety climate in VHA facilities are associated with lower work-related injury and illness rates. Employee perception of employee participation, management participation, organisational climate, supervisor participation, safety support activities and safety support climate were all associated with lower work-related injury rates. Future implications include fostering a robust safety climate for patients and healthcare workers to reduce healthcare worker injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Dimensions of Safety Climate among Iranian Nurses.

PubMed

Konjin, Z Naghavi; Shokoohi, Y; Zarei, F; Rahimzadeh, M; Sarsangi, V

2015-10-01

Workplace safety has been a concern of workers and managers for decades. Measuring safety climate is crucial in improving safety performance. It is also a method of benchmarking safety perception. To develop and validate a psychometrics scale for measuring nurses' safety climate. Literature review, subject matter experts and nurse's judgment were used in items developing. Content validity and reliability for new tool were tested by content validity index (CVI) and test-retest analysis, respectively. Exploratory factor analysis (EFA) with varimax rotation was used to improve the interpretation of latent factors. A 40-item scale in 6 factors was developed, which could explain 55% of the observed variance. The 6 factors included employees' involvement in safety and management support, compliance with safety rules, safety training and accessibility to personal protective equipment, hindrance to safe work, safety communication and job pressure, and individual risk perception. The proposed scale can be used in identifying the needed areas to implement interventions in safety climate of nurses.

Validation of the group nuclear safety climate questionnaire.

PubMed

Navarro, M Felisa Latorre; Gracia Lerín, Francisco J; Tomás, Inés; Peiró Silla, José María

2013-09-01

Group safety climate is a leading indicator of safety performance in high reliability organizations. Zohar and Luria (2005) developed a Group Safety Climate scale (ZGSC) and found it to have a single factor. The ZGSC scale was used as a basis in this study with the researchers rewording almost half of the items on this scale, changing the referents from the leader to the group, and trying to validate a two-factor scale. The sample was composed of 566 employees in 50 groups from a Spanish nuclear power plant. Item analysis, reliability, correlations, aggregation indexes and CFA were performed. Results revealed that the construct was shared by each unit, and our reworded Group Safety Climate (GSC) scale showed a one-factor structure and correlated to organizational safety climate, formalized procedures, safety behavior, and time pressure. This validation of the one-factor structure of the Zohar and Luria (2005) scale could strengthen and spread this scale and measure group safety climate more effectively. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Disentangling the roles of safety climate and safety culture: Multi-level effects on the relationship between supervisor enforcement and safety compliance.

PubMed

Petitta, Laura; Probst, Tahira M; Barbaranelli, Claudio; Ghezzi, Valerio

2017-02-01

Despite increasing attention to contextual effects on the relationship between supervisor enforcement and employee safety compliance, no study has yet explored the conjoint influence exerted simultaneously by organizational safety climate and safety culture. The present study seeks to address this literature shortcoming. We first begin by briefly discussing the theoretical distinctions between safety climate and culture and the rationale for examining these together. Next, using survey data collected from 1342 employees in 32 Italian organizations, we found that employee-level supervisor enforcement, organizational-level safety climate, and autocratic, bureaucratic, and technocratic safety culture dimensions all predicted individual-level safety compliance behaviors. However, the cross-level moderating effect of safety climate was bounded by certain safety culture dimensions, such that safety climate moderated the supervisor enforcement-compliance relationship only under the clan-patronage culture dimension. Additionally, the autocratic and bureaucratic culture dimensions attenuated the relationship between supervisor enforcement and compliance. Finally, when testing the effects of technocratic safety culture and cooperative safety culture, neither safety culture nor climate moderated the relationship between supervisor enforcement and safety compliance. The results suggest a complex relationship between organizational safety culture and safety climate, indicating that organizations with particular safety cultures may be more likely to develop more (or less) positive safety climates. Moreover, employee safety compliance is a function of supervisor safety leadership, as well as the safety climate and safety culture dimensions prevalent within the organization. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparing safety climate in naval aviation and hospitals: implications for improving patient safety.

PubMed

Singer, Sara J; Rosen, Amy; Zhao, Shibei; Ciavarelli, Anthony P; Gaba, David M

2010-01-01

Evidence of variation in safety climate suggests the need for improvement among at least some hospitals. However, comparisons only among hospitals may underestimate the improvement required. Comparison of hospitals with analogous industries may provide a broader perspective on the safety status of our nation's hospitals. The purpose of this study was to compare safety climate among hospital workers with personnel from naval aviation, an organization that operates with high reliability despite intrinsically hazardous conditions. We surveyed a random sample of health care workers in 67 U.S. hospitals and, for generalizability, 30 veterans affairs hospitals using questions comparable with those posed at approximately the same time (2007) to a census of personnel from 35 squadrons of U.S. naval aviators. We received 13,841 (41%) completed surveys in U.S. hospitals, 5,511 (50%) in veterans affairs hospitals, and 14,854 (82%) among naval aviators. We examined differences in respondents' perceptions of safety climate at their institution overall and for 16 individual items. Safety climate was three times better on average among naval aviators than among hospital personnel. Naval aviators perceived a safer climate (up to seven times safer) than hospital personnel with respect to each of the 16 survey items. Compared with hospital managers, naval commanders perceived climate more like frontline personnel did. When contrasting naval aviators with hospital personnel working in comparably hazardous areas, safety climate discrepancies increased rather than decreased. One individual hospital performed as well as naval aviation on average, and at least one hospital outperformed the Navy benchmark for all but three individual survey items. Results suggest that hospitals have not sufficiently created a uniform priority of safety. However, if each hospital performed as well as the top-performing hospital in each area measured, hospitals could achieve safety climate levels comparable

The Relationship Between the Learning and Patient Safety Climates of Clinical Departments and Residents' Patient Safety Behaviors.

PubMed

Silkens, Milou E W M; Arah, Onyebuchi A; Wagner, Cordula; Scherpbier, Albert J J A; Heineman, Maas Jan; Lombarts, Kiki M J M H

2018-05-15

Improving residents' patient safety behavior should be a priority in graduate medical education to ensure the safety of current and future patients. Supportive learning and patient safety climates may foster this behavior. This study examined the extent to which residents' self-reported patient safety behavior can be explained by the learning climate and patient safety climate of their clinical departments. The authors collected learning climate data from clinical departments in the Netherlands that used the web-based Dutch Residency Educational Climate Test between September 2015 and October 2016. They also gathered data on those departments' patient safety climate and on residents' self-reported patient safety behavior. They used generalized linear mixed models and multivariate general linear models to test for associations in the data. In total, 1,006 residents evaluated 143 departments in 31 teaching hospitals. Departments' patient safety climate was associated with residents' overall self-reported patient safety behavior (regression coefficient (b) = 0.33; 95% confidence interval (CI) = 0.14 - 0.52). Departments' learning climate was not associated with residents' patient safety behavior (b = 0.01; 95% CI = -0.17 - 0.19), although it was with their patient safety climate (b = 0.73; 95% CI = 0.69 - 0.77). Departments should focus on establishing a supportive patient safety climate to improve residents' patient safety behavior. Building a supportive learning climate might help to improve the patient safety climate and, in turn, residents' patient safety behavior.

An Overview of Patient Safety Climate in the VA

PubMed Central

Hartmann, Christine W; Rosen, Amy K; Meterko, Mark; Shokeen, Priti; Zhao, Shibei; Singer, Sara; Falwell, Alyson; Gaba, David M

2008-01-01

Objective To assess variation in safety climate across VA hospitals nationally. Study Setting Data were collected from employees at 30 VA hospitals over a 6-month period using the Patient Safety Climate in Healthcare Organizations survey. Study Design We sampled 100 percent of senior managers and physicians and a random 10 percent of other employees. At 10 randomly selected hospitals, we sampled an additional 100 percent of employees working in units with intrinsically higher hazards (high-hazard units [HHUs]). Data Collection Data were collected using an anonymous survey design. Principal Findings We received 4,547 responses (49 percent response rate). The percent problematic response—lower percent reflecting higher levels of patient safety climate—ranged from 12.0–23.7 percent across hospitals (mean=17.5 percent). Differences in safety climate emerged by management level, clinician status, and workgroup. Supervisors and front-line staff reported lower levels of safety climate than senior managers; clinician responses reflected lower levels of safety climate than those of nonclinicians; and responses of employees in HHUs reflected lower levels of safety climate than those of workers in other areas. Conclusions This is the first systematic study of patient safety climate in VA hospitals. Findings indicate an overall positive safety climate across the VA, but there is room for improvement. PMID:18355257

Should Psychosocial Safety Climate Theory Be Extended to Include Climate Strength?

PubMed

Afsharian, Ali; Zadow, Amy; Dollard, Maureen F; Dormann, Christian; Ziaian, Tahereh

2017-08-31

Psychosocial safety climate (PSC; climate for psychological health) is an organizational antecedent to work conditions articulated in the job demands-resources model. We responded to calls for broader consideration of organizational climate in terms of both climate level and strength. We tested PSC level and strength as main and interactive predictors of work conditions, psychological health, and engagement. Using multilevel analysis and cross-sectional data, the effects of unit-level PSC constructs were investigated in 21 hospital work units (n = 249 employees) in Australia. The correlation between PSC levels (measured at the unit mean) and PSC strength (measured as unit -1 × SD) was moderate and positive, suggesting that ceiling effects of PSC scores were not problematic. PSC level was a better predictor than PSC strength or their interactions for job demands (psychological and emotional demands), job resources (e.g., skill discretion and organizational support), and health (emotional exhaustion). For engagement, the interaction was significant-improving engagement, therefore, benefits from high levels of PSC and PSC strength within the work units. So, in answer to the research question regarding PSC theory extension, "it depends on the outcome." Research limitations are acknowledged, and the potential of the PSC model to guide the reduction of workplace psychosocial risk factors and the negative consequences is discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Survey on patient safety climate in public hospitals in China.

PubMed

Zhou, Ping; Bundorf, M Kate; Gu, Jianjun; He, Xiaoyan; Xue, Di

2015-02-07

Patient safety climate has been recognized as a core determinant for improving safety in hospitals. Describing workforce perceptions of patient safety climate is an important part of safety climate management. This study aimed to describe staff's perceptions of patient safety climate in public hospitals in Shanghai, China and to determine how perceptions of patient safety climate differ between different types of workers in the U.S. and China. Survey of employees of 6 secondary, general public hospitals in Shanghai conducted during 2013 using a modified version of the U.S. Patient Safety Climate in Health Care Organizations (PSCHO) tool. The percentage of "problematic responses" (PPRs) was used to measure safety climate, and the PPRs were compared among employees with different job types, using χ (2) tests and multivariate regression models. Perceptions of patient safety climate were relatively positive among hospital employees and similar to those of employees in U.S. hospitals along most dimensions. For workers in Chinese hospitals, the scales of "fear of blame" and "fear of shame" had the highest PPRs, whereas in the United States the scale of "fear of shame" had among the lowest PPRs. As in the United States, hospital managers in China perceived a more positive patient safety climate overall than other types of personnel. "Fear of shame" and "fear of blame" may be important barriers to improvement of patient safety in Chinese hospitals. Research on the effect of patient safety climate on outcomes is necessary to implement effective polices to improve patient safety and quality outcomes in China.

The Impact of Transformational Leadership on Safety Climate and Individual Safety Behavior on Construction Sites.

PubMed

Shen, Yuzhong; Ju, Chuanjing; Koh, Tas Yong; Rowlinson, Steve; Bridge, Adrian J

2017-01-05

Unsafe acts contribute dominantly to construction accidents, and increasing safety behavior is essential to reduce accidents. Previous research conceptualized safety behavior as an interaction between proximal individual differences (safety knowledge and safety motivation) and distal contextual factors (leadership and safety climate). However, relatively little empirical research has examined this conceptualization in the construction sector. Given the cultural background of the sample, this study makes a slight modification to the conceptualization and views transformational leadership as an antecedent of safety climate. Accordingly, this study establishes a multiple mediator model showing the mechanisms through which transformational leadership translates into safety behavior. The multiple mediator model is estimated by the structural equation modeling (SEM) technique, using individual questionnaire responses from a random sample of construction personnel based in Hong Kong. As hypothesized, transformational leadership has a significant impact on safety climate which is mediated by safety-specific leader-member exchange (LMX), and safety climate in turn impacts safety behavior through safety knowledge. The results suggest that future safety climate interventions should be more effective if supervisors exhibit transformational leadership, encourage construction personnel to voice safety concerns without fear of retaliation, and repeatedly remind them about safety on the job.

The Impact of Transformational Leadership on Safety Climate and Individual Safety Behavior on Construction Sites

PubMed Central

Shen, Yuzhong; Ju, Chuanjing; Koh, Tas Yong; Rowlinson, Steve; Bridge, Adrian J.

2017-01-01

Unsafe acts contribute dominantly to construction accidents, and increasing safety behavior is essential to reduce accidents. Previous research conceptualized safety behavior as an interaction between proximal individual differences (safety knowledge and safety motivation) and distal contextual factors (leadership and safety climate). However, relatively little empirical research has examined this conceptualization in the construction sector. Given the cultural background of the sample, this study makes a slight modification to the conceptualization and views transformational leadership as an antecedent of safety climate. Accordingly, this study establishes a multiple mediator model showing the mechanisms through which transformational leadership translates into safety behavior. The multiple mediator model is estimated by the structural equation modeling (SEM) technique, using individual questionnaire responses from a random sample of construction personnel based in Hong Kong. As hypothesized, transformational leadership has a significant impact on safety climate which is mediated by safety-specific leader–member exchange (LMX), and safety climate in turn impacts safety behavior through safety knowledge. The results suggest that future safety climate interventions should be more effective if supervisors exhibit transformational leadership, encourage construction personnel to voice safety concerns without fear of retaliation, and repeatedly remind them about safety on the job. PMID:28067775

Parents' perceptions of the family climate for road safety.

PubMed

Taubman-Ben-Ari, Orit

2015-01-01

The current study examined the applicability of the Family Climate for Road Safety Scale (FCRSS; Taubman-Ben-Ari and Katz-Ben-Ami, 2013) to the parents of young drivers. The sample consisted of 549 parents and 234 of their children, all of whom completed the FCRSS. In addition, the parents completed the multidimensional driving style inventory (MDSI; Taubman-Ben-Ari et al., 2004) and provided background data (e.g., age, gender). Confirmatory factor analysis supported a slightly modified structure of the scale for parents. Examination of the correlations revealed significant weak to strong associations between parents' scores on the various FCRSS dimensions on the one hand, and their self-reported driving styles and offspring's perceptions of the family climate for safety on the other. The findings indicate that the FCRSS is suitable for use with the parents of young drivers, and that perceptions of the family climate are shared by the two generations. Furthermore, they show that family climate is related to parents' customary driving behavior, with the careful driving style positively related to the positive dimensions of the FCRSS. The discussion stresses the importance of the parents' influence on the manner in which their children drive, and the multifaceted nature of this influence. Moreover, it indicates the potential value of the FCRSS, both for research and for designing interventions and measuring their effectiveness. Copyright © 2014 Elsevier Ltd. All rights reserved.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2014-10-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2015-01-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

The role of leader influence tactics and safety climate in engaging employees' safety participation.

PubMed

Clarke, Sharon; Ward, Katie

2006-10-01

This study examines the effect of leader influence tactics on employee safety participation in a U.K.-based manufacturing organization, examining the role of safety climate as a mediator. Structural equation modeling showed that leader influence tactics associated with a transformational leadership style had significant relationships with safety participation that were partially mediated by the safety climate (consultation) or fully mediated by the safety climate (inspirational appeals). In addition, leader influence tactics associated with a transactional leadership style had significant relationships with safety participation: rational persuasion (partially mediated by safety climate) and coalition tactics (direct effect). Thus, leaders may encourage safety participation using a combination of influence tactics, based on rational arguments, involvement in decision making, and generating enthusiasm for safety. The influence of building trust in managers is discussed as an underlying mechanism in this relationship. Practical implications are highlighted, including the design of leadership development programs, which may be particularly suited to high-reliability organizations.

Variation in Emergency Medical Services Workplace Safety Culture

PubMed Central

Patterson, P. Daniel; Huang, David T.; Fairbanks, Rollin J.; Simeone, Scott; Weaver, Matthew; Wang, Henry E.

2010-01-01

Introduction Workplace attitude, beliefs and culture may impact the safety of patient care. This study characterized perceptions of safety culture in a nationwide sample of Emergency Medical Services (EMS) agencies. Methods We conducted a cross-sectional survey involving 61 Advanced Life Support EMS agencies in North America. We administered a modified version of the Safety Attitudes Questionnaire (SAQ), a survey instrument measuring dimensions of workplace safety culture (Safety Climate, Teamwork Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition). We included full-time and part-time paramedics and Emergency Medical Technicians. We determined the variation in safety culture scores across EMS agencies. Using Hierarchical Linear Models (HLM), we determined associations between safety culture scores and individual and EMS agency characteristics. Results We received 1,715 completed surveys from 61 EMS agencies (mean agency response rate 47%; 95% CI 10%, 83%). There was wide variation in safety culture scores across EMS agencies [mean (min, max)]: Safety Climate 74.5 (Min 49.9, Max 89.7), Teamwork Climate 71.2 (Min 45.1, Max 90.1), Perceptions of Management 67.2 (Min 31.1, Max 92.2), Job Satisfaction 75.4 (Min 47.5, Max 93.8), Working Conditions 66.9 (Min 36.6, Max 91.4), Stress Recognition 55.1 (Min 31.3, Max 70.6). Air medical EMS agencies tended to score higher across all safety culture domains. Lower safety culture scores were associated with increased annual patient contacts. Safety climate domain scores were not associated with other individual or EMS agency characteristics. Conclusion In this sample, workplace safety culture varies between EMS agencies. PMID:20809688

[Study on occupational safety climate in different types of enterprises and its relationship with occupational accidental injury].

PubMed

Liu, Xinxia; Huang, Guoxian; Wang, Shuyu; Guo, Zhiping; Zhou, Yuchao; Chen, Weiqing

2014-04-01

To evaluate the occupational safety climate in different types of enterprises and its relationship with occupational accidental injury. A cross-sectional survey based on self-report questionnaires was performed among 3311 front-line workers from 54 medium and small-sized manufacturing enterprises of different types in Zhongshan, China to investigate the socio-demographic characteristics, safety climate experience in workplace, and incidence of occupational accidental injury in the past year. Analysis of the data revealed that employees in different types of companies perceived different levels of safety climate, according to the scores on four subscales; the European and American enterprises had significantly better safety climate than the Hong Kong and Chinese private enterprises (P < 0.01). The self-reported rates of occupational injury were 3.38%, 4.76%, and 6.72%, respectively, for European and American, Hong Kong, and Chinese private enterprises (χ(2) = 6.78, P < 0.05). After control of such factors as age, sex, income, education level, and marriage, the logistic regression analysis showed that the risk of occupational accidental injury in the European and American enterprises was significantly lower than that in the Chinese private enterprises (OR = 0.57, 95%CI = 0.35-0.91). The type of enterprise influences the occupational safety climate and incidence of occupational injury among workers.

The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers.

PubMed

Havermans, Bo M; Boot, Cécile R L; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

2017-06-08

Health care workers are exposed to psychosocial work factors. Autonomy and social support are psychosocial work factors that are related to stress, and are argued to largely result from the psychosocial safety climate within organisations. This study aimed to assess to what extent the relation between psychosocial safety climate and stress in health care workers can be explained by autonomy and social support. In a cross-sectional study, psychosocial safety climate, stress, autonomy, co-worker support, and supervisor support were assessed using questionnaires, in a sample of health care workers (N = 277). Linear mixed models analyses were performed to assess to what extent social support and autonomy explained the relation between psychosocial safety climate and stress. A lower psychosocial safety climate score was associated with significantly higher stress (B = -0.21, 95% CI = -0.27 - -0.14). Neither co-worker support, supervisor support, nor autonomy explained the relation between psychosocial safety climate and stress. Taken together, autonomy and both social support measures diminished the relation between psychosocial safety climate and stress by 12% (full model: B = -0.18, 95% CI = -0.25 - -0.11). Autonomy and social support together seemed to bring about a small decrease in the relation between psychosocial safety climate and stress in health care workers. Future research should discern whether other psychosocial work factors explain a larger portion of this relation. This study was registered in the Netherlands National Trial Register, trial code: NTR5527 .

Safety climate as a mediator between foundation climates and occupational accidents: a group-level investigation.

PubMed

Wallace, J Craig; Popp, Eric; Mondore, Scott

2006-05-01

Building on recent work in occupational safety and climate, the authors examined 2 organizational foundation climates thought to be antecedents of specific safety climate and the relationships among these climates and occupational accidents. It is believed that both foundation climates (i.e., management-employee relations and organizational support) will predict safety climate, which will in turn mediate the relationship between occupational accidents and these 2 distal foundation climates. Using a sample of 9,429 transportation workers in 253 work groups, the authors tested the proposed relationships at the group level. Results supported all hypotheses. Overall it appears that different climates have direct and indirect effects on occupational accidents.

An item-response theory approach to safety climate measurement: The Liberty Mutual Safety Climate Short Scales.

PubMed

Huang, Yueng-Hsiang; Lee, Jin; Chen, Zhuo; Perry, MacKenna; Cheung, Janelle H; Wang, Mo

2017-06-01

Zohar and Luria's (2005) safety climate (SC) scale, measuring organization- and group- level SC each with 16 items, is widely used in research and practice. To improve the utility of the SC scale, we shortened the original full-length SC scales. Item response theory (IRT) analysis was conducted using a sample of 29,179 frontline workers from various industries. Based on graded response models, we shortened the original scales in two ways: (1) selecting items with above-average discriminating ability (i.e. offering more than 6.25% of the original total scale information), resulting in 8-item organization-level and 11-item group-level SC scales; and (2) selecting the most informative items that together retain at least 30% of original scale information, resulting in 4-item organization-level and 4-item group-level SC scales. All four shortened scales had acceptable reliability (≥0.89) and high correlations (≥0.95) with the original scale scores. The shortened scales will be valuable for academic research and practical survey implementation in improving occupational safety. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Safety compliance and safety climate: A repeated cross-sectional study in the oil and gas industry.

PubMed

Kvalheim, Sverre A; Dahl, Øyvind

2016-12-01

Violations of safety rules and procedures are commonly identified as a causal factor in accidents in the oil and gas industry. Extensive knowledge on effective management practices related to improved compliance with safety procedures is therefore needed. Previous studies of the causal relationship between safety climate and safety compliance demonstrate that the propensity to act in accordance with prevailing rules and procedures is influenced to a large degree by workers' safety climate. Commonly, the climate measures employed differ from one study to another and identical measures of safety climate are seldom tested repeatedly over extended periods of time. This research gap is addressed in the present study. The study is based on a survey conducted four times among sharp-end workers of the Norwegian oil and gas industry (N=31,350). This is done by performing multiple tests (regression analysis) over a period of 7years of the causal relationship between safety climate and safety compliance. The safety climate measure employed is identical across the 7-year period. Taking all periods together, the employed safety climate model explained roughly 27% of the variance in safety compliance. The causal relationship was found to be stable across the period, thereby increasing the reliability and the predictive validity of the factor structure. The safety climate factor that had the most powerful effect on safety compliance was work pressure. The factor structure employed shows high predictive validity and should therefore be relevant to organizations seeking to improve safety in the petroleum sector. The findings should also be relevant to other high-hazard industries where safety rules and procedures constitute a central part of the approach to managing safety. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.

Factors predicting change in hospital safety climate and capability in a multi-site patient safety collaborative: a longitudinal survey study.

PubMed

Benn, Jonathan; Burnett, Susan; Parand, Anam; Pinto, Anna; Vincent, Charles

2012-07-01

The study had two specific objectives: (1) To analyse change in a survey measure of organisational patient safety climate and capability (SCC) resulting from participation in the UK Safer Patients Initiative and (2) To investigate the role of a range of programme and contextual factors in predicting change in SCC scores. Single group longitudinal design with repeated measurement at 12-month follow-up. Multiple service areas within NHS hospital sites across England, Wales, Scotland and Northern Ireland. Stratified sample of 284 respondents representing programme teams at 19 hospital sites. A complex intervention comprising a multi-component quality improvement collaborative focused upon patient safety and designed to impact upon hospital leadership, communication, organisation and safety climate. A survey including a 31-item SCC scale was administered at two time-points. Modest but significant positive movement in SCC score was observed between the study time-points. Individual programme responsibility, availability of early adopters, multi-professional collaboration and extent of process measurement were significant predictors of change in SCC. Hospital type and size, along with a range of programme preconditions, were not found to be significant. A range of social, cultural and organisational factors may be sensitive to this type of intervention but the measurable effect is small. Supporting critical local programme implementation factors may be an effective strategy in achieving development in organisational patient SCC, regardless of contextual factors and organisational preconditions.

Exploring Typical and Atypical Safety Climate Perceptions of Practitioners in the Repair, Maintenance, Minor Alteration and Addition (RMAA) Sector in Hong Kong

PubMed Central

Hon, Carol K.H.; Liu, Yulin

2016-01-01

The safety of repair, maintenance, minor alteration and addition (RMAA) work is an under-explored area. This study explored the typical and atypical safety climate perceptions of practitioners in the RMAA sector in Hong Kong, based on a self-administered questionnaire survey of 662 local practitioners in the industry. Profile analysis, via multidimensional scaling of the respondents’ scores of three safety climate scales, identified one typical perception: high in management commitment to occupational health and safety (OHS) and employee involvement, low in applicability for safety rules and regulations, and low in responsibility for OHS. The respondents were clustered into typical and atypical perception groups according to their safety climate scores’ match to the typical perception. A comparison of demographics between the two groups with logistic regression found that work level and direct employer significantly affect their classification. A multivariate analysis of variance of safety performance measures between the two groups indicated that the typical group had a significantly higher level of safety compliance than the atypical group, with no significant difference in safety participation or injury. The significance of this study lies in revealing the typical safety climate perception profile pattern of RMAA works and offering a new perspective of safety climate research. PMID:27669269

Co-worker characteristics and nurses' safety-climate perceptions.

PubMed

Abrahamson, Kathleen; Ramanujam, Rangaraj; Anderson, James G

2013-01-01

Previous research indicates that nurses' safety-climate perceptions are influenced by individual nurse characteristics, leadership, staffing levels and workplace structure. No literature was identified that explored the relationship between nurses' safety climate perceptions and staffing composition in a particular hospital unit. This paper aims to fill some of the gaps in the research in this area. Data supplied by 430 registered nurses working in two Midwestern US hospitals were analyzed to co-worker characteristics such as education, licensure, experience and full- or part-time status. Registered nurses working in hospitals with proportionally more-experienced nurses perceived their workplaces to be significantly safer for patients. Surprisingly, co-worker licensure, education and full- or part-time status did not significantly influence nurses' safety climate perceptions. Findings indicate that safety-climate perceptions vary significantly between hospital units and experienced nurses may act as a resource that promotes a positive safety climate. Hospitals retaining experienced nurses may potentially reduce errors. The paper illustrates that the results highlight the importance of providing nurses with an environment that encourages retention and creates a workplace where experienced nurses' skills are best utilized.

Relationships among Safety Climate, Safety Behavior, and Safety Outcomes for Ethnic Minority Construction Workers

PubMed Central

Lyu, Sainan; Chan, Albert P. C.; Wong, Francis K. W.

2018-01-01

In many countries, it is common practice to attract and employ ethnic minority (EM) or migrant workers in the construction industry. This primarily occurs in order to alleviate the labor shortage caused by an aging workforce with a lack of new entrants. Statistics show that EM construction workers are more likely to have occupational fatal and nonfatal injuries than their local counterparts; however, the mechanism underlying accidents and injuries in this vulnerable population has been rarely examined. This study aims to investigate relationships among safety climate, safety behavior, and safety outcomes for EM construction workers. To this end, a theoretical research model was developed based on a comprehensive review of the current literature. In total, 289 valid questionnaires were collected face-to-face from 223 Nepalese construction workers and 56 Pakistani construction workers working on 15 construction sites in Hong Kong. Structural equation modelling was employed to validate the constructs and test the hypothesized model. Results show that there were significant positive relationships between safety climate and safety behaviors, and significant negative relationships between safety behaviors and safety outcomes for EM construction workers. This research contributes to the literature regarding EM workers by providing empirical evidence of the mechanisms by which safety climate affects safety behaviors and outcomes. It also provides insights in order to help the key stakeholders formulate safety strategies for EM workers in many areas where numerous EM workers are employed, such as in the U.S., the UK, Australia, Singapore, Malaysia, and the Middle East. PMID:29522503

Relationships among Safety Climate, Safety Behavior, and Safety Outcomes for Ethnic Minority Construction Workers.

PubMed

Lyu, Sainan; Hon, Carol K H; Chan, Albert P C; Wong, Francis K W; Javed, Arshad Ali

2018-03-09

In many countries, it is common practice to attract and employ ethnic minority (EM) or migrant workers in the construction industry. This primarily occurs in order to alleviate the labor shortage caused by an aging workforce with a lack of new entrants. Statistics show that EM construction workers are more likely to have occupational fatal and nonfatal injuries than their local counterparts; however, the mechanism underlying accidents and injuries in this vulnerable population has been rarely examined. This study aims to investigate relationships among safety climate, safety behavior, and safety outcomes for EM construction workers. To this end, a theoretical research model was developed based on a comprehensive review of the current literature. In total, 289 valid questionnaires were collected face-to-face from 223 Nepalese construction workers and 56 Pakistani construction workers working on 15 construction sites in Hong Kong. Structural equation modelling was employed to validate the constructs and test the hypothesized model. Results show that there were significant positive relationships between safety climate and safety behaviors, and significant negative relationships between safety behaviors and safety outcomes for EM construction workers. This research contributes to the literature regarding EM workers by providing empirical evidence of the mechanisms by which safety climate affects safety behaviors and outcomes. It also provides insights in order to help the key stakeholders formulate safety strategies for EM workers in many areas where numerous EM workers are employed, such as in the U.S., the UK, Australia, Singapore, Malaysia, and the Middle East.

Nonlinear effects of team tenure on team psychological safety climate and climate strength: Implications for average team member performance.

PubMed

Koopmann, Jaclyn; Lanaj, Klodiana; Wang, Mo; Zhou, Le; Shi, Junqi

2016-07-01

The teams literature suggests that team tenure improves team psychological safety climate and climate strength in a linear fashion, but the empirical findings to date have been mixed. Alternatively, theories of group formation suggest that new and longer tenured teams experience greater team psychological safety climate than moderately tenured teams. Adopting this second perspective, we used a sample of 115 research and development teams and found that team tenure had a curvilinear relationship with team psychological safety climate and climate strength. Supporting group formation theories, team psychological safety climate and climate strength were higher in new and longer tenured teams compared with moderately tenured teams. Moreover, we found a curvilinear relationship between team tenure and average team member creative performance as partially mediated by team psychological safety climate. Team psychological safety climate improved average team member task performance only when team psychological safety climate was strong. Likewise, team tenure influenced average team member task performance in a curvilinear manner via team psychological safety climate only when team psychological safety climate was strong. We discuss theoretical and practical implications and offer several directions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Influence of safety motivation and climate on safety behaviour and outcomes: evidence from the Saudi Arabian construction industry.

PubMed

Panuwatwanich, Kriengsak; Al-Haadir, Saeed; Stewart, Rodney A

2017-03-01

Over the last three decades, safety literature has focused on safety climate and its role in forecasting injuries and accidents. However, research findings regarding the relationships between safety climate and other key outcome constructs are somewhat inconsistent. Recent safety climate literature suggests that examining the role of safety motivation may help provide a better explanation of such relationships. The research presented in this article aimed to empirically analyse the relationships among safety motivation, safety climate, safety behaviour and safety outcomes within the context of the Saudi Arabian construction industry. A conceptual model was developed to examine the relationships among four main constructs: safety motivation, safety climate, safety behaviour and safety outcomes. Based on the survey data collected in Saudi Arabia from site engineers and project managers (n = 295), statistical analyses were carried out, including confirmatory and exploratory factor analysis, and structural equation modelling to assess the model and test the hypotheses. The main results indicated that safety motivation could positively influence safety behaviour through safety climate, which plays a mediating role for this mechanism. The results also confirmed that safety behaviour could predict safety outcomes within the context of the Saudi Arabian construction industry.

The association between EMS workplace safety culture and safety outcomes.

PubMed

Weaver, Matthew D; Wang, Henry E; Fairbanks, Rollin J; Patterson, Daniel

2012-01-01

Prior studies have highlighted wide variation in emergency medical services (EMS) workplace safety culture across agencies. To determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, working conditions, stress recognition, and job satisfaction. A panel of medical directors, emergency medical technicians and paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. Sixteen percent of all respondents reported experiencing an injury in the past three months, four of every 10 respondents reported an error or adverse event (AE), and 89% reported safety-compromising behaviors. Respondents reporting injury scored lower on five of the six domains of safety culture. Respondents reporting an error or AE scored lower for four of the six domains, while respondents reporting safety-compromising behavior had lower safety culture scores for five of the six domains. Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes.

Work Safety Climate, Safety Behaviors, and Occupational Injuries of Youth Farmworkers in North Carolina

PubMed Central

Rodriguez, Guadalupe; Quandt, Sara A.; Arcury, Justin T.; Arcury, Thomas A.

2015-01-01

Objectives. The aims of this project were to describe the work safety climate and the association between occupational safety behaviors and injuries among hired youth farmworkers in North Carolina (n = 87). Methods. We conducted personal interviews among a cross-sectional sample of youth farmworkers aged 10 to 17 years. Results. The majority of youths reported that work safety practices were very important to management, yet 38% stated that supervisors were only interested in “doing the job quickly and cheaply.” Few youths reported appropriate work safety behavior, and 14% experienced an injury within the past 12 months. In bivariate analysis, perceptions of work safety climate were significantly associated with pesticide exposure risk factors for rewearing wet shoes (P = .01), wet clothes (P = .01), and shorts (P = .03). Conclusions. Youth farmworkers perceived their work safety climate as being poor. Although additional research is needed to support these findings, these results strengthen the need to increase employer awareness to improve the safety climate for protecting youth farmworkers from harmful exposures and injuries. PMID:25973817

Cross-validation of an employee safety climate model in Malaysia.

PubMed

Bahari, Siti Fatimah; Clarke, Sharon

2013-06-01

Whilst substantial research has investigated the nature of safety climate, and its importance as a leading indicator of organisational safety, much of this research has been conducted with Western industrial samples. The current study focuses on the cross-validation of a safety climate model in the non-Western industrial context of Malaysian manufacturing. The first-order factorial validity of Cheyne et al.'s (1998) [Cheyne, A., Cox, S., Oliver, A., Tomas, J.M., 1998. Modelling safety climate in the prediction of levels of safety activity. Work and Stress, 12(3), 255-271] model was tested, using confirmatory factor analysis, in a Malaysian sample. Results showed that the model fit indices were below accepted levels, indicating that the original Cheyne et al. (1998) safety climate model was not supported. An alternative three-factor model was developed using exploratory factor analysis. Although these findings are not consistent with previously reported cross-validation studies, we argue that previous studies have focused on validation across Western samples, and that the current study demonstrates the need to take account of cultural factors in the development of safety climate models intended for use in non-Western contexts. The results have important implications for the transferability of existing safety climate models across cultures (for example, in global organisations) and highlight the need for future research to examine cross-cultural issues in relation to safety climate. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate.

PubMed

Hystad, Sigurd W; Bartone, Paul T; Eid, Jarle

2014-01-01

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents.

Labor unions and safety climate: perceived union safety values and retail employee safety outcomes.

PubMed

Sinclair, Robert R; Martin, James E; Sears, Lindsay E

2010-09-01

Although trade unions have long been recognized as a critical advocate for employee safety and health, safety climate research has not paid much attention to the role unions play in workplace safety. We proposed a multiple constituency model of workplace safety which focused on three central safety stakeholders: top management, ones' immediate supervisor, and the labor union. Safety climate research focuses on management and supervisors as key stakeholders, but has not considered whether employee perceptions about the priority their union places on safety contributes contribute to safety outcomes. We addressed this gap in the literature by investigating unionized retail employee (N=535) perceptions about the extent to which their top management, immediate supervisors, and union valued safety. Confirmatory factor analyses demonstrated that perceived union safety values could be distinguished from measures of safety training, workplace hazards, top management safety values, and supervisor values. Structural equation analyses indicated that union safety values influenced safety outcomes through its association with higher safety motivation, showing a similar effect as that of supervisor safety values. These findings highlight the need for further attention to union-focused measures related to workplace safety as well as further study of retail employees in general. We discuss the practical implications of our findings and identify several directions for future safety research. 2009 Elsevier Ltd. All rights reserved.

A longitudinal study of an intervention to improve road safety climate: climate as an organizational boundary spanner.

PubMed

Naveh, Eitan; Katz-Navon, Tal

2015-01-01

This study presents and tests an intervention to enhance organizational climate and expands existing conceptualization of organizational climate to include its influence on employee behaviors outside the organization's physical boundaries. In addition, by integrating the literatures of climate and work-family interface, the study explored climate spillover and crossover from work to the home domain. Focusing on an applied practical problem within organizations, we investigated the example of road safety climate and employees' and their families' driving, using a longitudinal study design of road safety intervention versus control groups. Results demonstrated that the intervention increased road safety climate and decreased the number of traffic violation tickets and that road safety climate mediated the relationship between the intervention and the number of traffic violation tickets. Road safety climate spilled over to the family domain but did not cross over to influence family members' driving. (c) 2015 APA, all rights reserved.

Development and initial validation of an Aviation Safety Climate Scale.

PubMed

Evans, Bronwyn; Glendon, A Ian; Creed, Peter A

2007-01-01

A need was identified for a consistent set of safety climate factors to provide a basis for aviation industry benchmarking. Six broad safety climate themes were identified from the literature and consultations with industry safety experts. Items representing each of the themes were prepared and administered to 940 Australian commercial pilots. Data from half of the sample (N=468) were used in an exploratory factor analysis that produced a 3-factor model of Management commitment and communication, Safety training and equipment, and Maintenance. A confirmatory factor analysis on the remaining half of the sample showed the 3-factor model to be an adequate fit to the data. The results of this study have produced a scale of safety climate for aviation that is both reliable and valid. This study developed a tool to assess the level of perceived safety climate, specifically of pilots, but may also, with minor modifications, be used to assess other groups' perceptions of safety climate.

Achieving a climate for patient safety by focusing on relationships.

PubMed

Manojlovich, Milisa; Kerr, Mickey; Davies, Barbara; Squires, Janet; Mallick, Ranjeeta; Rodger, Ginette L

2014-12-01

Despite many initiatives, advances in patient safety remain uneven in part because poor relationships among health professionals have not been addressed. The purpose of this study was to determine whether relationships between health professionals contributed to a patient safety climate, after implementation of an intervention to improve inter-professional collaboration. This was a secondary analysis of data collected to evaluate the Interprofessional Model of Patient Care (IPMPC) at The Ottawa Hospital in Ontario, Canada, which consists of five sites. A series of generalized estimating equation models were generated, accounting for the clustering of responses by site. Thirteen health professionals including physicians, nurses, physiotherapists and others (n = 1896) completed anonymous surveys about 1 year after the IPMPC was introduced. The IPMPC was implemented to improve interdisciplinary collaboration. Reliable instruments were used to measure collaboration, respect, inter-professional conflict and patient safety climate. Collaboration (β = 0.13; P = 0.002) and respect (β = 1.07; P = 0.03) were significant independent predictors of patient safety climate. Conflict was an independent and significant inverse predictor of patient safety climate (β = -0.29; P = 0.03), but did not moderate linkages between collaboration and patient safety climate or between respect and patient safety climate. Through the IPMPC, all health professionals learned how to collaborate and build a patient safety climate, even in the presence of inter-professional conflict. Efforts by others to foster better work relationships may yield similar improvements in patient safety climate. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Positive organizational behavior and safety in the offshore oil industry: Exploring the determinants of positive safety climate

PubMed Central

Hystad, Sigurd W.; Bartone, Paul T.; Eid, Jarle

2013-01-01

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents. PMID:24454524

Measuring safety culture in the ambulatory setting: the safety attitudes questionnaire--ambulatory version.

PubMed

Modak, Isitri; Sexton, J Bryan; Lux, Thomas R; Helmreich, Robert L; Thomas, Eric J

2007-01-01

Provider attitudes about issues pertinent to patient safety may be related to errors and adverse events. We know of no instruments that measure safety-related attitudes in the outpatient setting. To adapt the safety attitudes questionnaire (SAQ) to the outpatient setting and compare attitudes among different types of providers in the outpatient setting. We modified the SAQ to create a 62-item SAQ-ambulatory version (SAQ-A). Patient care staff in a multispecialty, academic practice rated their agreement with the items using a 5-point Likert scale. Cronbach's alpha was calculated to determine reliability of scale scores. Differences in SAQ-A scores between providers were assessed using ANOVA. Of the 409 staff, 282 (69%) returned surveys. One hundred ninety (46%) surveys were included in the analyses. Cronbach's alpha ranged from 0.68 to 0.86 for the scales: teamwork climate, safety climate, perceptions of management, job satisfaction, working conditions, and stress recognition. Physicians had the least favorable attitudes about perceptions of management while managers had the most favorable attitudes (mean scores: 50.4 +/- 22.5 vs 72.5 +/- 19.6, P < 0.05; percent with positive attitudes 18% vs 70%, respectively). Nurses had the most positive stress recognition scores (mean score 66.0 +/- 24.0). All providers had similar attitudes toward teamwork climate, safety climate, job satisfaction, and working conditions. The SAQ-A is a reliable tool for eliciting provider attitudes about the ambulatory work setting. Attitudes relevant to medical error may differ among provider types and reflect behavior and clinic operations that could be improved.

Hospital safety climate and safety behavior: A social exchange perspective.

PubMed

Ancarani, Alessandro; Di Mauro, Carmela; Giammanco, Maria D

Safety climate is considered beneficial to the improvement of hospital safety outcomes. Nevertheless, the relations between two of its key constituents, namely those stemming from leader-subordinate relations and coworker support for safety, are still to be fully ascertained. This article uses the theoretical lens of Social Exchange Theory to study the joint impact of leader-member exchange in the safety sphere and coworker support for safety on safety-related behavior at the hospital ward level. Social exchange constructs are further related to the existence of a shame-/blame-free environment, seen as a potential antecedent of safety behavior. A cross-sectional study including 166 inpatients in hospital wards belonging to 10 public hospitals in Italy was undertaken to test the hypotheses developed. Hypothesized relations have been analyzed through a fully mediated multilevel structural equation model. This methodology allows studying behavior at the individual level, while keeping into account the heterogeneity among hospital specialties. Results suggest that the linkage between leader support for safety and individual safety behavior is mediated by coworker support on safety issues and by the creation of a shame-free environment. These findings call for the creation of a safety climate in which managerial efforts should be directed not only to the provision of new safety resources and the enforcement of safety rules but also to the encouragement of teamwork and freedom to report errors as ways to foster the capacity of the staff to communicate, share, and learn from each other.

Safety perception referents of permanent and temporary employees: safety climate boundaries in the industrial workplace.

PubMed

Luria, Gil; Yagil, Dana

2010-09-01

To explore the significant referents of safety perceptions among permanent and temporary employees in order to identify the boundaries of safety climate in a heterogeneous workforce. Collection of data from semi-structured interviews with employees in manufacturing organizations, using a combination of qualitative and quantitative methods to identify basic safety perceptions. Independent raters used content analysis to examine the data. Analysis of the data revealed differences between safety themes at organization, group and individual levels. Themes relating to the individual were more prevalent among temporary employees, while those relating to the group and the organization prevailed among permanent employees. Permanent employees view organizational and group levels as significant referents of safety perceptions, while temporary employees focus on the individual level. The results challenge the current view of safety climate as a uniform concept for all employees and prescribe boundary conditions for safety climate. It is suggested that organizations should implement "tailor-made" safety-climate practices according to the referents of employee sub-groups. 2009 Elsevier Ltd. All rights reserved.

The association between EMS workplace safety culture and safety outcomes

PubMed Central

Weaver, Matthew D.; Wang, Henry E.; Fairbanks, Rollin J.; Patterson, Daniel

2012-01-01

Objective Prior studies have highlighted wide variation in EMS workplace safety culture across agencies. We sought to determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. Methods We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, perceptions of working conditions, stress recognition, and job satisfaction. A panel of medical directors, paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. Results Sixteen percent of all respondents reported experiencing an injury in the past 3 months, four of every 10 respondents reported an error or adverse event (AE), and 90% reported safety-compromising behaviors. Respondents reporting injury scored lower on 5 of the 6 domains of safety culture. Respondents reporting an error or AE scored lower for 4 of the 6 domains, while respondents reporting safety-compromising behavior had lower safety culture scores for 5 of 6 domains. Conclusions Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes. PMID:21950463

Relationships between psychological safety climate facets and safety behavior in the rail industry: a dominance analysis.

PubMed

Morrow, Stephanie L; McGonagle, Alyssa K; Dove-Steinkamp, Megan L; Walker, Curtis T; Marmet, Matthew; Barnes-Farrell, Janet L

2010-09-01

The goals of this study were twofold: (1) to confirm a relationship between employee perceptions of psychological safety climate and safety behavior for a sample of workers in the rail industry and (2) to explore the relative strengths of relationships between specific facets of safety climate and safety behavior. Non-management rail maintenance workers employed by a large North American railroad completed a survey (n=421) regarding workplace safety perceptions and behaviors. Three facets of safety climate (management safety, coworker safety, and work-safety tension) were assessed as relating to individual workers' reported safety behavior. All three facets were significantly associated with safety behavior. Dominance analysis was used to assess the relative importance of each facet as related to the outcome, and work-safety tension evidenced the strongest relationship with safety behavior. Published by Elsevier Ltd.

Revealing and Resolving Patient Safety Defects: The Impact of Leadership WalkRounds on Frontline Caregiver Assessments of Patient Safety

PubMed Central

Frankel, Allan; Grillo, Sarah Pratt; Pittman, Mary; Thomas, Eric J; Horowitz, Lisa; Page, Martha; Sexton, Bryan

2008-01-01

Objective To evaluate the impact of rigorous WalkRounds on frontline caregiver assessments of safety climate, and to clarify the steps and implementation of rigorous WalkRounds. Data Sources/Study Setting Primary outcome variables were baseline and post WalkRounds safety climate scores from the Safety Attitudes Questionnaire (SAQ). Secondary outcomes were safety issues elicited through WalkRounds. Study period was August 2002 to April 2005; seven hospitals in Massachusetts agreed to participate; and the project was implemented in all patient care areas. Study Design Prospective study of the impact of rigorously applied WalkRounds on frontline caregivers assessments of safety climate in their patient care area. WalkRounds were conducted weekly and according to the seven-step WalkRounds Guide. The SAQ was administered at baseline and approximately 18 months post-WalkRounds implementation to all caregivers in patient care areas. Results Two of seven hospitals complied with the rigorous WalkRounds approach; hospital A was an academic teaching center and hospital B a community teaching hospital. Of 21 patient care areas, SAQ surveys were received from 62 percent of respondents at baseline and 60 percent post WalkRounds. At baseline, 10 of 21 care areas (48 percent) had safety climate scores below 60 percent, whereas post-WalkRounds three care areas (14 percent) had safety climate scores below 60 percent without improving by 10 points or more. Safety climate scale scores in hospital A were 62 percent at baseline and 77 percent post-WalkRounds (t=2.67, p=.03), and in hospital B were 46 percent at baseline and 56 percent post WalkRounds (t=2.06, p=.06). Main safety issues by category were equipment/facility (A [26 percent] and B [33 percent]) and communication (A [24 percent] and B [18 percent]). Conclusions WalkRounds implementation requires significant organizational will; sustainability requires outstanding project management and leadership engagement. In the patient

The mediating role of integration of safety by activity versus operator between organizational culture and safety climate.

PubMed

Auzoult, Laurent; Gangloff, Bernard

2018-04-20

In this study, we analyse the impact of the organizational culture and introduce a new variable, the integration of safety, which relates to the modalities for the implementation and adoption of safety in the work process, either through the activity or by the operator. One hundred and eighty employees replied to a questionnaire measuring the organizational climate, the safety climate and the integration of safety. We expected that implementation centred on the activity or on the operator would mediate the relationship between the organizational culture and the safety climate. The results support our assumptions. A regression analysis highlights the positive impact on the safety climate of organizational values of the 'rule' and 'support' type, as well as of integration by the operator and activity. Moreover, integration mediates the relation between these variables. The results suggest to take into account organizational culture and to introduce different implementation modalities to improve the safety climate.

Patient safety climate profiles across time: Strength and level of safety climate associated with a quality improvement program in Switzerland-A cross-sectional survey study.

PubMed

Mascherek, Anna C; Schwappach, David L B

2017-01-01

Safety Climate has been acknowledged as an unspecific factor influencing patient safety. However, studies rarely provide in-depth analysis of climate data. As a helpful approach, the concept of "climate strength" has been proposed. In the present study we tested the hypotheses that even if safety climate remains stable on mean-level across time, differences might be evident in strength or shape. The data of two hospitals participating in a large national quality improvement program were analysed for differences in climate profiles at two measurement occasions. We analysed differences on mean-level, differences in percent problematic response, agreement within groups, and frequency histograms in two large hospitals in Switzerland at two measurement occasions (2013 and 2015) applying the Safety Climate Survey. In total, survey responses of 1193 individuals were included in the analyses. Overall, small but significant differences on mean-level of safety climate emerged for some subgroups. Also, although agreement was strong at both time-points within groups, tendencies of divergence or consensus were present in both hospitals. Depending on subgroup and analyses chosen, differences were more or less pronounced. The present study illustrated that taking several measures into account and describing safety climate from different perspectives is necessary in order to fully understand differences and trends within groups and to develop interventions addressing the needs of different groups more precisely.

Patient safety climate profiles across time: Strength and level of safety climate associated with a quality improvement program in Switzerland—A cross-sectional survey study

PubMed Central

Mascherek, Anna C.

2017-01-01

Safety Climate has been acknowledged as an unspecific factor influencing patient safety. However, studies rarely provide in-depth analysis of climate data. As a helpful approach, the concept of “climate strength” has been proposed. In the present study we tested the hypotheses that even if safety climate remains stable on mean-level across time, differences might be evident in strength or shape. The data of two hospitals participating in a large national quality improvement program were analysed for differences in climate profiles at two measurement occasions. We analysed differences on mean-level, differences in percent problematic response, agreement within groups, and frequency histograms in two large hospitals in Switzerland at two measurement occasions (2013 and 2015) applying the Safety Climate Survey. In total, survey responses of 1193 individuals were included in the analyses. Overall, small but significant differences on mean-level of safety climate emerged for some subgroups. Also, although agreement was strong at both time-points within groups, tendencies of divergence or consensus were present in both hospitals. Depending on subgroup and analyses chosen, differences were more or less pronounced. The present study illustrated that taking several measures into account and describing safety climate from different perspectives is necessary in order to fully understand differences and trends within groups and to develop interventions addressing the needs of different groups more precisely. PMID:28753633

The patient safety climate in healthcare organizations (PSCHO) survey: Short-form development.

PubMed

Benzer, Justin K; Meterko, Mark; Singer, Sara J

2017-08-01

Measures of safety climate are increasingly used to guide safety improvement initiatives. However, cost and respondent burden may limit the use of safety climate surveys. The purpose of this study was to develop a 15- to 20-item safety climate survey based on the Patient Safety Climate in Healthcare Organizations survey, a well-validated 38-item measure of safety climate. The Patient Safety Climate in Healthcare Organizations was administered to all senior managers, all physicians, and a 10% random sample of all other hospital personnel in 69 private sector hospitals and 30 Veterans Health Administration hospitals. Both samples were randomly divided into a derivation sample to identify a short-form subset and a confirmation sample to assess the psychometric properties of the proposed short form. The short form consists of 15 items represented 3 overarching domains in the long-form scale-organization, work unit, and interpersonal. The proposed short form efficiently captures 3 important sources of variance in safety climate: organizational, work-unit, and interpersonal. The short-form development process was a practical method that can be applied to other safety climate surveys. This safety climate short form may increase response rates in studies that involve busy clinicians or repeated measures. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Quality management and perceptions of teamwork and safety climate in European hospitals.

PubMed

Kristensen, Solvejg; Hammer, Antje; Bartels, Paul; Suñol, Rosa; Groene, Oliver; Thompson, Caroline A; Arah, Onyebuchi A; Kutaj-Wasikowska, Halina; Michel, Philippe; Wagner, Cordula

2015-12-01

This study aimed to investigate the associations of quality management systems with teamwork and safety climate, and to describe and compare differences in perceptions of teamwork climate and safety climate among clinical leaders and frontline clinicians. We used a multi-method, cross-sectional approach to collect survey data of quality management systems and perceived teamwork and safety climate. Our data analyses included descriptive and multilevel regression methods. Data on implementation of quality management system from seven European countries were evaluated including patient safety culture surveys from 3622 clinical leaders and 4903 frontline clinicians. Perceived teamwork and safety climate. Teamwork climate was reported as positive by 67% of clinical leaders and 43% of frontline clinicians. Safety climate was perceived as positive by 54% of clinical leaders and 32% of frontline clinicians. We found positive associations between implementation of quality management systems and teamwork and safety climate. Our findings, which should be placed in a broader clinical quality improvement context, point to the importance of quality management systems as a supportive structural feature for promoting teamwork and safety climate. To gain a deeper understanding of this association, further qualitative and quantitative studies using longitudinally collected data are recommended. The study also confirms that more clinical leaders than frontline clinicians have a positive perception of teamwork and safety climate. Such differences should be accounted for in daily clinical practice and when tailoring initiatives to improve teamwork and safety climate. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

A mediation model linking dispatcher leadership and work ownership with safety climate as predictors of truck driver safety performance.

PubMed

Zohar, Dov; Huang, Yueng-hsiang; Lee, Jin; Robertson, Michelle

2014-01-01

The study was designed to test the effect of safety climate on safety behavior among lone employees whose work environment promotes individual rather than consensual or shared climate perceptions. The paper presents a mediation path model linking psychological (individual-level) safety climate antecedents and consequences as predictors of driving safety of long-haul truck drivers. Climate antecedents included dispatcher (distant) leadership and driver work ownership, two contextual attributes of lone work, whereas its proximal consequence included driving safety. Using a prospective design, safety outcomes, consisting of hard-braking frequency (i.e. traffic near-miss events) were collected six months after survey completion, using GPS-based truck deceleration data. Results supported the hypothesized model, indicating that distant leadership style and work ownership promote psychological safety climate perceptions, with subsequent prediction of hard-braking events mediated by driving safety. Theoretical and practical implications for studying safety climate among lone workers in general and professional drivers in particular are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

An investigation of safety climate in OHSAS 18001-certified and non-certified organizations.

PubMed

Ghahramani, Abolfazl

2016-09-01

Many organizations worldwide have implemented Occupational Health and Safety Assessment Series (OHSAS) 18001 in their premises because of the assumed positive effects of this standard on safety. Few studies have analyzed the effect of the safety climate in OHSAS 18001-certified organizations. This case-control study used a new safety climate questionnaire to evaluate three OHSAS 18001-certified and three non-certified manufacturing companies in Iran. Hierarchical regression indicated that the safety climate was influenced by OHSAS implementation and by safety training. Employees who received safety training had better perceptions of the safety climate and its dimensions than other respondents within the certified companies. This study found that the implementation of OHSAS 18001 does not guarantee improvement of the safety climate. This study also emphasizes the need for high-quality safety training for employees of the certified companies to improve the safety climate.

Pre-surgery briefings and safety climate in the operating theatre.

PubMed

Allard, Jon; Bleakley, Alan; Hobbs, Adrian; Coombes, Lee

2011-08-01

In 2008, the WHO produced a surgical safety checklist against a background of a poor patient safety record in operating theatres. Formal team briefings are now standard practice in high-risk settings such as the aviation industry and improve safety, but are resisted in surgery. Research evidence is needed to persuade the surgical workforce to adopt safety procedures such as briefings. To investigate whether exposure to pre-surgery briefings is related to perception of safety climate. Three Safety Attitude Questionnaires, completed by operating theatre staff in 2003, 2004 and 2006, were used to evaluate the effects of an educational intervention introducing pre-surgery briefings. Individual practitioners who agree with the statement 'briefings are common in the operating theatre' also report a better 'safety climate' in operating theatres. The study reports a powerful link between briefing practices and attitudes towards safety. Findings build on previous work by reporting on the relationship between briefings and safety climate within a 4-year period. Briefings, however, remain difficult to establish in local contexts without appropriate team-based patient safety education. Success in establishing a safety culture, with associated practices, may depend on first establishing unidirectional, positive change in attitudes to create a safety climate.

Patient safety culture in Norwegian primary care: a study in out-of-hours casualty clinics and GP practices.

PubMed

Bondevik, Gunnar Tschudi; Hofoss, Dag; Hansen, Elisabeth Holm; Deilkås, Ellen Catharina Tveter

2014-09-01

This study aimed to investigate patient safety attitudes amongst health care providers in Norwegian primary care by using the Safety Attitudes Questionnaire, in both out-of-hours (OOH) casualty clinics and GP practices. The questionnaire identifies five major patient safety factors: Teamwork climate, Safety climate, Job satisfaction, Perceptions of management, and Working conditions. Cross-sectional study. Statistical analysis included multiple linear regression and independent samples t-tests. Seven OOH casualty clinics and 17 GP practices in Norway. In October and November 2012, 510 primary health care providers working in OOH casualty clinics and GP practices (316 doctors and 194 nurses) were invited to participate anonymously. To study whether patterns in patient safety attitudes were related to professional background, gender, age, and clinical setting. The overall response rate was 52%; 72% of the nurses and 39% of the doctors answered the questionnaire. In the OOH clinics, nurses scored significantly higher than doctors on Safety climate and Job satisfaction. Older health care providers scored significantly higher than younger on Safety climate and Working conditions. In GP practices, male health professionals scored significantly higher than female on Teamwork climate, Safety climate, Perceptions of management and Working conditions. Health care providers in GP practices had significant higher mean scores on the factors Safety climate and Working conditions, compared with those working in the OOH clinics. Our study showed that nurses scored higher than doctors, older health professionals scored higher than younger, male GPs scored higher than female GPs, and health professionals in GP practices scored higher than those in OOH clinics - on several patient safety factors.

A multilevel examination of affective job insecurity climate on safety outcomes.

PubMed

Jiang, Lixin; Probst, Tahira M

2016-07-01

Previous research has established a causal link between individual perceptions of job insecurity and safety outcomes. However, whether job insecurity climate is associated with safety outcomes has not been studied. The purpose of the current study was to explore the main and cross-level interaction effects of affective job insecurity climate on safety outcomes, including behavioral safety compliance, reporting attitudes, workplace injuries, experienced safety events, unreported safety events, and accident underreporting, beyond individual affective job insecurity. With 171 employees nested in 40 workgroups, multilevel analyses revealed that the negative impacts of individual affective job insecurity on safety outcomes are exacerbated when they occur in a climate of high affective job insecurity. These results are interpreted in light of safety management efforts and suggest that efforts to create a secure climate within one's workgroup may reap safety-related benefits. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Development and Validation of a Safety Climate Scale for Manufacturing Industry

PubMed Central

Ghahramani, Abolfazl; Khalkhali, Hamid R.

2015-01-01

Background This paper describes the development of a scale for measuring safety climate. Methods This study was conducted in six manufacturing companies in Iran. The scale developed through conducting a literature review about the safety climate and constructing a question pool. The number of items was reduced to 71 after performing a screening process. Results The result of content validity analysis showed that 59 items had excellent item content validity index (≥ 0.78) and content validity ratio (> 0.38). The exploratory factor analysis resulted in eight safety climate dimensions. The reliability value for the final 45-item scale was 0.96. The result of confirmatory factor analysis showed that the safety climate model is satisfactory. Conclusion This study produced a valid and reliable scale for measuring safety climate in manufacturing companies. PMID:26106508

Relationship of hospital organizational culture to patient safety climate in the Veterans Health Administration.

PubMed

Hartmann, Christine W; Meterko, Mark; Rosen, Amy K; Shibei Zhao; Shokeen, Priti; Singer, Sara; Gaba, David M

2009-06-01

Improving safety climate could enhance patient safety, yet little evidence exists regarding the relationship between hospital characteristics and safety climate. This study assessed the relationship between hospitals' organizational culture and safety climate in Veterans Health Administration (VA) hospitals nationally. Data were collected from a sample of employees in a stratified random sample of 30 VA hospitals over a 6-month period (response rate = 50%; n = 4,625). The Patient Safety Climate in Healthcare Organizations (PSCHO) and the Zammuto and Krakower surveys were used to measure safety climate and organizational culture, respectively. Higher levels of safety climate were significantly associated with higher levels of group and entrepreneurial cultures, while lower levels of safety climate were associated with higher levels of hierarchical culture. Hospitals could use these results to design specific interventions aimed at improving safety climate.

Safety Climate Among Nontraditional Workers in Construction: Arguing for a Focus on Construed External Safety Image.

PubMed

Stiehl, Emily; Forst, Linda

2018-05-01

Safety climate, employees' perceptions of work-related safety, 1 has been promoted as a leading indicator of workplace safety in construction. 2 , 3 While research has primarily examined internal organizational sources (e.g., manager attitudes, formal organizational policies) on these perceptions, external sources of information might be more relevant to construction workers in nontraditional jobs who work for a limited time and/or have limited interaction with other employees. This paper argues for the future development of a construed external safety image scale to measure employees' perceptions about how external groups view their organization's safety. 4 The construed external safety image would capture the external sources that nontraditional workers use to assess safety climate and will allow public health researchers to identify and change dangerous workplaces while more effectively communicating information about safe workplaces to workers. The public health relevance of safety climate and construed external safety image for monitoring and communicating safety to nontraditional workers require examination.

Organizational safety climate and supervisor safety enforcement: Multilevel explorations of the causes of accident underreporting.

PubMed

Probst, Tahira M

2015-11-01

According to national surveillance statistics, over 3 million employees are injured each year; yet, research indicates that these may be substantial underestimates of the true prevalence. The purpose of the current project was to empirically test the hypothesis that organizational safety climate and transactional supervisor safety leadership would predict the extent to which accidents go unreported by employees. Using hierarchical linear modeling and survey data collected from 1,238 employees in 33 organizations, employee-level supervisor safety enforcement behaviors (and to a less consistent extent, organizational-level safety climate) predicted employee accident underreporting. There was also a significant cross-level interaction, such that the effect of supervisor enforcement on underreporting was attenuated in organizations with a positive safety climate. These results may benefit human resources and safety professionals by pinpointing methods of increasing the accuracy of accident reporting, reducing actual safety incidents, and reducing the costs to individuals and organizations that result from underreporting. (c) 2015 APA, all rights reserved).

Workplace injuries, safety climate and behaviors: application of an artificial neural network.

PubMed

Abubakar, A Mohammed; Karadal, Himmet; Bayighomog, Steven W; Merdan, Ethem

2018-05-09

This article proposes and tests a model for the interaction effect of the organizational safety climate and behaviors on workplace injuries. Using artificial neural network and survey data from 306 metal casting industry employees in central Anatolia, we found that an organizational safety climate mitigates workplace injuries, and safety behaviors enforce the strength of the negative impact of the safety climate on workplace injuries. The results suggest a complex relationship between the organizational safety climate, safety behavior and workplace injuries. Theoretical and practical implications are discussed in light of decreasing workplace injuries in the Anatolian metal casting industry.

The role of organizational trust in safety climate's influence on organizational outcomes.

PubMed

Kath, Lisa M; Magley, Vicki J; Marmet, Matthew

2010-09-01

Based on elements of social exchange theory and other conceptualizations of trust, a model was developed situating organizational trust as a central component to the relationship that safety climate has with organizational outcomes. Specifically, the model specified that two facets of safety climate--upward safety communication and management attitudes toward safety--would be positively related to organizational trust. Increased levels of trust would then predict increased motivation to engage in safe job-related behaviors, increased job satisfaction, and decreased turnover intentions. Another hypothesis investigated whether job safety relevance would moderate the relationship between safety climate and trust. Online survey research was conducted with 599 employees from 97 work groups across a New England grocery store chain. Hierarchical linear modeling indicated support for trust mediating the relationship between safety climate and organizational outcomes; further, the relationship between safety climate and trust was stronger within work groups where safety was more relevant. 2009 Elsevier Ltd. All rights reserved.

The effects of crew resource management on teamwork and safety climate at Veterans Health Administration facilities.

PubMed

Schwartz, Miriam E; Welsh, Deborah E; Paull, Douglas E; Knowles, Regina S; DeLeeuw, Lori D; Hemphill, Robin R; Essen, Keith E; Sculli, Gary L

2017-11-09

Communication failure is a significant source of adverse events in health care and a leading root cause of sentinel events reported to the Joint Commission. The Veterans Health Administration National Center for Patient Safety established Clinical Team Training (CTT) as a comprehensive program to enhance patient safety and to improve communication and teamwork among health care professionals. CTT is based on techniques used in aviation's Crew Resource Management (CRM) training. The aviation industry has reached a significant safety record in large part related to the culture change generated by CRM and sustained by its recurrent implementation. This article focuses on the improvement of communication, teamwork, and patient safety by utilizing a standardized, CRM-based, interprofessional, immersive training in diverse clinical areas. The Teamwork and Safety Climate Questionnaire was used to evaluate safety climate before and after CTT. The scores for all of the 27 questions on the questionnaire showed an increase from baseline to 12 months, and 11 of those increases were statistically significant. A recurrent training is recommended to maintain the positive outcomes. CTT enhances patient safety and reduces risk of patient harm by improving teamwork and facilitating clear, concise, specific and timely communication among health care professionals. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

EMS providers' perceptions of safety climate and adherence to safe work practices.

PubMed

Eliseo, Laura J; Murray, Kate A; White, Laura F; Dyer, Sophia; Mitchell, Patricia A; Fernandez, William G

2012-01-01

Occupational injuries are an important source of morbidity for emergency medical services (EMS) providers. Previous work has shown that employee perceptions of an organization's commitment to safety (i.e., safety climate) correlate with adherence to safe practices. To assess the association between perceived safety climate and compliance with safety procedures in an urban EMS system with >100,000 calls/year. EMS providers were issued a self-administered survey that included questions on demographics, years of experience, perceived safety climate, and adherence to safety procedures. Safety climate was assessed with a 20-item validated instrument. Adherence to safety procedures was assessed with a nine-item list of safety behaviors. Strict adherence to safety procedures was defined as endorsing "agree" or "strongly agree" on 80% of items. The effect of safety climate on compliance with safe practices was estimated using multiple logistic regression. One hundred ninety-six of 221 providers (89%) completed surveys; 74% were male; the median age was 36-40 years; and the median amount of experience was 8 years. One hundred twenty-seven of 196 respondents (65%) reported strict adherence to safe work practice. Factor analysis confirmed the original six-factor grouping of questions; frequent safety-related feedback/training was significantly associated with safe practices (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.01-4.51). EMS workers perceiving a high degree of perceived safety climate was associated with twofold greater odds of self-reported level of strict adherence to safe work practices. Frequent safety-related feedback/training was the one dimension of safety climate that had the strongest association with adherence to safe workplace behaviors.

Multilevel Safety Climate and Safety Performance in the Construction Industry: Development and Validation of a Top-Down Mechanism

PubMed Central

Gao, Ran; Chan, Albert P.C.; Utama, Wahyudi P.; Zahoor, Hafiz

2016-01-01

The character of construction projects exposes front-line workers to dangers and accidents. Safety climate has been confirmed to be a predictor of safety performance in the construction industry. This study aims to explore the underlying mechanisms of the relationship between multilevel safety climate and safety performance. An integrated model was developed to study how particular safety climate factors of one level affect those of other levels, and then affect safety performance from the top down. A questionnaire survey was administered on six construction sites in Vietnam. A total of 1030 valid questionnaires were collected from this survey. Approximately half of the data were used to conduct exploratory factor analysis (EFA) and the remaining data were submitted to structural equation modeling (SEM). Top management commitment (TMC) and supervisors’ expectation (SE) were identified as factors to represent organizational safety climate (OSC) and supervisor safety climate (SSC), respectively, and coworkers’ caring and communication (CCC) and coworkers’ role models (CRM) were identified as factors to denote coworker safety climate (CSC). SEM results show that OSC factor is positively related to SSC factor and CSC factors significantly. SSC factor could partially mediate the relationship between OSC factor and CSC factors, as well as the relationship between OSC factor and safety performance. CSC factors partially mediate the relationship between OSC factor and safety performance, and the relationship between SSC factor and safety performance. The findings imply that a positive safety culture should be established both at the organizational level and the group level. Efforts from all top management, supervisors, and coworkers should be provided to improve safety performance in the construction industry. PMID:27834823

Multilevel Safety Climate and Safety Performance in the Construction Industry: Development and Validation of a Top-Down Mechanism.

PubMed

Gao, Ran; Chan, Albert P C; Utama, Wahyudi P; Zahoor, Hafiz

2016-11-08

The character of construction projects exposes front-line workers to dangers and accidents. Safety climate has been confirmed to be a predictor of safety performance in the construction industry. This study aims to explore the underlying mechanisms of the relationship between multilevel safety climate and safety performance. An integrated model was developed to study how particular safety climate factors of one level affect those of other levels, and then affect safety performance from the top down. A questionnaire survey was administered on six construction sites in Vietnam. A total of 1030 valid questionnaires were collected from this survey. Approximately half of the data were used to conduct exploratory factor analysis (EFA) and the remaining data were submitted to structural equation modeling (SEM). Top management commitment (TMC) and supervisors' expectation (SE) were identified as factors to represent organizational safety climate (OSC) and supervisor safety climate (SSC), respectively, and coworkers' caring and communication (CCC) and coworkers' role models (CRM) were identified as factors to denote coworker safety climate (CSC). SEM results show that OSC factor is positively related to SSC factor and CSC factors significantly. SSC factor could partially mediate the relationship between OSC factor and CSC factors, as well as the relationship between OSC factor and safety performance. CSC factors partially mediate the relationship between OSC factor and safety performance, and the relationship between SSC factor and safety performance. The findings imply that a positive safety culture should be established both at the organizational level and the group level. Efforts from all top management, supervisors, and coworkers should be provided to improve safety performance in the construction industry.

Safety climate in OHSAS 18001-certified organisations: antecedents and consequences of safety behaviour.

PubMed

Fernández-Muñiz, Beatriz; Montes-Peón, José Manuel; Vázquez-Ordás, Camilo José

2012-03-01

The occupational health and safety standard OHSAS 18001 has gained considerable acceptance worldwide, and firms from diverse sectors and of varying sizes have implemented it. Despite this, very few studies have analysed safety management or the safety climate in OHSAS 18001-certified organisations. The current work aims to analyse the safety climate in these organisations, identify its dimensions, and propose and test a structural equation model that will help determine the antecedents and consequences of employees' safety behaviour. For this purpose, the authors carry out an empirical study using a sample of 131 OHSAS 18001-certified organisations located in Spain. The results show that management's commitment, and particularly communication, have an effect on safety behaviour and on safety performance, employee satisfaction, and firm competitiveness. These findings are particularly important for management since they provide evidence about the factors that should be encouraged to reduce risks and improve performance in this type of organisation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Behaving safely under pressure: The effects of job demands, resources, and safety climate on employee physical and psychosocial safety behavior.

PubMed

Bronkhorst, Babette

2015-12-01

Previous research has shown that employees who experience high job demands are more inclined to show unsafe behaviors in the workplace. In this paper, we examine why some employees behave safely when faced with these demands while others do not. We add to the literature by incorporating both physical and psychosocial safety climate in the job demands and resources (JD-R) model and extending it to include physical and psychosocial variants of safety behavior. Using a sample of 6230 health care employees nested within 52 organizations, we examined the relationship between job demands and (a) resources, (b) safety climate, and (c) safety behavior. We conducted multilevel analyses to test our hypotheses. Job demands (i.e., work pressure), job resources (i.e., job autonomy, supervisor support, and co-worker support) and safety climate (both physical and psychosocial safety climate) are directly associated with, respectively, lower and higher physical and psychosocial safety behavior. We also found some evidence that safety climate buffers the negative impact of job demands (i.e., work-family conflict and job insecurity) on safety behavior and strengthens the positive impact of job resources (i.e., co-worker support) on safety behavior. Regardless of whether the focus is physical or psychological safety, our results show that strengthening the safety climate within an organization can increase employees' safety behavior. Practical implication: An organization's safety climate is an optimal target of intervention to prevent and ameliorate negative physical and psychological health and safety outcomes, especially in times of uncertainty and change. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

Testing the reliability and validity of a measure of safety climate.

PubMed

Anderson, E; McGovern, P M; Kochevar, L; Vesley, D; Gershon, R

2000-01-01

The lack of compliance with universal precautions (UP) is well documented across a wide variety of healthcare professions and has been reported both before and after the enactment of the Occupational Safety and Health Administration's Bloodborne Pathogens Standard. Gershon, Karkashian, and Felknor (1994) found that several factors correlated significantly with healthcare workers' lack of compliance with UP, including a measure of organizational safety climate (e.g., the employees' perception of their organizational culture and practices regarding safety). We conducted a secondary analysis using data from a cross-sectional survey of a convenience sample of 1,746 healthcare workers at risk of occupational exposure to bloodborne pathogens to assess the validity and reliability of Gershon's measure of safety climate. Findings revealed no relationship between safety climate and employees' gender, age, education, tenure in position, profession, hours worked per day, perceived risk, attitude toward risk, and training. An association was demonstrated between safety climate and (1) healthcare worker compliance with UP and (2) the availability of personal protective equipment, providing support for the construct validity of this measure of safety climate. These findings could be used by occupational health professionals to assess employees' perceptions of the safety culture and practices in the workplace and to guide the institution's risk management efforts in association with U.P.

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey.

PubMed

Smits, Marleen; Keizer, Ellen; Giesen, Paul; Deilkås, Ellen Catharina Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2018-03-01

To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness. Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience. Overall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors. Our study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents' profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture. Key Points Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that: • healthcare providers in Dutch GP cooperatives

Safety climate in university and college laboratories: impact of organizational and individual factors.

PubMed

Wu, Tsung-Chih; Liu, Chi-Wei; Lu, Mu-Chen

2007-01-01

Universities and colleges serve to be institutions of education excellence; however, problems in the areas of occupational safety may undermine such goals. Occupational safety must be the concern of every employee in the organization, regardless of job position. Safety climate surveys have been suggested as important tools for measuring the effectiveness and improvement direction of safety programs. Thus, this study aims to investigate the influence of organizational and individual factors on safety climate in university and college laboratories. Employees at 100 universities and colleges in Taiwan were mailed a self-administered questionnaire survey; the response rate was 78%. Multivariate analysis of variance revealed that organizational category of ownership, the presence of a safety manager and safety committee, gender, age, title, accident experience, and safety training significantly affected the climate. Among them, accident experience and safety training affected the climate with practical significance. The authors recommend that managers should address important factors affecting safety issues and then create a positive climate by enforcing continuous improvements.

Improving safety climate through a communication and recognition program for construction: a mixed-methods study

PubMed Central

Sparer, Emily H; Catalano, Paul J; Herrick, Robert F; Dennerlein, Jack T

2016-01-01

Objectives This study aimed to evaluate the efficacy of a safety communication and recognition program (B-SAFE), designed to encourage improvement of physical working conditions and hazard reduction in construction. Methods A matched pair cluster randomized controlled trial was conducted on eight worksites (four received the B-SAFE intervention, four served as control sites) for approximately five months per site. Pre- and post-exposure worker surveys were collected at all sites (N=615, pre-exposure response rate of 74%, post-exposure response rate of 88%). Multi-level mixed-effect regression models evaluated the effect of B-SAFE on safety climate as assessed from surveys. Focus groups (N=6–8 workers/site) were conducted following data collection. Transcripts were coded and analyzed for thematic content using Atlas.ti (version 6). Results The mean safety climate score at intervention sites, as measured on a 0–50 point scale, increased 0.5 points (1%) between pre- and post-B-SAFE exposure, compared to control sites that decreased 0.8 points (1.6%). The intervention effect size was 1.64 (3.28%) (P-value=0.01) when adjusted for month the worker started on-site, total length of time on-site, as well as individual characteristics (trade, title, age, and race/ethnicity). At intervention sites, workers noted increased levels of safety awareness, communication, and teamwork compared to control sites. Conclusions B-SAFE led to many positive changes, including an improvement in safety climate, awareness, teambuilding, and communication. B-SAFE was a simple intervention that engaged workers through effective communication infrastructures and had a significant, positive effect on worksite safety. PMID:27158914

Employer, use of personal protective equipment, and work safety climate: Latino poultry processing workers.

PubMed

Arcury, Thomas A; Grzywacz, Joseph G; Anderson, Andrea M; Mora, Dana C; Carrillo, Lourdes; Chen, Haiying; Quandt, Sara A

2013-02-01

This analysis describes the work safety climate of Latino poultry processing workers and notes differences by worker personal characteristics and employer; describes the use of common personal protective equipment (PPE) among workers; and examines the associations of work safety climate with use of common PPE. Data are from a cross-sectional study of 403 Latino poultry processing workers in western North Carolina. Work safety climate differed little by personal characteristics, but it did differ consistently by employer. Provision of PPE varied; for example, 27.2% of participants were provide with eye protection at no cost, 57.0% were provided with hand protection at no cost, and 84.7% were provided with protective clothing at no cost. PPE use varied by type. Provision of PPE at no cost was associated with lower work safety climate; this result was counter-intuitive. Consistent use of PPE was associated with higher work safety climate. Work safety climate is important for improving workplace safety for immigrant workers. Research among immigrant workers should document work safety climate for different employers and industries, and delineate how work safety climate affects safety behavior and injuries. Copyright © 2012 Wiley Periodicals, Inc.

Transport company safety climate-The impact on truck driver behavior and crash involvement.

PubMed

Sullman, Mark J M; Stephens, Amanda N; Pajo, Karl

2017-04-03

The present study investigated the relationships between safety climate and driving behavior and crash involvement. A total of 339 company-employed truck drivers completed a questionnaire that measured their perceptions of safety climate, crash record, speed choice, and aberrant driving behaviors (errors, lapses, and violations). Although there was no direct relationship between the drivers' perceptions of safety climate and crash involvement, safety climate was a significant predictor of engagement in risky driving behaviors, which were in turn predictive of crash involvement. This research shows that safety climate may offer an important starting point for interventions aimed at reducing risky driving behavior and thus fewer vehicle collisions.

Measuring safety climate in health care.

PubMed

Flin, R; Burns, C; Mearns, K; Yule, S; Robertson, E M

2006-04-01

To review quantitative studies of safety climate in health care to examine the psychometric properties of the questionnaires designed to measure this construct. A systematic literature review was undertaken to study sample and questionnaire design characteristics (source, no of items, scale type), construct validity (content validity, factor structure and internal reliability, concurrent validity), within group agreement, and level of analysis. Twelve studies were examined. There was a lack of explicit theoretical underpinning for most questionnaires and some instruments did not report standard psychometric criteria. Where this information was available, several questionnaires appeared to have limitations. More consideration should be given to psychometric factors in the design of healthcare safety climate instruments, especially as these are beginning to be used in large scale surveys across healthcare organisations.

Quality and strength of patient safety climate on medical-surgical units.

PubMed

Hughes, Linda C; Chang, Yunkyung; Mark, Barbara A

2009-01-01

Describing the safety climate in hospitals is an important first step in creating work environments where safety is a priority. Yet, little is known about the patient safety climate on medical-surgical units. Study purposes were to describe quality and strength of the patient safety climate on medical-surgical units and explore hospital and unit characteristics associated with this climate. Data came from a larger organizational study to investigate hospital and unit characteristics associated with organizational, nurse, and patient outcomes. The sample for this study was 3,689 RNs on 286 medical-surgical units in 146 hospitals. Nursing workgroup and managerial commitment to safety were the two most strongly positive attributes of the patient safety climate. However, issues surrounding the balance between job duties and safety compliance and nurses' reluctance to reveal errors continue to be problematic. Nurses in Magnet hospitals were more likely to communicate about errors and participate in error-related problem solving. Nurses on smaller units and units with lower work complexity reported greater safety compliance and were more likely to communicate about and reveal errors. Nurses on smaller units also reported greater commitment to patient safety and participation in error-related problem solving. Nursing workgroup commitment to safety is a valuable resource that can be leveraged to promote a sense of personal responsibility for and shared ownership of patient safety. Managers can capitalize on this commitment by promoting a work environment in which control over nursing practice and active participation in unit decisions are encouraged and by developing channels of communication that increase staff nurse involvement in identifying patient safety issues, prioritizing unit-level safety goals, and resolving day-to-day operational problems the have the potential to jeopardize patient safety.

Relationship between organizational justice and organizational safety climate: do fairness perceptions influence employee safety behaviour?

PubMed

Gyekye, Seth Ayim; Haybatollahi, Mohammad

2014-01-01

This study investigated the relationships between organizational justice, organizational safety climate, job satisfaction, safety compliance and accident frequency. Ghanaian industrial workers participated in the study (N = 320). Safety climate and justice perceptions were assessed with Hayes, Parender, Smecko, et al.'s (1998) and Blader and Tyler's (2003) scales respectively. A median split was performed to dichotomize participants into 2 categories: workers with positive and workers with negative justice perceptions. Confirmatory factors analysis confirmed the 5-factor structure of the safety scale. Regression analyses and t tests indicated that workers with positive fairness perceptions had constructive perspectives regarding workplace safety, expressed greater job satisfaction, were more compliant with safety policies and registered lower accident rates. These findings provide evidence that the perceived level of fairness in an organization is closely associated with workplace safety perception and other organizational factors which are important for safety. The implications for safety research are discussed.

Patient safety culture in Norwegian nursing homes.

PubMed

Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter

2017-06-20

Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values <0.05 were considered to be significant. Out of the 463 employees invited, 288 (62.2%) answered the questionnaire. Response rates varied between 56.9% and 72.2% across the five nursing homes. In multiple linear regression analysis, we found that increasing age and job position among the healthcare providers were associated with significantly increased mean scores for the patient safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient

Organizational climate determinants of resident safety culture in nursing homes.

PubMed

Arnetz, Judith E; Zhdanova, Ludmila S; Elsouhag, Dalia; Lichtenberg, Peter; Luborsky, Mark R; Arnetz, Bengt B

2011-12-01

In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes. Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures.  The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05). Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.

Safety climate, emotional exhaustion and job satisfaction among Brazilian paediatric professional nurses.

PubMed

Alves, D F S; Guirardello, E B

2016-09-01

International studies indicate that job satisfaction and burnout interfere with the safety climate and quality of care. However, no evidence of such relationships is available for Brazilian paediatric hospitals. To assess the correlation and predictive effect of emotional exhaustion and job satisfaction on the perception of professional nurses at paediatric hospitals regarding safety climate and quality of care. Cross-sectional correlational design. The study was conducted with registered nurses, technician and assistant nurses from two Brazilian paediatric hospitals over 3 months in 2013-2014 using instruments to assess safety climate, quality of care, job satisfaction and emotional exhaustion. Data related to 267 professional nurses from 15 inpatient wards and 3 intensive care units were analysed. Overall, the respondents exhibited moderate emotional exhaustion, were satisfied with their jobs and considered the quality of care as good. However, the respondents exhibited low concordance as to the positive perception of the safety climate. The variables, emotional exhaustion and job satisfaction, exhibited significant correlations with safety climate and were considered predictive of the latter. Emotional exhaustion and job satisfaction among professional nurses influence the safety climate at paediatric hospitals. Investments to reduce emotional exhaustion and to improve job satisfaction among professional nurses allocated to paediatric hospitals might contribute to the patients' safety. © 2016 International Council of Nurses.

Improving staff perception of a safety climate with crew resource management training.

PubMed

Kuy, SreyRam; Romero, Ramon A L

2017-06-01

Communication failure is one of the top root causes in patient safety adverse events. Crew resource management (CRM) is a team building communication process intended to improve patient safety by improving team dynamics. First, to describe implementation of CRM in a Veterans Affair (VA) surgical service. Second, to assess whether staff CRM training is related to improvement in staff perception of a safety climate. Mandatory CRM training was implemented for all surgical service staff at a VA Hospital at 0 and 12 mo. Safety climate questionnaires were completed by operating room staff at a baseline, 6 and 12 mo after the initial CRM training. Participants reported improvement on all 27 points on the safety climate questionnaire at 6 mo compared with the baseline. At 12 mo, there was sustained improvement in 23 of the 27 areas. This is the first published report about the effect of CRM training on staff perception of a safety climate in a VA surgical service. We demonstrate that CRM training can be successfully implemented widespread in a surgical program. Overall, there was improvement in 100% of areas assessed on the safety climate questionnaire at 6 mo after CRM training. By 1 y, this improvement was sustained in 23 of 27 areas, with the areas of greatest improvement being the performance of briefings, collaboration between nurses and doctors, valuing nursing input, knowledge about patient safety, and institutional promotion of a patient safety climate. Published by Elsevier Inc.

The Impact of Market Orientation on Patient Safety Climate Among Hospital Nurses.

PubMed

Weng, Rhay-Hung; Chen, Jung-Chien; Pong, Li-Jung; Chen, Li-Mei; Lin, Tzu-Chi

2016-03-01

Improving market orientation and patient safety have become the key concerns of nursing management. For nurses, establishing a patient safety climate is the key to enhancing nursing quality. This study explores how market orientation affects the climate of patient safety among hospital nurses. We proposed adopting a cross-sectional research design and using questionnaires to collect responses from nurses working in two Taiwanese hospitals. Three-hundred and forty-three valid samples were obtained. Multiple regression and path analyses were conducted to test the study. Market orientation was defined as the combination of customer orientation, competitor orientation, and interfunctional coordination. Customer orientation directly affects the climate of patient safety. Although the findings only supported Hypothesis 1, competitor orientation and interfunctional coordination positively affected the patient safety climate through the mediating effects of hospital support for staff. Health care managers could encourage nurses to adopt customer-oriented perspectives to enhance their nursing care. In addition, to enhance competitor orientation, interfunctional coordination, and the patient safety climate, hospital managers could strengthen their support for staff members. © The Author(s) 2014.

Patient safety culture in out-of-hours primary care services in the Netherlands: a cross-sectional survey

PubMed Central

Smits, Marleen; Keizer, Ellen; Giesen, Paul; Deilkås, Ellen Catharina Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2018-01-01

Objective To examine patient safety culture in Dutch out-of-hours primary care using the safety attitudes questionnaire (SAQ) which includes five factors: teamwork climate, safety climate, job satisfaction, perceptions of management and communication openness. Design Cross-sectional observational study using an anonymous web-survey. Setting Sixteen out-of-hours general practitioner (GP) cooperatives and two call centers in the Netherlands. Subjects Primary healthcare providers in out-of-hours services. Main outcome measures Mean scores on patient safety culture factors; association between patient safety culture and profession, gender, age, and working experience. Results Overall response rate was 43%. A total of 784 respondents were included; mainly GPs (N = 470) and triage nurses (N = 189). The healthcare providers were most positive about teamwork climate and job satisfaction, and less about communication openness and safety climate. The largest variation between clinics was found on safety climate; the lowest on teamwork climate. Triage nurses scored significantly higher than GPs on each of the five patient safety factors. Older healthcare providers scored significantly higher than younger on safety climate and perceptions of management. More working experience was positively related to higher teamwork climate and communication openness. Gender was not associated with any of the patient safety factors. Conclusions Our study showed that healthcare providers perceive patient safety culture in Dutch GP cooperatives positively, but there are differences related to the respondents’ profession, age and working experience. Recommendations for future studies are to examine reasons for these differences, to examine the effects of interventions to improve safety culture and to make international comparisons of safety culture. Key Points Creating a positive patient safety culture is assumed to be a prerequisite for quality and safety. We found that: �

Identifying and addressing the limitations of safety climate surveys.

PubMed

O'Connor, Paul; Buttrey, Samuel E; O'Dea, Angela; Kennedy, Quinn

2011-08-01

There are a variety of qualitative and quantitative tools for measuring safety climate. However, questionnaires are by far the most commonly used methodology. This paper reports the descriptive analysis of a large sample of safety climate survey data (n=110,014) collected over 10 years from U.S. Naval aircrew using the Command Safety Assessment Survey (CSAS). The analysis demonstrated that there was substantial non-random response bias associated with the data (the reverse worded items had a unique pattern of responses, there was a increasing tendency over time to only provide a modal response, the responses to the same item towards the beginning and end of the questionnaire did not correlate as highly as might be expected, and the faster the questionnaire was completed the higher the frequency of modal responses). It is suggested that the non-random responses bias was due to the negative effect on participant motivation of a number of factors (questionnaire design, lack of a belief in the importance of the response, participant fatigue, and questionnaire administration). Researchers must consider the factors that increase the likelihood of non-random measurement error in safety climate survey data and cease to rely on data that are solely collected using a long and complex questionnaire. In the absence of valid and reliable data it will not be possible for organizations to take the measures required to improve safety climate. Copyright © 2011 Elsevier B.V. All rights reserved.

A structural equation modelling approach examining the pathways between safety climate, behaviour performance and workplace slipping

PubMed Central

Swedler, David I; Verma, Santosh K; Huang, Yueng-Hsiang; Lombardi, David A; Chang, Wen-Ruey; Brennan, Melayne; Courtney, Theodore K

2015-01-01

Objective Safety climate has previously been associated with increasing safe workplace behaviours and decreasing occupational injuries. This study seeks to understand the structural relationship between employees’ perceptions of safety climate, performing a safety behaviour (ie, wearing slip-resistant shoes) and risk of slipping in the setting of limited-service restaurants. Methods At baseline, we surveyed 349 employees at 30 restaurants for their perceptions of their safety training and management commitment to safety as well as demographic data. Safety performance was identified as wearing slip-resistant shoes, as measured by direct observation by the study team. We then prospectively collected participants’ hours worked and number of slips weekly for the next 12 weeks. Using a confirmatory factor analysis, we modelled safety climate as a higher order factor composed of previously identified training and management commitment factors. Results The 349 study participants experienced 1075 slips during the 12-week follow-up. Confirmatory factor analysis supported modelling safety climate as a higher order factor composed of safety training and management commitment. In a structural equation model, safety climate indirectly affected prospective risk of slipping through safety performance, but no direct relationship between safety climate and slips was evident. Conclusions Results suggest that safety climate can reduce workplace slips through performance of a safety behaviour as well as suggesting a potential causal mechanism through which safety climate can reduce workplace injuries. Safety climate can be modelled as a higher order factor composed of safety training and management commitment. PMID:25710968

Work safety climate, musculoskeletal discomfort, working while injured, and depression among migrant farmworkers in North Carolina.

PubMed

Arcury, Thomas A; O'Hara, Heather; Grzywacz, Joseph G; Isom, Scott; Chen, Haiying; Quandt, Sara A

2012-05-01

This analysis described Latino migrant farmworkers' work safety climate and its association with musculoskeletal discomfort, working while injured or ill, and depressive symptoms. Data were from a cross-sectional survey of 300 farmworkers conducted in North Carolina in 2009. Generalized estimating equations models were used to investigate the association of work safety climate with health and safety outcomes. Farmworkers perceived their work safety climate to be poor. About 40% had elevated musculoskeletal discomfort, 5.0% had worked at least 1 day while injured or ill, and 27.9% had elevated depressive symptoms. The odds of elevated musculoskeletal discomfort were 12% lower and the odds of working while injured or ill were 15% lower with each 1-unit increase in the work safety climate. Work safety climate was not associated with depressive symptoms. Work safety climate was important for agricultural workers. Poor work safety climate was associated with health outcomes (musculoskeletal discomfort) and safety (working while injured or ill). Interventions to improve work safety climate in agriculture are needed, with these interventions being directed to employers and workers.

Work Safety Climate, Musculoskeletal Discomfort, Working While Injured, and Depression Among Migrant Farmworkers in North Carolina

PubMed Central

O’Hara, Heather; Grzywacz, Joseph G.; Isom, Scott; Chen, Haiying; Quandt, Sara A.

2012-01-01

Objectives. This analysis described Latino migrant farmworkers’ work safety climate and its association with musculoskeletal discomfort, working while injured or ill, and depressive symptoms. Methods. Data were from a cross-sectional survey of 300 farmworkers conducted in North Carolina in 2009. Generalized estimating equations models were used to investigate the association of work safety climate with health and safety outcomes. Results. Farmworkers perceived their work safety climate to be poor. About 40% had elevated musculoskeletal discomfort, 5.0% had worked at least 1 day while injured or ill, and 27.9% had elevated depressive symptoms. The odds of elevated musculoskeletal discomfort were 12% lower and the odds of working while injured or ill were 15% lower with each 1-unit increase in the work safety climate. Work safety climate was not associated with depressive symptoms. Conclusions. Work safety climate was important for agricultural workers. Poor work safety climate was associated with health outcomes (musculoskeletal discomfort) and safety (working while injured or ill). Interventions to improve work safety climate in agriculture are needed, with these interventions being directed to employers and workers. PMID:22401520

A systematic review of the safety climate intervention literature: Past trends and future directions.

PubMed

Lee, Jin; Huang, Yueng-Hsiang; Cheung, Janelle H; Chen, Zhuo; Shaw, William S

2018-04-26

Safety climate represents the meaningfulness of safety and how safety is valued in an organization. The contributions of safety climate to organizational safety have been well documented. There is a dearth of empirical research, however, on specific safety climate interventions and their effectiveness. The present study aims at examining the trend of safety climate interventions and offering compiled information for designing and implementing evidence-based safety climate interventions. Our literature search yielded 384 titles that were inspected by three examiners. Using a stepwise process that allowed for assessment of interobserver agreement, 19 full articles were selected and reviewed. Results showed that 10 out of the 19 articles (52.6%) were based on a quasi-experimental pre- and postintervention design, whereas 42.1% (n = 8) studies were based on a mixed-design approach (including both between- and within-subject design). All interventions in these 19 studies involved either safety-/health-related communication or education/training. Improvement of safety leadership was also a common component of safety climate interventions. According to the socio-technical systems classification of intervention strategies, all studies were categorized as interventions focusing on improving organizational and managerial structure as well as the personnel subsystem; four of them also aimed at improving technological aspects of work, and five of them aimed at improving the physical work subsystem. In general, a vast majority of the studies (89.5%, n = 17) showed a statistically significant improvement in safety climate across their organizations postintervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Adjusting the Passing Scores for Gearing up for Safety: Production Agriculture Safety Training for Youth Curriculum Test Instruments

ERIC Educational Resources Information Center

Hoover, William Brian; French, Brian F.; Field, William E.; Tormoehlen, Roger L.

2012-01-01

Minimum passing scores for the Gearing Up for Safety: Production Agriculture Safety Training for Youth curriculum (Gearing Up for Safety) were set in 2006 with widely used and established procedures by efforts of subject matter experts (French, Breidenbach et al., 2007; French, Field, and Tormoehlen, 2006, 2007). While providing a research-based…

Impact of individual resilience and safety climate on safety performance and psychological stress of construction workers: A case study of the Ontario construction industry.

PubMed

Chen, Yuting; McCabe, Brenda; Hyatt, Douglas

2017-06-01

The construction industry has hit a plateau in terms of safety performance. Safety climate is regarded as a leading indicator of safety performance; however, relatively little safety climate research has been done in the Canadian construction industry. Safety climate may be geographically sensitive, thus it is necessary to examine how the construct of safety climate is defined and used to improve safety performance in different regions. On the other hand, more and more attention has been paid to job related stress in the construction industry. Previous research proposed that individual resilience may be associated with a better safety performance and may help employees manage stress. Unfortunately, few empirical research studies have examined this hypothesis. This paper aims to examine the role of safety climate and individual resilience in safety performance and job stress in the Canadian construction industry. The research was based on 837 surveys collected in Ontario between June 2015 and June 2016. Structural equation modeling (SEM) techniques were used to explore the impact of individual resilience and safety climate on physical safety outcomes and on psychological stress among construction workers. The results show that safety climate not only affected construction workers' safety performance but also indirectly affected their psychological stress. In addition, it was found that individual resilience had a direct negative impact on psychological stress but had no impact on physical safety outcomes. These findings highlight the roles of both organizational and individual factors in individual safety performance and in psychological well-being. Construction organizations need to not only monitor employees' safety performance, but also to assess their employees' psychological well-being. Promoting a positive safety climate together with developing training programs focusing on improving employees' psychological health - especially post-trauma psychological

Safety climate and attitude toward medication error reporting after hospital accreditation in South Korea.

PubMed

Lee, Eunjoo

2016-09-01

This study compared registered nurses' perceptions of safety climate and attitude toward medication error reporting before and after completing a hospital accreditation program. Medication errors are the most prevalent adverse events threatening patient safety; reducing underreporting of medication errors significantly improves patient safety. Safety climate in hospitals may affect medication error reporting. This study employed a longitudinal, descriptive design. Data were collected using questionnaires. A tertiary acute hospital in South Korea undergoing a hospital accreditation program. Nurses, pre- and post-accreditation (217 and 373); response rate: 58% and 87%, respectively. Hospital accreditation program. Perceived safety climate and attitude toward medication error reporting. The level of safety climate and attitude toward medication error reporting increased significantly following accreditation; however, measures of institutional leadership and management did not improve significantly. Participants' perception of safety climate was positively correlated with their attitude toward medication error reporting; this correlation strengthened following completion of the program. Improving hospitals' safety climate increased nurses' medication error reporting; interventions that help hospital administration and managers to provide more supportive leadership may facilitate safety climate improvement. Hospitals and their units should develop more friendly and intimate working environments that remove nurses' fear of penalties. Administration and managers should support nurses who report their own errors. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Systematic impact of institutional pressures on safety climate in the construction industry.

PubMed

He, Qinghua; Dong, Shuang; Rose, Timothy; Li, Heng; Yin, Qin; Cao, Dongping

2016-08-01

This paper explores how three types of institutional pressure (i.e., coercive, mimetic and normative pressures) systematically impact on the safety climate of construction projects. These impacts are empirically tested by survey data collected from 186 questionnaires of construction companies operating in Shanghai, China. The results, obtained by partial least squares analysis, show that organizational management commitment to safety and employee involvement is positively related to all three institutional pressures, while the perception of responsibility for safety and health is significantly influenced by coercive and mimetic pressure. However, coercive and normative pressures have no significant effect on the applicability of safety rules and work practices, revealing the importance of external organizational pressures in improving project safety climate from a systematic view. The findings also provide insights into the use of institutional forces to facilitate the improvement of safety climate in the construction industry. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using the Job Demands-Resources model to investigate risk perception, safety climate and job satisfaction in safety critical organizations.

PubMed

Nielsen, Morten Birkeland; Mearns, Kathryn; Matthiesen, Stig Berge; Eid, Jarle

2011-10-01

Using the Job Demands-Resources model (JD-R) as a theoretical framework, this study investigated the relationship between risk perception as a job demand and psychological safety climate as a job resource with regard to job satisfaction in safety critical organizations. In line with the JD-R model, it was hypothesized that high levels of risk perception is related to low job satisfaction and that a positive perception of safety climate is related to high job satisfaction. In addition, it was hypothesized that safety climate moderates the relationship between risk perception and job satisfaction. Using a sample of Norwegian offshore workers (N = 986), all three hypotheses were supported. In summary, workers who perceived high levels of risk reported lower levels of job satisfaction, whereas this effect diminished when workers perceived their safety climate as positive. Follow-up analyses revealed that this interaction was dependent on the type of risks in question. The results of this study supports the JD-R model, and provides further evidence for relationships between safety-related concepts and work-related outcomes indicating that organizations should not only develop and implement sound safety procedures to reduce the effects of risks and hazards on workers, but can also enhance other areas of organizational life through a focus on safety. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

Organizational injury rate underreporting: the moderating effect of organizational safety climate.

PubMed

Probst, Tahira M; Brubaker, Ty L; Barsotti, Anthony

2008-09-01

The goals of this study were (a) to assess the extent to which construction industry workplace injuries and illness are underreported, and (b) to determine whether safety climate predicts the extent of such underreporting. Data from 1,390 employees of 38 companies contracted to work at a large construction site in the northwestern United States were collected to assess the safety climate of the companies. Data from the Occupational Safety and Health Administration (OSHA) logs kept by the contractors allowed for calculation of each company's OSHA recordable injury rate (i.e., the reported injury rate), whereas medical claims data from an Owner-Controlled Insurance Program provided the actual experienced rate of injuries for those same companies. While the annual injury rate reported to OSHA was 3.11 injuries per 100 workers, the rate of eligible injuries that were not reported to OSHA was 10.90 injuries per 100 employees. Further, organizations with a poor safety climate had significantly higher rates of underreporting (81% of eligible injuries unreported) compared with organizations with a positive safety climate (47% of eligible injuries unreported). Implications for organizations and the accuracy of the Bureau of Labor Statistics's national occupational injury and illness surveillance system are discussed.

Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries?

PubMed

Mark, Barbara A; Hughes, Linda C; Belyea, Michael; Chang, Yunkyung; Hofmann, David; Jones, Cheryl B; Bacon, Cynthia T

2007-01-01

Hospital nurses have one of the highest work-related injury rates in the United States. Yet, approaches to improving employee safety have generally focused on attempts to modify individual behavior through enforced compliance with safety rules and mandatory participation in safety training. We examined a theoretical model that investigated the impact on nurse injuries (back injuries and needlesticks) of critical structural variables (staffing adequacy, work engagement, and work conditions) and further tested whether safety climate moderated these effects. A longitudinal, non-experimental, organizational study, conducted in 281 medical-surgical units in 143 general acute care hospitals in the United States. Work engagement and work conditions were positively related to safety climate, but not directly to nurse back injuries or needlesticks. Safety climate moderated the relationship between work engagement and needlesticks, while safety climate moderated the effect of work conditions on both needlesticks and back injuries, although in unexpected ways. DISCUSSION AND IMPACT ON INDUSTRY: Our findings suggest that positive work engagement and work conditions contribute to enhanced safety climate and can reduce nurse injuries.

Investment in workforce health: exploring the implications for workforce safety climate and commitment.

PubMed

Mearns, Kathryn; Hope, Lorraine; Ford, Michael T; Tetrick, Lois E

2010-09-01

The relationship between investment in employee health and non-health outcomes has received little research attention. Drawing from social exchange and climate theory, the current study uses a multilevel approach to examine the implications of worksite health investment for worksite safety and health climate and employee safety compliance and commitment to the worksite. Data were collected from 1932 personnel working on 31 offshore installations operating in UK waters. Installation medics provided corporate workforce health investment details for 20 of these installations. The findings provide support for a strong link between health investment practices and worksite safety and health climate. The results also found a relationship between health investment practices and organizational commitment among employees. These results suggest that health investment practices are associated with committed workforces and climates that reflect a priority on health and safety. 2009 Elsevier Ltd. All rights reserved.

Comparing safety climate for nurses working in operating theatres, critical care and ward areas in the UK: a mixed methods study

PubMed Central

Tarling, Maggie; Jones, Anne; Murrells, Trevor; McCutcheon, Helen

2017-01-01

Objectives The main aim of the study was to explore the potential sources of variation and understand the meaning of safety climate for nursing practice in acute hospital settings in the UK. Design A sequential mixed methods design included a cross-sectional survey using the Safety Climate Questionnaire (SCQ) and thematic analysis of focus group discussions. Confirmatory factor analysis (CFA) was used to validate the factor structure of the SCQ. Factor scores were compared between nurses working in operating theatres, critical care and ward areas. Results from the survey and the thematic analysis were then compared and synthesised. Setting A London University. Participants 319 registered nurses working in acute hospital settings completed the SCQ and a further 23 nurses participated in focus groups. Results CFA indicated that there was a good model fit on some criteria (χ2=1683.699, df=824, p<0.001; χ2/df=2.04; root mean square error of approximation=0.058) but a less acceptable fit on comparative fit index which is 0.804. There was a statistically significant difference between clinical specialisms in management commitment (F (4,266)=4.66, p=0.001). Nurses working in operating theatres had lower scores compared with ward areas and they also reported negative perceptions about management in their focus group. There was significant variation in scores for communication across clinical specialism (F (4,266)=2.62, p=0.035) but none of the pairwise comparisons achieved statistical significance. Thematic analysis identified themes of human factors, clinical management and protecting patients. The system and the human side of caring was identified as a meta-theme. Conclusions The results suggest that the SCQ has some utility but requires further exploration. The findings indicate that safety in nursing practice is a complex interaction between safety systems and the social and interpersonal aspects of clinical practice. PMID:29084793

Safety in the c-suite: How chief executive officers influence organizational safety climate and employee injuries.

PubMed

Tucker, Sean; Ogunfowora, Babatunde; Ehr, Dayle

2016-09-01

According to social learning theory, powerful and high status individuals can significantly influence the behaviors of others. In this paper, we propose that chief executive officers (CEOs) indirectly impact frontline injuries through the collective social learning experiences and effort of different groups of organizational actors-including members of the top management team (TMT), organizational supervisors, and frontline employees. We found support for our collective social learning model using data from 2,714 frontline employees, 1,398 supervisors, and 229 members of TMTs in 54 organizations. TMT members' experiences within a CEO-driven TMT safety climate was positively related to organizational supervisors' reports of the broader organizational safety climate and their subsequent collective support for safety (reported by frontline employees). In turn, supervisory support for safety was associated with fewer employee injuries at the individual level. We discuss the theoretical and practical implications of these findings for workplace safety research and practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Worker health and safety and climate change in the Americas: issues and research needs.

PubMed

Kiefer, Max; Rodríguez-Guzmán, Julietta; Watson, Joanna; van Wendel de Joode, Berna; Mergler, Donna; da Silva, Agnes Soares

2016-09-01

SYNOPSIS This report summarizes and discusses current knowledge on the impact that climate change can have on occupational safety and health (OSH), with a particular focus on the Americas. Worker safety and health issues are presented on topics related to specific stressors (e.g., temperature extremes), climate associated impacts (e.g., ice melt in the Arctic), and a health condition associated with climate change (chronic kidney disease of non-traditional etiology). The article discusses research needs, including hazards, surveillance, and risk assessment activities to better characterize and understand how OSH may be associated with climate change events. Also discussed are the actions that OSH professionals can take to ensure worker health and safety in the face of climate change.

Climate Change and Food Safety: Beyond Production

NASA Astrophysics Data System (ADS)

Ziska, L. H.; Crimmins, A. R.

2016-12-01

There is merited interest in determining the extent of climate disruption on agricultural production and food security. However, additional aspects of food security, including food safety, nutrition and distribution have, overall, received less attention. Beginning in 2013, the U.S. Global Change Research Program as part of the ongoing National Climate Assessment, began a directed effort to evaluate the vulnerability of climate change to these under-represented aspects of food security for developed countries. Based on this extensive review of current science, several key findings were developed: (a) Climate change, including rising temperatures and changes in weather extremes, is expected to increase the exposure of food to certain pathogens and toxins; (b) Climate change will increase human exposure to chemical contaminants in food through several pathways; (c) The nutritional value of agriculturally important food crops, including cereals, will decrease in response to the ongoing increase in atmospheric carbon dioxide; (d) Increases in the frequency or intensity of extreme weather events associated with climate change may disrupt food distribution. These findings will be presented as a means to describe the state of the science and expand on food security research in the broader context of public health and climate change.

The perception of the patient safety climate by professionals of the emergency department.

PubMed

Rigobello, Mayara Carvalho Godinho; Carvalho, Rhanna Emanuela Fontenele Lima de; Guerreiro, Juliana Magalhães; Motta, Ana Paula Gobbo; Atila, Elizabeth; Gimenes, Fernanda Raphael Escobar

2017-07-01

The aim of this study was to assess the patient safety climate from the perspective of healthcare professionals working in the emergency department of a hospital in Brazil. Emergency departments are complex and dynamic environments. They are prone to adverse events that compromise the quality of care provided and reveal the importance of patient safety culture and climate. This was a quantitative, descriptive, cross-sectional study. The Safety Attitudes Questionnaire (SAQ) - Short Form 2006 was used for data collection, validated and adapted into Portuguese. The study sample consisted of 125 participants. Most of the participants were female (57.6%) and had worked in emergency department for more than 10years (56.8%). Sixty-two participants (49.6%) were nursing professionals. The participants demonstrated satisfaction with their jobs and dissatisfaction with the actions of management with regard to safety issues. Participants' perceptions about the patient safety climate were found to be negative. Knowledge of professionals' perceptions of patient safety climate in the context of emergency care helps with assessments of the safety culture, contributes to improvement of health care, reduces adverse events, and can focus efforts to improve the quality of care provided to patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neonatal Intensive Care Unit Safety Culture Varies Widely

PubMed Central

Profit, Jochen; Etchegaray, Jason; Petersen, Laura A; Sexton, J Bryan; Hysong, Sylvia J; Mei, Minghua; Thomas, Eric J

2013-01-01

background Variation in health care delivery and outcomes in NICUs may be partly explained by differences in safety culture. objective To describe NICU caregiver assessments of safety culture, explore the variability within and between NICUs on safety culture domains, and test for association with caregiver characteristics. methods We surveyed NICU caregivers in a convenience sample of 12 hospitals from a single health care system, using the Safety Attitudes Questionnaire (SAQ). The six scales of the SAQ include teamwork climate, safety climate, job satisfaction, stress recognition, perception of management, and working conditions. For each NICU we calculated scale means, standard deviations and percent positives (percent agreement). results We found substantial variation in safety culture domains among participating NICUs. A composite mean score across the six safety culture domains ranged from 56.3 to 77.8 on a 100-point scale and NICUs in the top four NICUs were significantly different from the bottom four (p < .001). Across the six domains, respondent assessments varied widely, but were least positive on perceptions of management (3–80% positive; mean 33.3%) and stress recognition (18–61% positive; mean 41.3%). Comparisons of SAQ scale scores between NICUs and a previously published cohort of adult ICUs generally revealed higher scores for NICUs. Physicians composite scores were 8.2 (p = .04) and 9.5 (p =.02) points higher than nurses and ancillary personnel. conclusion Significant variation and scope for improvement in safety culture exists among this sample of NICUs. The NICU variation was similar to variation in adult ICUs, but NICU scores were generally higher than adult ICU scores. Future studies should validate whether safety culture as measured with the SAQ correlates with clinical and operational outcomes in the NICU setting. PMID:21930691

Psychometric Support for an Abbreviated Version of the California School Climate and Safety Survey

ERIC Educational Resources Information Center

Rebelez, Jennica L.; Furlong, Michael J.

2013-01-01

The California School Climate and Safety Survey-Short Form (CSCSS-SF) was developed as a streamlined version (54 items) of the original CSCSS (102 items) for school safety teams to gather information regarding student perceptions of campus climate, safety, and experience of victimization. Using a longitudinal dataset, this study implemented…

Psychosocial safety climate moderates the job demand-resource interaction in predicting workgroup distress.

PubMed

Dollard, Maureen F; Tuckey, Michelle R; Dormann, Christian

2012-03-01

Psychosocial safety climate (PSC) arises from workplace policies, practices, and procedures for the protection of worker psychological health and safety that are largely driven by management. Many work stress theories are based on the fundamental interaction hypothesis - that a high level of job demands (D) will lead to psychological distress and that this relationship will be offset when there are high job resources (R). However we proposed that this interaction really depends on the organizational context; in particular high levels of psychosocial safety climate will enable the safe utilization of resources to reduce demands. The study sample consisted of police constables from 23 police units (stations) with longitudinal survey responses at two time points separated by 14 months (Time 1, N=319, Time 2, N=139). We used hierarchical linear modeling to assess the effect of the proposed three-way interaction term (PSC×D×R) on change in workgroup distress variance over time. Specifically we confirmed the interaction between emotional demands and emotional resources (assessed at the individual level), in the context of unit psychosocial safety climate (aggregated individual data). As predicted, high emotional resources moderated the positive relationship between emotional demands and change in workgroup distress but only when there were high levels of unit psychosocial safety climate. Results were confirmed using a split-sample analysis. Results support psychosocial safety climate as a property of the organization and a target for higher order controls for reducing work stress. The 'right' climate enables resources to do their job. Copyright © 2011 Elsevier Ltd. All rights reserved.

Use of a safety climate questionnaire in UK health care: factor structure, reliability and usability.

PubMed

Hutchinson, A; Cooper, K L; Dean, J E; McIntosh, A; Patterson, M; Stride, C B; Laurence, B E; Smith, C M

2006-10-01

To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care. Four acute hospital trusts and nine primary care trusts in England. The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then sent to 3650 staff within the 13 NHS trusts, seeking to achieve at least 600 responses as the basis for the factor analysis. 1307 questionnaires were returned (36% response). Factor analyses and reliability analyses were carried out on 897 responses from staff involved in direct patient care, to explore how consistently the questions measured the underlying constructs of safety climate and teamwork. Some questionnaire items related to multiple factors or did not relate strongly to any factor. Five items were discarded. Two teamwork factors were derived from the remaining 11 teamwork items and three safety climate factors were derived from the remaining 11 safety items. Internal consistency reliabilities were satisfactory to good (Cronbach's alpha > or =0.69 for all five factors). This is one of the few studies to undertake a detailed evaluation of a patient safety climate questionnaire in UK health care and possibly the first to do so in primary as well as secondary care. The results indicate that a 22 item version of this safety climate questionnaire is useable as a research instrument in both settings, but also demonstrates a more general need for thorough validation of safety climate questionnaires before widespread usage.

Worker health and safety and climate change in the Americas: issues and research needs

PubMed Central

Kiefer, Max; Rodríguez-Guzmán, Julietta; Watson, Joanna; van Wendel de Joode, Berna; Mergler, Donna; da Silva, Agnes Soares

2016-01-01

SYNOPSIS This report summarizes and discusses current knowledge on the impact that climate change can have on occupational safety and health (OSH), with a particular focus on the Americas. Worker safety and health issues are presented on topics related to specific stressors (e.g., temperature extremes), climate associated impacts (e.g., ice melt in the Arctic), and a health condition associated with climate change (chronic kidney disease of non-traditional etiology). The article discusses research needs, including hazards, surveillance, and risk assessment activities to better characterize and understand how OSH may be associated with climate change events. Also discussed are the actions that OSH professionals can take to ensure worker health and safety in the face of climate change. PMID:27991978

The development and psychometric evaluation of a safety climate measure for primary care.

PubMed

de Wet, C; Spence, W; Mash, R; Johnson, P; Bowie, P

2010-12-01

Building a safety culture is an important part of improving patient care. Measuring perceptions of safety climate among healthcare teams and organisations is a key element of this process. Existing measurement instruments are largely developed for secondary care settings in North America and many lack adequate psychometric testing. Our aim was to develop and test an instrument to measure perceptions of safety climate among primary care teams in National Health Service for Scotland. Questionnaire development was facilitated through a steering group, literature review, semistructured interviews with primary care team members, a modified Delphi and completion of a content validity index by experts. A cross-sectional postal survey utilising the questionnaire was undertaken in a random sample of west of Scotland general practices to facilitate psychometric evaluation. Statistical methods, including exploratory and confirmatory factor analysis, and Cronbach and Raykov reliability coefficients were conducted. Of the 667 primary care team members based in 49 general practices surveyed, 563 returned completed questionnaires (84.4%). Psychometric evaluation resulted in the development of a 30-item questionnaire with five safety climate factors: leadership, teamwork, communication, workload and safety systems. Retained items have strong factor loadings to only one factor. Reliability coefficients was satisfactory (α = 0.94 and ρ = 0.93). This study is the first stage in the development of an appropriately valid and reliable safety climate measure for primary care. Measuring safety climate perceptions has the potential to help primary care organisations and teams focus attention on safety-related issues and target improvement through educational interventions. Further research is required to explore acceptability and feasibility issues for primary care teams and the potential for organisational benchmarking.

External validity of a generic safety climate scale for lone workers across different industries and companies.

PubMed

Lee, Jin; Huang, Yueng-hsiang; Robertson, Michelle M; Murphy, Lauren A; Garabet, Angela; Chang, Wen-Ruey

2014-02-01

The goal of this study was to examine the external validity of a 12-item generic safety climate scale for lone workers in order to evaluate the appropriateness of generalized use of the scale in the measurement of safety climate across various lone work settings. External validity evidence was established by investigating the measurement equivalence (ME) across different industries and companies. Confirmatory factor analysis (CFA)-based and item response theory (IRT)-based perspectives were adopted to examine the ME of the generic safety climate scale for lone workers across 11 companies from the trucking, electrical utility, and cable television industries. Fairly strong evidence of ME was observed for both organization- and group-level generic safety climate sub-scales. Although significant invariance was observed in the item intercepts across the different lone work settings, absolute model fit indices remained satisfactory in the most robust step of CFA-based ME testing. IRT-based ME testing identified only one differentially functioning item from the organization-level generic safety climate sub-scale, but its impact was minimal and strong ME was supported. The generic safety climate scale for lone workers reported good external validity and supported the presence of a common feature of safety climate among lone workers. The scale can be used as an effective safety evaluation tool in various lone work situations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Patient safety in surgical environments: cross-countries comparison of psychometric properties and results of the Norwegian version of the Hospital Survey on Patient Safety.

PubMed

Haugen, Arvid S; Søfteland, Eirik; Eide, Geir E; Nortvedt, Monica W; Aase, Karina; Harthug, Stig

2010-09-22

How hospital health care personnel perceive safety climate has been assessed in several countries by using the Hospital Survey on Patient Safety (HSOPS). Few studies have examined safety climate factors in surgical departments per se. This study examined the psychometric properties of a Norwegian translation of the HSOPS and also compared safety climate factors from a surgical setting to hospitals in the United States, the Netherlands and Norway. This survey included 575 surgical personnel in Haukeland University Hospital in Bergen, an 1100-bed tertiary hospital in western Norway: surgeons, operating theatre nurses, anaesthesiologists, nurse anaesthetists and ancillary personnel. Of these, 358 returned the HSOPS, resulting in a 62% response rate. We used factor analysis to examine the applicability of the HSOPS factor structure in operating theatre settings. We also performed psychometric analysis for internal consistency and construct validity. In addition, we compared the percent of average positive responds of the patient safety climate factors with results of the US HSOPS 2010 comparative data base report. The professions differed in their perception of patient safety climate, with anaesthesia personnel having the highest mean scores. Factor analysis using the original 12-factor model of the HSOPS resulted in low reliability scores (r = 0.6) for two factors: "adequate staffing" and "organizational learning and continuous improvement". For the remaining factors, reliability was ≥ 0.7. Reliability scores improved to r = 0.8 by combining the factors "organizational learning and continuous improvement" and "feedback and communication about error" into one six-item factor, supporting an 11-factor model. The inter-item correlations were found satisfactory. The psychometric properties of the questionnaire need further investigations to be regarded as reliable in surgical environments. The operating theatre personnel perceived their hospital's patient safety climate

Beyond safety outcomes: An investigation of the impact of safety climate on job satisfaction, employee engagement and turnover using social exchange theory as the theoretical framework.

PubMed

Huang, Yueng-Hsiang; Lee, Jin; McFadden, Anna C; Murphy, Lauren A; Robertson, Michelle M; Cheung, Janelle H; Zohar, Dov

2016-07-01

Safety climate, a measure of the degree to which safety is perceived by employees to be a priority in their company, is often implicated as a key factor in the promotion of injury-reducing behavior and safe work environments. Using social exchange theory as a theoretical basis, this study hypothesized that safety climate would be related to employees' job satisfaction, engagement, and turnover rate, highlighting the beneficial effects of safety climate beyond typical safety outcomes. Survey data were collected from 6207 truck drivers from two U.S. trucking companies. The objective turnover rate was collected one year after the survey data collection. Results showed that employees' safety climate perceptions were linked to employees' level of job satisfaction, engagement, and objective turnover rate, thus supporting the application of social exchange theory. Job satisfaction was also a significant mediator between safety climate and the two human resource outcomes (i.e., employee engagement and turnover rate). This study is among the first to assess the impact of safety climate beyond safety outcomes among lone workers (using truck drivers as an exemplar). Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Thrill and adventure seeking in risky driving at work: The moderating role of safety climate.

PubMed

Wishart, Darren; Somoray, Klaire; Evenhuis, Amanda

2017-12-01

Introduction Within many industrialized countries, the leading cause of worker fatalities and serious injuries can be attributed to road trauma. In non-occupational research, high levels of sensation seeking personality, and specifically thrill and adventure seeking, have been associated with risky driving behaviors. In work driving literature, high organizational safety climate has been associated with reduced risky driving in work drivers. However, the extent that factors such as safety climate and thrill seeking interact in regard to work driving safety remains unclear, and the current research examined this interaction. Methods A total of 1,011 work drivers from four organizations participated in the research. Surveys were distributed online and hardcopies were sent via mail. The survey included measures of thrill and adventure seeking, safety climate and work-related driving behaviors, as well as questions relating to participant demographics and information about their work driving. Results The results demonstrated that safety climate significantly moderated the effect of thrill and adventure seeking trait on driving errors, driving violations, and driving while fatigued. Conclusion These results suggest that the development of a strong safety climate has the potential to improve work driving safety outcomes by reducing the impact of particular personality traits such as thrill seeking within an organizational context. Practical application To improve work driving safety, organizations and management need to develop strategies to encourage and foster positive work driving safety climate, particularly within work settings that may attract thrill and adventure seeking employees. Copyright © 2017. Published by Elsevier Ltd.

Safety culture perceptions of pharmacists in Malaysian hospitals and health clinics: a multicentre assessment using the Safety Attitudes Questionnaire

PubMed Central

Samsuri, Srima Elina; Pei Lin, Lua; Fahrni, Mathumalar Loganathan

2015-01-01

Objective To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors. Design A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ). Setting 3 public hospitals and 27 health clinics. Participants 117 pharmacists. Main outcome measure(s) Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation. Results Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (p<0.05) and higher scores (overall score as well as score for each domain except for stress recognition) correlated negatively with reported number of medication errors. Conversely, those working in hospital (versus health clinic) were 8.9 times more likely (p<0.01) to report a medication error (OR 8.9, CI 3.08 to 25.7). As stress recognition increased, the number of medication errors reported increased (p=0.023). Years of work experience (p=0.017) influenced the number of medication errors reported. For every additional year of work experience, pharmacists were 0.87 times less likely to report a medication error (OR 0.87, CI 0.78 to 0.98). Conclusions A minority (20.5%) of the pharmacists working in hospitals and health clinics was in agreement with the overall SAQ questions and scales. Pharmacists in outpatient and ambulatory units and those in health clinics had better perceptions of safety

Poor safety climate, long work hours, and musculoskeletal discomfort among Latino horse farm workers.

PubMed

Swanberg, Jennifer; Clouser, Jessica Miller; Gan, Wenqi; Flunker, John C; Westneat, Susan; Browning, Steven R

2017-09-03

This study investigated the prevalence of self-reported musculoskeletal discomfort (MSD) and work-related factors associated with elevated MSD among Latino thoroughbred farm workers. Participants (N = 225) were recruited using a community-based purposive sampling approach to participate in in-person interviews. Of these workers, 85% experienced MSD. MSD was divided into tertiles; the upper tertile was defined as elevated. Multivariable Poisson regression revealed associations between any elevated MSD and longer tenure on horse farms, longer work hours, and poor safety climate. Elevated neck/back MSD was associated with longer tenure, longer work hours, and poor safety climate. Elevated upper extremity MSD was associated with age and poor safety climate. Elevated lower extremity MSD was associated with longer tenure, longer work hours, and being female. Musculoskeletal discomfort is common among these workers. Improving safety climate and minimizing long work hours is recommended.

Multilevel models in the explanation of the relationship between safety climate and safe behavior.

PubMed

Cheyne, Alistair; Tomás, José M; Oliver, Amparo

2013-01-01

This study examines the relationships between components of organizational safety climate, including employee attitudes to organizational safety issues; perceptions of the physical working environment, and evaluations of worker engagement with safety issues; and relates these to self-reported levels of safety behavior. It attempts to explore the relationships between these variables in 1189 workers across 78 work groups in a large transportation organization. Evaluations of safety climate, the working environment and worker engagement, as well as safe behaviors, were collected using a self report questionnaire. The multilevel analysis showed that both levels of evaluation (the work group and the individual), and some cross-level interactions, were significant in explaining safe behaviors. Analyses revealed that a number of variables, at both levels, were associated with worker engagement and safe behaviors. The results suggest that, while individual evaluations of safety issues are important, there is also a role for the fostering of collective safety climates in encouraging safe behaviors and therefore reducing accidents.

School Climate: An Essential Component of a Comprehensive School Safety Plan

ERIC Educational Resources Information Center

Stark, Heidi

2017-01-01

The intentional assessment and management of school climate is an essential component of a comprehensive school safety plan. The value of this preventive aspect of school safety is often diminished as schools invest resources in physical security measures as a narrowly focused effort to increase school safety (Addington, 2009). This dissertation…

Measurement of worker perceptions of trust and safety climate in managers and supervisors at commercial grain elevators.

PubMed

Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

2013-04-01

The safety climate of an agricultural workplace may be affected by several things, including the level of trust that workers have in their work group supervisor and organizational management. Safety climate has been used by previous safety researchers as a measure of worker perceptions of the relative importance of safety as compared with other operational goals. Trust has been linked to several positive safety outcomes, particularly in hazardous work environments, but has not been examined relative to safety climate in the perennially hazardous work environment of a commercial grain elevator. In this study, 177 workers at three Midwest grain elevator companies completed online surveys measuring their perceptions of trust and safety at two administrative levels: organizational management and work group supervisors. Positive and significant relationships were noted between trust and safety climate perceptions for organizational managers and for work group supervisors. Results from this research suggest that worker trust in organizational management and work group supervisors has a positive influence on the employees' perceptions of safety climate at the organizational and work group levels in an agricultural workplace.

Climate change and safety at work with ionizing radiations.

PubMed

Contessa, Gian Marco; Grandi, Carlo; Scognamiglio, Mario; Genovese, Elisabetta; Sandri, Sandro

2016-01-01

The accident at Tokyo Electric Power Company's (TEPCO's) Fukushima Daiichi nuclear power plant (NPP) has been one of the dominant topic in nuclear safety and it has brought new attention on the matter of accidents in NPPs due to external events related to natural causes. Climate change has risen new risks and the growing probability of extreme external events has increased exposure and vulnerability of workers in the nuclear sector. However extreme natural events are a threat not only to NPPs but to all facilities dealing with radioactive material and in an emergency scenario they can affect the effectiveness and implementation of safety devices and procedures and also prevent communications, causing delays in the readiness of response. It is clear that adaptation strategies are necessary to cope with emerging changes in climate and a new nuclear safety culture is growing, that addresses accidents initiated not only by internal but also by external events.

The S.A.C.S. (Satisfaction-Anatomy-Continence-Safety) score for evaluating pelvic organ prolapse surgery: a proposal for an outcome-based scoring system.

PubMed

Mearini, Luigi; Zucchi, Alessandro; Nunzi, Elisabetta; Di Biase, Manuel; Bini, Vittorio; Costantini, Elisabetta

2015-07-01

To date, there is no overall consensus on the definition of cure after surgery for pelvic organ prolapse (POP). The aim of the study was to design and test the scoring system S.A.C.S. (Satisfaction-Anatomy-Continence-Safety) to assess and compare the outcomes of POP repair. A total of 233 women underwent open sacrocolpopexy. The S.A.C.S. outcome scoring system was scheduled at 24 months of follow-up, and each component was detected according to: Satisfaction by mean of Patient Global Improvement Inventory scale, Anatomy by mean of POP Quantification system and bulge symptom, Continence by mean of pad use, and Safety by mean of the Clavien-Dindo classification of surgical complications. Each component produced a binary nominal categorical variable (1 or 0), with a total score of 4 representing cure. As a comparative tool, patients answered a simple yes/no question: "If you had to undergo surgery all over again, would you still do it?". The degree of concordance was estimated using Cohen's Kappa test. According to the S.A.C.S. scoring system, only 160 patients (68.6 %) reached the maximum score of cure. Sensitivity of the S.A.C.S. score was 74.1 %, specificity was 90 %, total diagnostic capacity was 75.5 %. The S.A.C.S. score internal consistency was good; the k-coefficient was higher for the satisfaction component of the score (k = 0.560). This study proposes an original, simple post-operative scoring system integrating satisfaction, anatomy, continence, and safety reports for patients undergoing surgery for POP, providing a complete, although perfectible, method to accurately report outcomes in all clinical scenarios.

Heteronormativity, School Climates, and Perceived Safety for Gender Nonconforming Peers

ERIC Educational Resources Information Center

Toomey, Russell B.; McGuire, Jenifer K.; Russell, Stephen T.

2012-01-01

Students' perceptions of their school climates are associated with psychosocial and academic adjustment. The present study examined the role of school strategies to promote safety in predicting students' perceptions of safety for gender nonconforming peers among 1415 students in 28 high schools. Using multilevel modeling techniques, we examined…

Measurement equivalence of patient safety climate in Chinese hospitals: can we compare across physicians and nurses?

PubMed

Zhu, Junya

2018-06-11

Self-report instruments have been widely used to better understand variations in patient safety climate between physicians and nurses. Research is needed to determine whether differences in patient safety climate reflect true differences in the underlying concepts. This is known as measurement equivalence, which is a prerequisite for meaningful group comparisons. This study aims to examine the degree of measurement equivalence of the responses to a patient safety climate survey of Chinese hospitals and to demonstrate how the measurement equivalence method can be applied to self-report climate surveys for patient safety research. Using data from the Chinese Hospital Survey of Patient Safety Climate from six Chinese hospitals in 2011, we constructed two groups: physicians and nurses (346 per group). We used multiple-group confirmatory factor analyses to examine progressively more stringent restrictions for measurement equivalence. We identified weak factorial equivalence across the two groups. Strong factorial equivalence was found for Organizational Learning, Unit Management Support for Safety, Adequacy of Safety Arrangements, Institutional Commitment to Safety, Error Reporting and Teamwork. Strong factorial equivalence, however, was not found for Safety System, Communication and Peer Support and Staffing. Nevertheless, further analyses suggested that nonequivalence did not meaningfully affect the conclusions regarding physician-nurse differences in patient safety climate. Our results provide evidence of at least partial equivalence of the survey responses between nurses and physicians, supporting mean comparisons of its constructs between the two groups. The measurement equivalence approach is essential to ensure that conclusions about group differences are valid.

Should Weights and Risk Categories Be Used for Inspection Scores To Evaluate Food Safety in Restaurants?

PubMed

da Cunha, Diogo Thimoteo; de Rosso, Veridiana Vera; Stedefeldt, Elke

2016-03-01

The objective of this study was to verify the characteristics of food safety inspections, considering risk categories and binary scores. A cross-sectional study was performed with 439 restaurants in 43 Brazilian cities. A food safety checklist with 177 items was applied to the food service establishments. These items were classified into four groups (R1 to R4) according to the main factors that can cause outbreaks involving food: R1, time and temperature aspects; R2, direct contamination; R3, water conditions and raw material; and R4, indirect contamination (i.e., structures and buildings). A score adjusted for 100 was calculated for the overall violation score and the violation score for each risk category. The average violation score (standard deviation) was 18.9% (16.0), with an amplitude of 0.0 to 76.7%. Restaurants with a low overall violation score (approximately 20%) presented a high number of violations from the R1 and R2 groups, representing the most risky violations. Practical solutions to minimize this evaluation bias were discussed. Food safety evaluation should use weighted scores and be risk-based. However, some precautions must be taken by researchers, health inspectors, and health surveillance departments to develop an adequate and reliable instrument.

You can't improve what you don't measure: Safety climate measures available in the German-speaking countries to support safety culture development in healthcare.

PubMed

Manser, Tanja; Brösterhaus, Mareen; Hammer, Antje

2016-01-01

Safety climate measurement is a key input into safety culture development. The aim of this review is to provide an overview of the safety climate measures that have been evaluated for their psychometric properties in a German-speaking country and to make recommendations on how to use them in quality and patient safety improvement. A systematic search strategy was implemented to obtain relevant articles. PubMed and Web of Science databases were searched, and 128 abstracts were identified. After application of limits, 33 full texts were retrieved for subsequent evaluation. Studies were included on the basis of predetermined inclusion criteria and independent assessment by two reviewers. Publications were reviewed concerning healthcare setting, target group, safety culture dimensions covered and results of their psychometric evaluation. This review identified 11 instruments for safety climate assessment in different healthcare settings (i. e. hospitals, nursing homes, primary care, dental care and community pharmacy) for which acceptable to good internal consistency was reported. We observed wide variability concerning the number of dimensions (1 to 14; in some cases including outcome dimensions) and items (9 to 128) that the instruments were comprised of. Nevertheless, consistency with regard to the thematic areas covered was rather high. While there is clear evidence that we can assess safety climate in healthcare, the application of safety climate measures by quality and patient safety practitioners has so far been rather limited. This review bridges this gap between research and improvement practice by highlighting the central role of safety climate assessment in a mixed methods approach to inform safety culture development. Copyright © 2016. Published by Elsevier GmbH.

Advancing the framework for considering the effects of climate change on worker safety and health.

PubMed

Schulte, P A; Bhattacharya, A; Butler, C R; Chun, H K; Jacklitsch, B; Jacobs, T; Kiefer, M; Lincoln, J; Pendergrass, S; Shire, J; Watson, J; Wagner, G R

2016-11-01

In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988-2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008-2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers.

Advancing the framework for considering the effects of climate change on worker safety and health

PubMed Central

Schulte, P.A.; Bhattacharya, A.; Butler, C.R.; Chun, H.K.; Jacklitsch, B.; Jacobs, T.; Kiefer, M.; Lincoln, J.; Pendergrass, S.; Shire, J.; Watson, J.; Wagner, G.R.

2016-01-01

ABSTRACT In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988–2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008–2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers. PMID:27115294

Workforce perceptions of hospital safety culture: development and validation of the patient safety climate in healthcare organizations survey.

PubMed

Singer, Sara; Meterko, Mark; Baker, Laurence; Gaba, David; Falwell, Alyson; Rosen, Amy

2007-10-01

To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's alpha coefficients ranged from 0.50 to 0.89. It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes.

Safety culture perceptions of pharmacists in Malaysian hospitals and health clinics: a multicentre assessment using the Safety Attitudes Questionnaire.

PubMed

Samsuri, Srima Elina; Pei Lin, Lua; Fahrni, Mathumalar Loganathan

2015-11-26

To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors. A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ). 3 public hospitals and 27 health clinics. 117 pharmacists. Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation. Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (p<0.05) and higher scores (overall score as well as score for each domain except for stress recognition) correlated negatively with reported number of medication errors. Conversely, those working in hospital (versus health clinic) were 8.9 times more likely (p<0.01) to report a medication error (OR 8.9, CI 3.08 to 25.7). As stress recognition increased, the number of medication errors reported increased (p=0.023). Years of work experience (p=0.017) influenced the number of medication errors reported. For every additional year of work experience, pharmacists were 0.87 times less likely to report a medication error (OR 0.87, CI 0.78 to 0.98). A minority (20.5%) of the pharmacists working in hospitals and health clinics was in agreement with the overall SAQ questions and scales. Pharmacists in outpatient and ambulatory units and those in health clinics had better perceptions of safety culture. As perceptions improved, the number of medication errors reported

Validation of the Dutch language version of the Safety Attitudes Questionnaire (SAQ-NL).

PubMed

Haerkens, Marck Htm; van Leeuwen, Wouter; Sexton, J Bryan; Pickkers, Peter; van der Hoeven, Johannes G

2016-08-15

As the first objective of caring for patients is to do no harm, patient safety is a priority in delivering clinical care. An essential component of safe care in a clinical department is its safety climate. Safety climate correlates with safety-specific behaviour, injury rates, and accidents. Safety climate in healthcare can be assessed by the Safety Attitudes Questionnaire (SAQ), which provides insight by scoring six dimensions: Teamwork Climate, Job Satisfaction, Safety Climate, Stress Recognition, Working Conditions and Perceptions of Management. The objective of this study was to assess the psychometric properties of the Dutch language version of the SAQ in a variety of clinical departments in Dutch hospitals. The Dutch version (SAQ-NL) of the SAQ was back translated, and analyzed for semantic characteristics and content. From October 2010 to November 2015 SAQ-NL surveys were carried out in 17 departments in two university and seven large non-university teaching hospitals in the Netherlands, prior to a Crew Resource Management human factors intervention. Statistical analyses were used to examine response patterns, mean scores, correlations, internal consistency reliability and model fit. Cronbach's α's and inter-item correlations were calculated to examine internal consistency reliability. One thousand three hundred fourteen completed questionnaires were returned from 2113 administered to health care workers, resulting in a response rate of 62 %. Confirmatory Factor Analysis revealed the 6-factor structure fit the data adequately. Response patterns were similar for professional positions, departments, physicians and nurses, and university and non-university teaching hospitals. The SAQ-NL showed strong internal consistency (α = .87). Exploratory analysis revealed differences in scores on the SAQ dimensions when comparing different professional positions, when comparing physicians to nurses and when comparing university to non-university hospitals. The SAQ

Weather and Climate Impacts on Commercial Motor Vehicle Safety

DOT National Transportation Integrated Search

2011-04-01

The Federal Motor Carrier Safety Administration (FMCSA) has an interest in how adverse weather may influence trucking industry practices, and what climate change might mean for future FMCSA efforts to reduce weather-related crashes. Weather condition...

The safety climate in primary care (SAP-C) study: study protocol for a randomised controlled feasibility study.

PubMed

Lydon, Sinéad; Cupples, Margaret E; Hart, Nigel; Murphy, Andrew W; Faherty, Aileen; O'Connor, Paul

2016-01-01

Research on patient safety has focused largely on secondary care settings, and there is a dearth of knowledge relating to safety culture or climate, and safety climate improvement strategies, in the context of primary care. This is problematic given the high rates of usage of primary care services and the myriad of opportunities for clinical errors daily. The current research programme aimed to assess the effectiveness of an intervention derived from the Scottish Patient Safety Programme in Primary Care. The intervention consists of safety climate measurement and feedback and patient chart audit using the trigger review method. The purpose of this paper is to describe the background to this research and to present the methodology of this feasibility study in preparation for a future definitive RCT. The SAP-C study is a feasibility study employing a randomised controlled pretest-posttest design that will be conducted in 10 general practices in the Republic of Ireland and Northern Ireland. Five practices will receive the safety climate intervention over a 9-month period. The five practices in the control group will continue care as usual but will complete the GP-SafeQuest safety climate questionnaire at baseline (month 1) and at the terminus of the intervention (month 9). The outcomes of the study include process evaluation metrics (i.e. rates of participant recruitment and retention, rates of completion of safety climate measures, qualitative data regarding participants' perceptions of the intervention's potential efficacy, acceptability, and sustainability), patient safety culture in intervention and control group practices at posttest, and instances of undetected patient harm identified through patient chart audit using the trigger review method. The planned study investigates an intervention to improve safety climate in Irish primary care settings. The resulting data may inform our knowledge of the frequency of undetected patient safety incidents in primary care

Differences in Hospital Managers’, Unit Managers’, and Health Care Workers’ Perceptions of the Safety Climate for Respiratory Protection

PubMed Central

Peterson, Kristina; Rogers, Bonnie M. E.; Brosseau, Lisa M.; Payne, Julianne; Cooney, Jennifer; Joe, Lauren; Novak, Debra

2017-01-01

This article compares hospital managers’ (HM), unit managers’ (UM), and health care workers’ (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers’ safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management’s supervision of HCWs’ respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs’ inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices. PMID:27056750

Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection.

PubMed

Peterson, Kristina; Rogers, Bonnie M E; Brosseau, Lisa M; Payne, Julianne; Cooney, Jennifer; Joe, Lauren; Novak, Debra

2016-07-01

This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices. © 2016 The Author(s).

Workforce Perceptions of Hospital Safety Culture: Development and Validation of the Patient Safety Climate in Healthcare Organizations Survey

PubMed Central

Singer, Sara; Meterko, Mark; Baker, Laurence; Gaba, David; Falwell, Alyson; Rosen, Amy

2007-01-01

Objective To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. Data Sources/Study Setting Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. Study Design Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. Data Collection We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). Principal Findings We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's α coefficients ranged from 0.50 to 0.89. Conclusions It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes. PMID:17850530

Emergency Preparedness Safety Climate and Other Factors Associated With Mental Health Outcomes Among World Trade Center Disaster Evacuees.

PubMed

Sherman, Martin F; Gershon, Robyn R; Riley, Halley E M; Zhi, Qi; Magda, Lori A; Peyrot, Mark

2017-06-01

We examined psychological outcomes in a sample of participants who evacuated from the World Trade Center towers on September 11, 2011. This study aimed to identify risk factors for psychological injury that might be amenable to change, thereby reducing adverse impacts associated with emergency high-rise evacuation. We used data from a cross-sectional survey conducted 2 years after the attacks to classify 789 evacuees into 3 self-reported psychological outcome categories: long-term psychological disorder diagnosed by a physician, short-term psychological disorder and/or memory problems, and no known psychological disorder. After nonmodifiable risk factors were controlled for, diagnosed psychological disorder was more likely for evacuees who reported lower "emergency preparedness safety climate" scores, more evacuation challenges (during exit from the towers), and evacuation-related physical injuries. Other variables associated with increased risk of psychological disorder outcome included gender (female), lower levels of education, preexisting physical disability, preexisting psychological disorder, greater distance to final exit, and more information sources during egress. Improving the "emergency preparedness safety climate" of high-rise business occupancies and reducing the number of egress challenges are potential strategies for reducing the risk of adverse psychological outcomes of high-rise evacuations. Focused safety training for individuals with physical disabilities is also warranted. (Disaster Med Public Health Preparedness. 2017;11:326-336).

Climate change and wildland firefighter health and safety.

PubMed

Withen, Patrick

2015-02-01

The author examines how climate change is impacting wildland firefighters. Climate change has made wildland fires more frequent and more intense. The increase in frequency and intensity of fires has pushed the number of fatalities and injuries higher in recent decades. The most common hazards on fires follow the trend of fire in general in that these hazards become more frequent and intense. Burnovers, heat exhaustion, tree hazards, and many other common fire hazards are more likely. The fire suppression agencies are making every effort to improve health and safety on fires by improving communication, weather forecasting, mapping, fire shelters, decision making and more. Despite these efforts, wildfires are becoming ever more hazardous because of climate change and the increasing frequency and intensity of wildfires. © 2015 SAGE Publications.

Exploring the possibility of a common structural model measuring associations between safety climate factors and safety behaviour in health care and the petroleum sectors.

PubMed

Olsen, Espen

2010-09-01

The aim of the present study was to explore the possibility of identifying general safety climate concepts in health care and petroleum sectors, as well as develop and test the possibility of a common cross-industrial structural model. Self-completion questionnaire surveys were administered in two organisations and sectors: (1) a large regional hospital in Norway that offers a wide range of hospital services, and (2) a large petroleum company that produces oil and gas worldwide. In total, 1919 and 1806 questionnaires were returned from the hospital and petroleum organisation, with response rates of 55 percent and 52 percent, respectively. Using a split sample procedure principal factor analysis and confirmatory factor analysis revealed six identical cross-industrial measurement concepts in independent samples-five measures of safety climate and one of safety behaviour. The factors' psychometric properties were explored with satisfactory internal consistency and concept validity. Thus, a common cross-industrial structural model was developed and tested using structural equation modelling (SEM). SEM revealed that a cross-industrial structural model could be identified among health care workers and offshore workers in the North Sea. The most significant contributing variables in the model testing stemmed from organisational management support for safety and supervisor/manager expectations and actions promoting safety. These variables indirectly enhanced safety behaviour (stop working in dangerous situations) through transitions and teamwork across units, and teamwork within units as well as learning, feedback, and improvement. Two new safety climate instruments were validated as part of the study: (1) Short Safety Climate Survey (SSCS) and (2) Hospital Survey on Patient Safety Culture-short (HSOPSC-short). Based on development of measurements and structural model assessment, this study supports the possibility of a common safety climate structural model across health

Psychosocial safety climate, emotional exhaustion, and work injuries in healthcare workplaces.

PubMed

Zadow, Amy Jane; Dollard, Maureen Frances; Mclinton, Sarven Savia; Lawrence, Peter; Tuckey, Michelle Rae

2017-12-01

Preventing work injuries requires a clear understanding of how they occur, how they are recorded, and the accuracy of injury surveillance. Our innovation was to examine how psychosocial safety climate (PSC) influences the development of reported and unreported physical and psychological workplace injuries beyond (physical) safety climate, via the erosion of psychological health (emotional exhaustion). Self-report data (T2, 2013) from 214 hospital employees (18 teams) were linked at the team level to the hospital workplace injury register (T1, 2012; T2, 2013; and T3, 2014). Concordance between survey-reported and registered injury rates was low (36%), indicating that many injuries go unreported. Safety climate was the strongest predictor of T2 registered injury rates (controlling for T1); PSC and emotional exhaustion also played a role. Emotional exhaustion was the strongest predictor of survey-reported total injuries and underreporting. Multilevel analysis showed that low PSC, emanating from senior managers and transmitted through teams, was the origin of psychological health erosion (i.e., low emotional exhaustion), which culminated in greater self-reported work injuries and injury underreporting (both physical and psychological). These results underscore the need to consider, in theory and practice, a dual physical-psychosocial safety explanation of injury events and a psychosocial explanation of injury underreporting. Copyright © 2017 John Wiley & Sons, Ltd.

Assessing safety climate in acute hospital settings: a systematic review of the adequacy of the psychometric properties of survey measurement tools.

PubMed

Alsalem, Gheed; Bowie, Paul; Morrison, Jillian

2018-05-10

The perceived importance of safety culture in improving patient safety and its impact on patient outcomes has led to a growing interest in the assessment of safety climate in healthcare organizations; however, the rigour with which safety climate tools were developed and psychometrically tested was shown to be variable. This paper aims to identify and review questionnaire studies designed to measure safety climate in acute hospital settings, in order to assess the adequacy of reported psychometric properties of identified tools. A systematic review of published empirical literature was undertaken to examine sample characteristics and instrument details including safety climate dimensions, origin and theoretical basis, and extent of psychometric evaluation (content validity, criterion validity, construct validity and internal reliability). Five questionnaire tools, designed for general evaluation of safety climate in acute hospital settings, were included. Detailed inspection revealed ambiguity around concepts of safety culture and climate, safety climate dimensions and the methodological rigour associated with the design of these measures. Standard reporting of the psychometric properties of developed questionnaires was variable, although evidence of an improving trend in the quality of the reported psychometric properties of studies was noted. Evidence of the theoretical underpinnings of climate tools was limited, while a lack of clarity in the relationship between safety culture and patient outcome measures still exists. Evidence of the adequacy of the psychometric development of safety climate questionnaire tools is still limited. Research is necessary to resolve the controversies in the definitions and dimensions of safety culture and climate in healthcare and identify related inconsistencies. More importance should be given to the appropriate validation of safety climate questionnaires before extending their usage in healthcare contexts different from those in

Development of a multilevel health and safety climate survey tool within a mining setting.

PubMed

Parker, Anthony W; Tones, Megan J; Ritchie, Gabrielle E

2017-09-01

This study aimed to design, implement and evaluate the reliability and validity of a multifactorial and multilevel health and safety climate survey (HSCS) tool with utility in the Australian mining setting. An 84-item questionnaire was developed and pilot tested on a sample of 302 Australian miners across two open cut sites. A 67-item, 10 factor solution was obtained via exploratory factor analysis (EFA) representing prioritization and attitudes to health and safety across multiple domains and organizational levels. Each factor demonstrated a high level of internal reliability, and a series of ANOVAs determined a high level of consistency in responses across the workforce, and generally irrespective of age, experience or job category. Participants tended to hold favorable views of occupational health and safety (OH&S) climate at the management, supervisor, workgroup and individual level. The survey tool demonstrated reliability and validity for use within an open cut Australian mining setting and supports a multilevel, industry specific approach to OH&S climate. Findings suggested a need for mining companies to maintain high OH&S standards to minimize risks to employee health and safety. Future research is required to determine the ability of this measure to predict OH&S outcomes and its utility within other mine settings. As this tool integrates health and safety, it may have benefits for assessment, monitoring and evaluation in the industry, and improving the understanding of how health and safety climate interact at multiple levels to influence OH&S outcomes. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Patient Safety Culture in Slovenian out-of-hours Primary Care Clinics.

PubMed

Klemenc-Ketiš, Zalika; Deilkås, Ellen Tveter; Hofoss, Dag; Bondevik, Gunnar Tschudi

2017-10-01

Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC) clinics, and determine the possible factors that might be associated with it. This was a cross-sectional study, which took place in Slovenian OOHC, as part of the international study entitled Patient Safety Culture in European Out-of-Hours Services (SAFE-EUR-OOH). All the OOHC clinics in Slovenia (N=60) were invited to participate, and 37 agreed to do so; 438 employees from these clinics were invited to participate. We used the Slovenian version of the Safety Attitudes Questionnaire - an ambulatory version (SAQAV) to measure the climate of safety. Out of 438 invited participants, 250 answered the questionnaire (57.1% response rate). The mean overall score ± standard deviation of the SAQ was 56.6±16.0 points, of Perceptions of Management 53.6±19.6 points, of Job Satisfaction 48.5±18.3 points, of Safety Climate 59.1±22.1 points, of Teamwork Climate 72.7±16.6, and of Communication 51.5±23.4 points. Employees working in the Ravne na Koroškem region, employees with variable work shifts, and those with full-time jobs scored significantly higher on the SAQ-AV. The safety culture in Slovenian OOHC clinics needs improvement. The variations in the safety culture factor scores in Slovenian OOHC clinics point to the need to eliminate variations and improve working conditions in Slovenian OOHC clinics.

Underlying influence of perception of management leadership on patient safety climate in healthcare organizations - A mediation analysis approach.

PubMed

Weng, Shao-Jen; Kim, Seung-Hwan; Wu, Chieh-Liang

2017-02-01

We aim to draw insights on how medical staff's perception of management leadership affects safety climate with key safety related dimensions-teamwork climate, job satisfaction and working conditions. A cross-sectional survey using Safety Attitude Questionnaire (SAQ) was performed in a medical center in Taichung City, Taiwan. The relationships among the dimensions in SAQ were then analyzed by structural equation modeling with a mediation analysis. 2205 physicians and nurses of the medical center participated in the survey. Because not all questions in the survey are suitable for entire hospital staff, only the valid responses (n = 1596, response rate of 72%) were extracted for analysis. Key measures are the direct and indirect effects of teamwork climate, job satisfaction, perception of management leadership, and working conditions on safety climate. Outcomes show that effect of perception of management leadership on safety climate is significant (standardized indirect effect of 0.892 with P-value 0.002) and fully mediated by other dimensions, where 66.9% is mediated through teamwork climate, 24.1% through working conditions and 9.0% through job satisfaction. Our findings point to the importance of management leadership and the mechanism of its influence on safety climate. To improve safety climate, the implication is that commitment by management on leading safety improvement needs to be demonstrated when it implements daily supportive actions for other safety dimensions. For future improvement, development of a management system that can facilitate two-way trust between management and staff over the long term is recommended. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Validation of a pre-existing safety climate scale for the Turkish furniture manufacturing industry.

PubMed

Akyuz, Kadri Cemil; Yildirim, Ibrahim; Gungor, Celal

2018-03-22

Understanding the safety climate level is essential to implement a proactive safety program. The objective of this study is to explore the possibility of having a safety climate scale for the Turkish furniture manufacturing industry since there has not been any scale available. The questionnaire recruited 783 subjects. Confirmatory factor analysis (CFA) tested a pre-existing safety scale's fit to the industry. The CFA indicated that the structures of the model present a non-satisfactory fit with the data (χ 2  = 2033.4, df = 314, p ≤ 0.001; root mean square error of approximation = 0.08, normed fit index = 0.65, Tucker-Lewis index = 0.65, comparative fit index = 0.69, parsimony goodness-of-fit index = 0.68). The results suggest that a new scale should be developed and validated to measure the safety climate level in the Turkish furniture manufacturing industry. Due to the hierarchical structure of organizations, future studies should consider a multilevel approach in their exploratory factor analyses while developing a new scale.

Safety Climate and Occupational Stress According to Occupational Accidents Experience and Employment Type in Shipbuilding Industry of Korea.

PubMed

Kim, Kyung Woo; Park, Sung Jin; Lim, Hae Sun; Cho, Hm Hak

2017-09-01

Safety climate and occupational stress are related with occupational accident. The present study tried to identify the differences in safety climate and occupational stress according to occupational accidents experience and employment type (e.g., direct workers and subcontract workers). In this study, we conducted a survey using safety climate scale and Korean Occupational Stress Scale and classified the participants into four groups: direct workers working for accident-free departments, direct workers working for accident departments, subcontract workers working for accident-free departments, and subcontract workers working for accident departments for 2 years within the same workplace in the shipbuilding industry. The direct workers and subcontract workers showed diverse results in subscales of safety climate and occupational stress. This result is supported by existing studies; however, further study is necessary for more supporting evidence and elaborative methodological approach. The necessity of management for safety climate and psychosocial factor such as occupational stress for both direct workers and subcontract workers as a whole is suggested by this study.

Patient safety attitudes of paediatric trainee physicians.

PubMed

Parry, G; Horowitz, L; Goldmann, D

2009-12-01

To measure the patient safety attitudes of trainee physicians at an academic paediatric hospital. Cross-sectional survey. An academic paediatric hospital. 209 trainee physicians based at the academic paediatric hospital in January 2004. Patient safety attitudes of trainee physicians measured using the Safety Attitudes Questionnaire (Inpatient Version) and a specific trainee survey. In the Safety Attitudes Questionnaire, responses were most positive in areas associated with independent care: job satisfaction (mean factor score = 77.5) safety climate (76.1), working conditions (75.6), perception of management (70.4) and less positively in areas associated with interdependent care: teamwork climate (64.6) and stress recognition (59.1). In the trainee survey, following a principal component analysis to identify summary factors, responses were most positive in the independent areas of clinical supervision and support (75.0), communication with their immediate senior physician (65.5) and orientation of new personnel (63.9), and less positive in the interdependent areas of handoffs and multiple services, (58.1), role identification during codes (51.0) and support following an adverse event (42.8). The combined independent factor scores were higher than the interdependent (difference = 17.9, 95% CI 16.1 to 19.7, p<0.001). Fellows reported higher independent factor scores than residents (5.5, 95% CI 2.2 to 8.9, p = 0.001), but not for the interdependent scores (-0.5, 95% CI -3.6 to 2.7, p = 0.767). Trainees appear comfortable with caring independently for patients but less so caring interdependently. With experience, trainee physicians may experience improvement in their ability to act independently but not interdependently. Recently developed patient safety culture instruments may enable additional understanding of what could be implemented to make improvements.

Effect of a Publicly Accessible Disclosure System on Food Safety Inspection Scores in Retail and Food Service Establishments.

PubMed

Choi, Jihee; Scharff, Robert L

2017-07-01

The increased frequency with which people are dining out coupled with an increase in the publicity of foodborne disease outbreaks has led the public to an increased awareness of food safety issues associated with food service establishments. To accommodate consumer needs, local health departments have increasingly publicized food establishments' health inspection scores. The objective of this study was to estimate the effect of the color-coded inspection score disclosure system in place since 2006 in Columbus, OH, by controlling for several confounding factors. This study incorporated cross-sectional time series data from food safety inspections performed from the Columbus Public Health Department. An ordinary least squares regression was used to assess the effect of the new inspection regime. The introduction of the new color-coded food safety inspection disclosure system increased inspection scores for all types of establishments and for most types of inspections, although significant differences were found in the degree of improvement. Overall, scores increased significantly by 1.14 points (of 100 possible). An exception to the positive results was found for inspections in response to foodborne disease complaints. Scores for these inspections declined significantly by 10.2 points. These results should be useful for both food safety researchers and public health decision makers.

An assessment of safety climate, job satisfaction and turnover intention relationships using a national sample of workers from the USA.

PubMed

Smith, Todd D

2018-03-01

The association between safety climate, job satisfaction and turnover intention has not been thoroughly researched. This research is needed so that safety researchers and practitioners can begin to delineate the impact of safety on organizational and business outcomes. A path analysis was completed using data from a national sample of workers from the USA (n = 1525). The overall fit of the model was excellent and analyses determined that both training and resource adequacy positively affected safety climate and job satisfaction. Safety climate also positively influenced job satisfaction. Both safety climate and job satisfaction were negatively associated with respondents' turnover intention. In the study, the relationship between job satisfaction and turnover intention is reiterated in a sample of workers across many industries. This study is novel because it is one of the first studies to confirm that turnover intention is reduced with increased safety climate in a diverse sample of workers.

Propensity scores-potential outcomes framework to incorporate severity probabilities in the highway safety manual crash prediction algorithm.

PubMed

Sasidharan, Lekshmi; Donnell, Eric T

2014-10-01

Accurate estimation of the expected number of crashes at different severity levels for entities with and without countermeasures plays a vital role in selecting countermeasures in the framework of the safety management process. The current practice is to use the American Association of State Highway and Transportation Officials' Highway Safety Manual crash prediction algorithms, which combine safety performance functions and crash modification factors, to estimate the effects of safety countermeasures on different highway and street facility types. Many of these crash prediction algorithms are based solely on crash frequency, or assume that severity outcomes are unchanged when planning for, or implementing, safety countermeasures. Failing to account for the uncertainty associated with crash severity outcomes, and assuming crash severity distributions remain unchanged in safety performance evaluations, limits the utility of the Highway Safety Manual crash prediction algorithms in assessing the effect of safety countermeasures on crash severity. This study demonstrates the application of a propensity scores-potential outcomes framework to estimate the probability distribution for the occurrence of different crash severity levels by accounting for the uncertainties associated with them. The probability of fatal and severe injury crash occurrence at lighted and unlighted intersections is estimated in this paper using data from Minnesota. The results show that the expected probability of occurrence of fatal and severe injury crashes at a lighted intersection was 1 in 35 crashes and the estimated risk ratio indicates that the respective probabilities at an unlighted intersection was 1.14 times higher compared to lighted intersections. The results from the potential outcomes-propensity scores framework are compared to results obtained from traditional binary logit models, without application of propensity scores matching. Traditional binary logit analysis suggests that

Nursing practice environment, job outcomes and safety climate: a structural equation modelling analysis.

PubMed

Dos Santos Alves, Daniela Fernanda; da Silva, Dirceu; de Brito Guirardello, Edinêis

2017-01-01

To assess correlations between the characteristics of the nursing practice environment, job outcomes and safety climate. The nursing practice environment is critical to the well-being of professionals and to patient safety, as highlighted by national and international studies; however, there is a lack of evidence regarding this theme in paediatric units. A cross-sectional study, in two paediatric hospitals in Brazil, was conducted from December 2013 to February 2014. For data collection, we used the Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and the Maslach Burnout Inventory, and for analysis Spearman's correlation coefficient and structural equation modelling were used. Two hundred and sixty-seven professional nurses participated in the study. Autonomy, control over the work environment and the relationship between nursing and medical staff are factors associated with job outcomes and safety climate and can be considered their predictors. Professional nurses with greater autonomy, good working relationships and control over their work environment have lower levels of emotional exhaustion, higher job satisfaction, less intention of leaving the job and the safety climate is positive. Initiatives to improve the professional practice environment can improve the safety of paediatric patients and the well-being of professional nurses. © 2016 John Wiley & Sons Ltd.

A test of safety, violence prevention, and civility climate domain-specific relationships with relevant workplace hazards.

PubMed

Gazica, Michele W; Spector, Paul E

2016-01-01

Safety climate, violence prevention climate, and civility climate were independently developed and linked to domain-specific workplace hazards, although all three were designed to promote the physical and psychological safety of workers. To test domain specificity between conceptually related workplace climates and relevant workplace hazards. Data were collected from 368 persons employed in various industries and descriptive statistics were calculated for all study variables. Correlational and relative weights analyses were used to test for domain specificity. The three climate domains were similarly predictive of most workplace hazards, regardless of domain specificity. This study suggests that the three climate domains share a common higher order construct that may predict relevant workplace hazards better than any of the scales alone.

[The role of safety climate and the relationship with job satisfaction: an exploratory study across three different occupational contexts.

PubMed

Emanuel, Federica; Colombo, Lara; Cortese, Claudio G; Ghislieri, Chiara

2017-12-01

This study examined the role of the "safety climate", or the organization's attention to health and safety of workers, and of job demand and resources in relation with job satisfaction. Wellbeing at work is a topic of growing interest, in line with the legislation and the programs on health and safety of workers and management and the evaluation of psychosocial risks. Several studies show that organizational actions concerning health and safety can be an indicator of the attention to employees' wellbeing, even if studies about the relationship between safety climate and some psychosocial outcomes are scant. The study analysed the relationship between job demand, job resources, safety climate and job satisfaction in three different occupational contexts (public authority, N = 224; social care organization, N = 115; pharmaceutical company, N = 127); workers were divided into groups based on the risk level appeared in the objective assessment of work-related stress, in order to identify differences. The self-report questionnaire gathered information about: job satisfaction, work efforts, supervisors' support, colleagues support, safety climate (α between .72 and .93). Data analysis provided: Cronbach α, analysis of variance, correlations, stepwise multiple regressions. The results showed that job satisfaction (R2 between .23 and .88) had a negative relationship with efforts and a positive relationship with job resources and safety climate. It emerges the importance of safety climate: to support and promote wellbeing at work, organizations could endorse training and information programs on health and safety for all workers and management, not only for professional groups with high-risk level. Future studies could explore the relation between safety climate and other outcomes, such as emotional exhaustion or objective indicators of organizational health (e.g. absenteeism, accidents, etc.). Copyright© by Aracne Editrice, Roma, Italy.

Measuring school climate in high schools: a focus on safety, engagement, and the environment.

PubMed

Bradshaw, Catherine P; Waasdorp, Tracy E; Debnam, Katrina J; Johnson, Sarah Lindstrom

2014-09-01

School climate has been linked to multiple student behavioral, academic, health, and social-emotional outcomes. The US Department of Education (USDOE) developed a 3-factor model of school climate comprised of safety, engagement, and environment. This article examines the factor structure and measurement invariance of the USDOE model. Drawing upon 2 consecutive waves of data from over 25,000 high school students (46% minority), a series of exploratory and confirmatory factor analyses examined the fit of the Maryland Safe and Supportive Schools Climate Survey with the USDOE model. The results indicated adequate model fit with the theorized 3-factor model of school climate, which included 13 subdomains: safety (perceived safety, bullying and aggression, and drug use); engagement (connection to teachers, student connectedness, academic engagement, school connectedness, equity, and parent engagement); environment (rules and consequences, physical comfort, and support, disorder). We also found consistent measurement invariance with regard to student sex, grade level, and ethnicity. School-level interclass correlation coefficients ranged from 0.04 to .10 for the scales. Findings supported the USDOE 3-factor model of school climate and suggest measurement invariance and high internal consistency of the 3 scales and 13 subdomains. These results suggest the 56-item measure may be a potentially efficient, yet comprehensive measure of school climate. © 2014, American School Health Association.

Development and psychometric testing of an instrument to measure safety climate perceptions in community pharmacy.

PubMed

Newham, Rosemary; Bennie, Marion; Maxwell, David; Watson, Anne; de Wet, Carl; Bowie, Paul

2014-12-01

A positive and strong safety culture underpins effective learning from patient safety incidents in health care, including the community pharmacy (CP) setting. To build this culture, perceptions of safety climate must be measured with context-specific and reliable instruments. No pre-existing instruments were specifically designed or suitable for CP within Scotland. We therefore aimed to develop a psychometrically sound instrument to measure perceptions of safety climate within Scottish CPs. The first stage, development of a preliminary instrument, comprised three steps: (i) a literature review; (ii) focus group feedback; and (iii) content validation. The second stage, psychometric testing, consisted of three further steps: (iv) a pilot survey; (v) a survey of all CP staff within a single health board in NHS Scotland; and (vi) application of statistical methods, including principal components analysis and calculation of Cronbach's reliability coefficients, to derive the final instrument. The preliminary questionnaire was developed through a process of literature review and feedback. This questionnaire was completed by staff in 50 CPs from the 131 (38%) sampled. 250 completed questionnaires were suitable for analysis. Psychometric evaluation resulted in a 30-item instrument with five positively correlated safety climate factors: leadership, teamwork, safety systems, communication and working conditions. Reliability coefficients were satisfactory for the safety climate factors (α > 0.7) and overall (α = 0.93). The robust nature of the technical design and testing process has resulted in the development of an instrument with sufficient psychometric properties, which can be implemented in the community pharmacy setting in NHS Scotland. © 2014 John Wiley & Sons, Ltd.

A test of safety, violence prevention, and civility climate domain-specific relationships with relevant workplace hazards

PubMed Central

Spector, Paul E.

2016-01-01

Background Safety climate, violence prevention climate, and civility climate were independently developed and linked to domain-specific workplace hazards, although all three were designed to promote the physical and psychological safety of workers. Purpose To test domain specificity between conceptually related workplace climates and relevant workplace hazards. Methods Data were collected from 368 persons employed in various industries and descriptive statistics were calculated for all study variables. Correlational and relative weights analyses were used to test for domain specificity. Results The three climate domains were similarly predictive of most workplace hazards, regardless of domain specificity. Discussion This study suggests that the three climate domains share a common higher order construct that may predict relevant workplace hazards better than any of the scales alone. PMID:27110930

Speaking up behaviors and safety climate in an Austrian university hospital.

PubMed

Schwappach, David; Sendlhofer, Gerald; Häsler, Lynn; Gombotz, Veronika; Leitgeb, Karina; Hoffmann, Magdalena; Jantscher, Lydia; Brunner, Gernot

2018-04-26

To analyze speaking up behavior and safety climate with a validated questionnaire for the first time in an Austrian university hospital. Survey amongst healthcare workers (HCW). Data were analyzed using descriptive statistics, Cronbach's alpha was calculated as a measure of internal consistencies of scales. Analysis of variance and t-tests were used. The survey was conducted in 2017. About 2.149 HCW from three departments were asked to participate. To measure speaking up behavior and safety climate. To explore psychological safety, encouraging environment and resignation towards speaking up. About 859 evaluable questionnaires were returned (response rate: 40%). More than 50% of responders perceived specific concerns about patient safety within the last 4 weeks and observed a potential error or noticed rule violations. For the different items, between 16% and 42% of HCW reported that they remained silent though concerns for safety. In contrast, between 96% and 98% answered that they did speak up in certain situations. The psychological safety for speaking up was lower for HCW with a managerial function (P < 0.001). HCW with managerial functions perceived the environment as less encouraging to speak up (P < 0.05) than HCW without managerial function. We identified speaking up behaviors for the first time in an Austrian university hospital. Only moderately frequent concerns were in conflict with frequent speaking up behaviors. These results clearly show that a paradigm shift is needed to increase speaking up culture.

Roles of safety climate and shift work on perceived injury risk: a multi-level analysis.

PubMed

Huang, Yueng-Hsiang; Chen, Jiu-Chiuan; DeArmond, Sarah; Cigularov, Konstantin; Chen, Peter Y

2007-11-01

This study evaluated the relationship between employees' work shift (i.e., day shift versus night shift) and perceptions of injury risk, and how the relationship is affected by company level safety climate and injury frequency. The results showed that night shift workers perceived a higher level of injury risk compared to day shift workers. Both company level safety climate and injury frequency played critical roles in predicting individual perceived work injury risk. Perception of injury risk of night shift workers was significantly lower when they perceived high-level rather than low-level safety climate. However, this pattern was not noticeable for day shift workers. These findings highlighted the importance of considering company level factors when attempting to understand the differences between day shift and night shift work on an individual's perception of injury risk.

Perceptions of safety culture vary across the intensive care units of a single institution.

PubMed

Huang, David T; Clermont, Gilles; Sexton, J Bryan; Karlo, Crystal A; Miller, Rachel G; Weissfeld, Lisa A; Rowan, Kathy M; Angus, Derek C

2007-01-01

To determine whether safety culture factors varied across the intensive care units (ICUs) of a single hospital, between nurses and physicians, and to explore ICU nursing directors' perceptions of their personnel's attitudes. Cross-sectional surveys using the Safety Attitudes Questionnaire-ICU version, a validated, aviation industry-based safety culture survey instrument. It assesses culture across six factors: teamwork climate, perceptions of management, safety climate, stress recognition, job satisfaction, and work environment. Four ICUs in one tertiary care hospital. All ICU personnel. We conducted the survey from January 1 to April 1, 2003, and achieved a 70.2% response rate (318 of 453). We calculated safety culture factor mean and percent-positive scores (percentage of respondents with a mean score of > or =75 on a 0-100 scale for which 100 is best) for each ICU. We compared mean ICU scores by ANOVA and percent-positive scores by chi-square. Mean and percent-positive scores by job category were modeled using a generalized estimating equations approach and compared using Wald statistics. We asked ICU nursing directors to estimate their personnel's mean scores and generated ratios of their estimates to the actual scores.Overall, factor scores were low to moderate across all factors (range across ICUs: 43.4-74.9 mean scores, 8.6-69.4 percent positive). Mean and percent-positive scores differed significantly (p < .0083, Bonferroni correction) across ICUs, except for stress recognition, which was uniformly low. Compared with physicians, nurses had significantly lower mean working conditions and perceptions of management scores. ICU nursing directors tended to overestimate their personnel's attitudes. This was greatest for teamwork, for which all director estimates exceeded actual scores, with a mean overestimate of 16%. Significant safety culture variation exists across ICUs of a single hospital. ICU nursing directors tend to overestimate their personnel

THE REGRESSION MODEL OF IRAN LIBRARIES ORGANIZATIONAL CLIMATE.

PubMed

Jahani, Mohammad Ali; Yaminfirooz, Mousa; Siamian, Hasan

2015-10-01

The purpose of this study was to drawing a regression model of organizational climate of central libraries of Iran's universities. This study is an applied research. The statistical population of this study consisted of 96 employees of the central libraries of Iran's public universities selected among the 117 universities affiliated to the Ministry of Health by Stratified Sampling method (510 people). Climate Qual localized questionnaire was used as research tools. For predicting the organizational climate pattern of the libraries is used from the multivariate linear regression and track diagram. of the 9 variables affecting organizational climate, 5 variables of innovation, teamwork, customer service, psychological safety and deep diversity play a major role in prediction of the organizational climate of Iran's libraries. The results also indicate that each of these variables with different coefficient have the power to predict organizational climate but the climate score of psychological safety (0.94) plays a very crucial role in predicting the organizational climate. Track diagram showed that five variables of teamwork, customer service, psychological safety, deep diversity and innovation directly effects on the organizational climate variable that contribution of the team work from this influence is more than any other variables. Of the indicator of the organizational climate of climateQual, the contribution of the team work from this influence is more than any other variables that reinforcement of teamwork in academic libraries can be more effective in improving the organizational climate of this type libraries.

An Analysis of Home Energy Score and REM/Rate Energy Simulation Results for Homes in Three Climates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Merket, Noel D

Energy ratings and scores for homes attempt to give homeowners a understandable metric to compare the energy efficiency of homes. Two rating systems in the marketplace include RESNET's Home Energy Rating System (HERS) and DOE's Home Energy Score (HEScore) and include differing energy calculation methodologies. This report compares the energy predictions from both REM/Rate and Home Energy Score for populations of real homes in three climates and determines some features of homes that lead to the greatest differences between energy predictions.

The associations between work-life balance behaviours, teamwork climate and safety climate: cross-sectional survey introducing the work-life climate scale, psychometric properties, benchmarking data and future directions.

PubMed

Sexton, J Bryan; Schwartz, Stephanie P; Chadwick, Whitney A; Rehder, Kyle J; Bae, Jonathan; Bokovoy, Joanna; Doram, Keith; Sotile, Wayne; Adair, Kathryn C; Profit, Jochen

2017-08-01

Improving the resiliency of healthcare workers is a national imperative, driven in part by healthcare workers having minimal exposure to the skills and culture to achieve work-life balance (WLB). Regardless of current policies, healthcare workers feel compelled to work more and take less time to recover from work. Satisfaction with WLB has been measured, as has work-life conflict, but how frequently healthcare workers engage in specific WLB behaviours is rarely assessed. Measurement of behaviours may have advantages over measurement of perceptions; behaviours more accurately reflect WLB and can be targeted by leaders for improvement. 1. To describe a novel survey scale for evaluating work-life climate based on specific behavioural frequencies in healthcare workers.2. To evaluate the scale's psychometric properties and provide benchmarking data from a large healthcare system.3. To investigate associations between work-life climate, teamwork climate and safety climate. Cross-sectional survey study of US healthcare workers within a large healthcare system. 7923 of 9199 eligible healthcare workers across 325 work settings within 16 hospitals completed the survey in 2009 (86% response rate). The overall work-life climate scale internal consistency was Cronbach α=0.790. t-Tests of top versus bottom quartile work settings revealed that positive work-life climate was associated with better teamwork climate, safety climate and increased participation in safety leadership WalkRounds with feedback (p<0.001). Univariate analysis of variance demonstrated differences that varied significantly in WLB between healthcare worker role, hospitals and work setting. The work-life climate scale exhibits strong psychometric properties, elicits results that vary widely by work setting, discriminates between positive and negative workplace norms, and aligns well with other culture constructs that have been found to correlate with clinical outcomes. Published by the BMJ Publishing Group

Food safety in food services in Lombardy: proposal for an inspection-scoring model

PubMed Central

Balzaretti, Claudia M.; Razzini, Katia; Ziviani, Silvia; Ratti, Sabrina; Milicevic, Vesna; Chiesa, Luca M.; Panseri, Sara; Castrica, Marta

2017-01-01

The purpose of this study was to elaborate a checklist with an inspection scoring system at national level in order to assess compliance with sanitary hygiene requirements of food services. The inspection scoring system was elaborated taking into account the guidelines drawn up by NYC Department of Food Safety and Mental Hygiene. Moreover the checklist was used simultaneously with the standard inspection protocol adopted by Servizio Igiene Alimenti Nutrizione (Servizio Igiene Alimenti Nutrizione - Ss. I.A.N) and defined by D.G.R 6 March 2017 – n. X/6299 Lombardy Region. Ss. I.A.N protocol consists of a qualitative response according to which we have generated a new protocol with three different grading: A, B and C. The designed checklist was divided into 17 sections. Each section corresponds to prerequisites to be verified during the inspection. Every section includes the type of conformity to check and the type of violation: critical or general. Moreover, the failure to respect the expected compliance generates 4 severity levels that correspond to score classes. A total of 7 food services were checked with the two different inspection methods. The checklist results generated a food safety score for each food service that ranged from 0.0 (no flaws observed) to 187.2, and generates three grading class: A (0.0-28.0); B (29.0-70.0) and C (>71.00). The results from the Ss. I. A. N grading method and the checklist show positive correlation (r=0.94, P>0.01) suggesting that the methods are comparable. Moreover, our scoring checklist is an easy and unique method compared to standard and allows also managers to perform effective surveillance programs in food service. PMID:29564236

Food safety in food services in Lombardy: proposal for an inspection-scoring model.

PubMed

Balzaretti, Claudia M; Razzini, Katia; Ziviani, Silvia; Ratti, Sabrina; Milicevic, Vesna; Chiesa, Luca M; Panseri, Sara; Castrica, Marta

2017-10-20

The purpose of this study was to elaborate a checklist with an inspection scoring system at national level in order to assess compliance with sanitary hygiene requirements of food services. The inspection scoring system was elaborated taking into account the guidelines drawn up by NYC Department of Food Safety and Mental Hygiene. Moreover the checklist was used simultaneously with the standard inspection protocol adopted by Servizio Igiene Alimenti Nutrizione ( Servizio Igiene Alimenti Nutrizione - Ss. I.A.N) and defined by D.G.R 6 March 2017 - n. X/6299 Lombardy Region. Ss. I.A.N protocol consists of a qualitative response according to which we have generated a new protocol with three different grading: A, B and C. The designed checklist was divided into 17 sections. Each section corresponds to prerequisites to be verified during the inspection. Every section includes the type of conformity to check and the type of violation: critical or general. Moreover, the failure to respect the expected compliance generates 4 severity levels that correspond to score classes. A total of 7 food services were checked with the two different inspection methods. The checklist results generated a food safety score for each food service that ranged from 0.0 (no flaws observed) to 187.2, and generates three grading class: A (0.0-28.0); B (29.0-70.0) and C (>71.00). The results from the Ss. I. A. N grading method and the checklist show positive correlation ( r =0.94, P>0.01) suggesting that the methods are comparable. Moreover, our scoring checklist is an easy and unique method compared to standard and allows also managers to perform effective surveillance programs in food service.

Do nurse and patient injuries share common antecedents? An analysis of associations with safety climate and working conditions.

PubMed

Taylor, Jennifer A; Dominici, Francesca; Agnew, Jacqueline; Gerwin, Daniel; Morlock, Laura; Miller, Marlene R

2012-02-01

Safety climate and nurses' working conditions may have an impact on both patient outcomes and nurse occupational health, but these outcomes have rarely been examined concurrently. To examine the association of unit-level safety climate and specific nurse working conditions with injury outcomes for both nurses and patients in a single hospital. A cross-sectional study was conducted using nursing-unit level and individual-level data at an urban, level-one trauma centre in the USA. Multilevel logistic regressions were used to examine associations among injury outcomes, safety climate and working conditions on 29 nursing units, including a total of 723 nurses and 28 876 discharges. Safety climate was measured in 2004 using the Safety Attitudes Questionnaire (SAQ). Working conditions included registered nursing hours per patient day (RNHPPD) and unit turnover. Patient injuries included 290 falls, 167 pulmonary embolism/deep vein thrombosis (PE/DVT), and 105 decubitus ulcers. Nurse injury was defined as a reported needle-stick, splash, slip, trip, or fall (n=78). Working conditions and outcomes were measured in 2005. The study found a negative association between two SAQ domains, Safety and Teamwork, with the odds of both decubitus ulcers and nurse injury. RNHPPD showed a negative association with patient falls and decubitus ulcers. Unit turnover was positively associated with nurse injury and PE/DVT, but negatively associated with falls and decubitus ulcers. Safety climate was associated with both patient and nurse injuries, suggesting that patient and nurse safety may actually be linked outcomes. The findings also indicate that increased unit turnover should be considered a risk factor for nurse and patient injuries.

Undergraduate Understanding of Climate Change: The Influences of College Major and Environmental Group Membership on Survey Knowledge Scores

ERIC Educational Resources Information Center

Huxster, Joanna K.; Uribe-Zarain, Ximena; Kempton, Willett

2015-01-01

A survey covering the scientific and social aspects of climate change was administered to examine U.S. undergraduate student mental models, and compare knowledge between groups based on major and environmental group membership. A Knowledge Score (scale 0-35, mean score = 17.84) was generated for respondents at two, central East Coast, U.S.…

THE REGRESSION MODEL OF IRAN LIBRARIES ORGANIZATIONAL CLIMATE

PubMed Central

Jahani, Mohammad Ali; Yaminfirooz, Mousa; Siamian, Hasan

2015-01-01

Background: The purpose of this study was to drawing a regression model of organizational climate of central libraries of Iran’s universities. Methods: This study is an applied research. The statistical population of this study consisted of 96 employees of the central libraries of Iran’s public universities selected among the 117 universities affiliated to the Ministry of Health by Stratified Sampling method (510 people). Climate Qual localized questionnaire was used as research tools. For predicting the organizational climate pattern of the libraries is used from the multivariate linear regression and track diagram. Results: of the 9 variables affecting organizational climate, 5 variables of innovation, teamwork, customer service, psychological safety and deep diversity play a major role in prediction of the organizational climate of Iran’s libraries. The results also indicate that each of these variables with different coefficient have the power to predict organizational climate but the climate score of psychological safety (0.94) plays a very crucial role in predicting the organizational climate. Track diagram showed that five variables of teamwork, customer service, psychological safety, deep diversity and innovation directly effects on the organizational climate variable that contribution of the team work from this influence is more than any other variables. Conclusions: Of the indicator of the organizational climate of climateQual, the contribution of the team work from this influence is more than any other variables that reinforcement of teamwork in academic libraries can be more effective in improving the organizational climate of this type libraries. PMID:26622203

Development of a patient safety climate survey for Chinese hospitals: cross-national adaptation and psychometric evaluation.

PubMed

Zhu, Junya; Li, Liping; Zhao, Hailei; Han, Guangshu; Wu, Albert W; Weingart, Saul N

2014-10-01

Existing patient safety climate instruments, most of which have been developed in the USA, may not accurately reflect the conditions in the healthcare systems of other countries. To develop and evaluate a patient safety climate instrument for healthcare workers in Chinese hospitals. Based on a review of existing instruments, expert panel review, focus groups and cognitive interviews, we developed items relevant to patient safety climate in Chinese hospitals. The draft instrument was distributed to 1700 hospital workers from 54 units in six hospitals in five Chinese cities between July and October 2011, and 1464 completed surveys were received. We performed exploratory and confirmatory factor analyses and estimated internal consistency reliability, within-unit agreement, between-unit variation, unit-mean reliability, correlation between multi-item composites, and association between the composites and two single items of perceived safety. The final instrument included 34 items organised into nine composites: institutional commitment to safety, unit management support for safety, organisational learning, safety system, adequacy of safety arrangements, error reporting, communication and peer support, teamwork and staffing. All composites had acceptable unit-mean reliabilities (≥0.74) and within-unit agreement (Rwg ≥0.71), and exhibited significant between-unit variation with intraclass correlation coefficients ranging from 9% to 21%. Internal consistency reliabilities ranged from 0.59 to 0.88 and were ≥0.70 for eight of the nine composites. Correlations between composites ranged from 0.27 to 0.73. All composites were positively and significantly associated with the two perceived safety items. The Chinese Hospital Survey on Patient Safety Climate demonstrates adequate dimensionality, reliability and validity. The integration of qualitative and quantitative methods is essential to produce an instrument that is culturally appropriate for Chinese hospitals

Reaping the benefits of task conflict in teams: the critical role of team psychological safety climate.

PubMed

Bradley, Bret H; Postlethwaite, Bennett E; Klotz, Anthony C; Hamdani, Maria R; Brown, Kenneth G

2012-01-01

Past research suggests that task conflict may improve team performance under certain conditions; however, we know little about these specific conditions. On the basis of prior theory and research on conflict in teams, we argue that a climate of psychological safety is one specific context under which task conflict will improve team performance. Using evidence from 117 project teams, the present research found that psychological safety climate moderates the relationship between task conflict and performance. Specifically, task conflict and team performance were positively associated under conditions of high psychological safety. The results support the conclusion that psychological safety facilitates the performance benefits of task conflict in teams. Theoretical implications and suggestions for future research are discussed.

Fatigue in seafarers working in the offshore oil and gas re-supply industry: effects of safety climate, psychosocial work environment and shift arrangement.

PubMed

Hystad, Sigurd W; Saus, Evelyn-Rose; Sætrevik, Bjørn; Eid, Jarle

2013-01-01

This study examined the influence of safety climate and psychosocial work environment on the reported fatigue of seafarers working in the offshore oil and gas re-supply industry (n = 402). We found that seafarers who reported high psychological demands and perceived the organisational-level safety climate negatively,reported significantly more mental fatigue, physical fatigue, and lack of energy. In addition, seafarers who reported having high levels of job control reported being significantly less mentally fatigued. We also found some combined effects of safety climate and shift arrangement. Organisational-level safety climate did not influence the levels of physical fatigue in seafarers working on the night shift. On the contrary, seafarers working during the days reported to be more physically fatigued when they perceived the organisational-level climate to be negative compared with the positive. The opposite effect was found for group-level safety climate: seafarers working during the nights reported to be more physically fatigued when they perceived the group-level climate to be negative compared with the positive. The results from this study point to the importance of taking into consideration aspects of the psychosocial work environment and safety climate,and their potential impact on fatigue and safety in the maritime organisations.

Assessing safety culture in NICU: psychometric properties of the Italian version of Safety Attitude Questionnaire and result implications.

PubMed

Zenere, Alessandra; Zanolin, M Elisabetta; Negri, Roberta; Moretti, Francesca; Grassi, Mario; Tardivo, Stefano

2016-04-01

Neonatal intensive care units (NICUs) are a high-risk setting. The Safety Attitude Questionnaire (SAQ) is a widely used tool to measure safety culture. The aims of the study are to verify the psychometric properties of the Italian version of SAQ, to evaluate safety culture in the NICUs and to identify improvement interventions. A cross-sectional study was conducted in 6 level III NICUs. The SAQ was translated into Italian and adapted to the context, a confirmatory factor analysis (CFA) was performed to validate the questionnaire. 193 questionnaires were collected. The mean response rate was 59.7% (range 44.5%-95.7%). The answers were analysed according to six factors: f1 - teamwork climate, f2 - safety climate, f3 - job satisfaction, f4 - stress recognition, f5 - perception of management, f6 - working conditions. The CFA indexes were adequate (McDonald's omega indexes varied from 0.74 to 0.94, the SRMR index was equal to 0.79 and the RMSEA index was 0.070, 95% CI = 0.063-0.078). The mean composite score was 57.6 (SD 17.9), ranging between 42.3 and 69.7 on a standardized 100-point scale. We highlighted significant differences among units and professions (P < 0.05). The Italian version of the SAQ proved to be an effective tool to evaluate and compare the safety culture in the NICUs. The obtained scores significantly varied both within and among the NICUs. The organizational and structural characteristics of the involved hospitals probably affect the safety culture perception by the staff. © 2015 John Wiley & Sons, Ltd.

Measuring School Climate in High Schools: A Focus on Safety, Engagement, and the Environment

ERIC Educational Resources Information Center

Bradshaw, Catherine P.; Waasdorp, Tracy E.; Debnam, Katrina J.; Johnson, Sarah Lindstrom

2014-01-01

Background: School climate has been linked to multiple student behavioral, academic, health, and social-emotional outcomes. The US Department of Education (USDOE) developed a 3-factor model of school climate comprised of safety, engagement, and environment. This article examines the factor structure and measurement invariance of the USDOE model.…

A Quantitative Climate-Match Score for Risk-Assessment Screening of Reptile and Amphibian Introductions

NASA Astrophysics Data System (ADS)

van Wilgen, Nicola J.; Roura-Pascual, Núria; Richardson, David M.

2009-09-01

Assessing climatic suitability provides a good preliminary estimate of the invasive potential of a species to inform risk assessment. We examined two approaches for bioclimatic modeling for 67 reptile and amphibian species introduced to California and Florida. First, we modeled the worldwide distribution of the biomes found in the introduced range to highlight similar areas worldwide from which invaders might arise. Second, we modeled potentially suitable environments for species based on climatic factors in their native ranges, using three sources of distribution data. Performance of the three datasets and both approaches were compared for each species. Climate match was positively correlated with species establishment success (maximum predicted suitability in the introduced range was more strongly correlated with establishment success than mean suitability). Data assembled from the Global Amphibian Assessment through NatureServe provided the most accurate models for amphibians, while ecoregion data compiled by the World Wide Fund for Nature yielded models which described reptile climatic suitability better than available point-locality data. We present three methods of assigning a climate-match score for use in risk assessment using both the mean and maximum climatic suitabilities. Managers may choose to use different methods depending on the stringency of the assessment and the available data, facilitating higher resolution and accuracy for herpetofaunal risk assessment. Climate-matching has inherent limitations and other factors pertaining to ecological interactions and life-history traits must also be considered for thorough risk assessment.

School climate factors contributing to student and faculty perceptions of safety in select Arizona schools.

PubMed

Bosworth, Kris; Ford, Lysbeth; Hernandaz, Diley

2011-04-01

To ensure that schools are safe places where students can learn, researchers and educators must understand student and faculty safety concerns. This study examines student and teacher perceptions of school safety. Twenty-two focus groups with students and faculty were conducted in 11 secondary schools. Schools were selected from a stratified sample to vary in location, proximity to Indian reservations, size, and type. The data analysis was based on grounded theory. In 9 of 11 schools, neither faculty nor students voiced overwhelming concerns about safety. When asked what makes school safe, students tended to report physical security features. School climate and staff actions also increased feelings of safety. Faculty reported that relationships and climate are key factors in making schools safe. High student performance on standardized tests does not buffer students from unsafe behavior, nor does living in a dangerous neighborhood necessarily lead to more drug use or violence within school walls. School climate seemed to explain the difference between schools in which students and faculty reported higher versus lower levels of violence and alcohol and other drug use. The findings raise provocative questions about school safety and provide insight into elements that lead to perceptions of safety. Some schools have transcended issues of location and neighborhood to provide an environment perceived as safe. Further study of those schools could provide insights for policy makers, program planners, and educational leaders. © 2011, American School Health Association.

Medical students' situational motivation to participate in simulation based team training is predicted by attitudes to patient safety.

PubMed

Escher, Cecilia; Creutzfeldt, Johan; Meurling, Lisbet; Hedman, Leif; Kjellin, Ann; Felländer-Tsai, Li

2017-02-10

Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training. In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ). We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples. In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.

Associations between communication climate and the frequency of medical error reporting among pharmacists within an inpatient setting.

PubMed

Patterson, Mark E; Pace, Heather A; Fincham, Jack E

2013-09-01

Although error-reporting systems enable hospitals to accurately track safety climate through the identification of adverse events, these systems may be underused within a work climate of poor communication. The objective of this analysis is to identify the extent to which perceived communication climate among hospital pharmacists impacts medical error reporting rates. This cross-sectional study used survey responses from more than 5000 pharmacists responding to the 2010 Hospital Survey on Patient Safety Culture (HSOPSC). Two composite scores were constructed for "communication openness" and "feedback and about error," respectively. Error reporting frequency was defined from the survey question, "In the past 12 months, how many event reports have you filled out and submitted?" Multivariable logistic regressions were used to estimate the likelihood of medical error reporting conditional upon communication openness or feedback levels, controlling for pharmacist years of experience, hospital geographic region, and ownership status. Pharmacists with higher communication openness scores compared with lower scores were 40% more likely to have filed or submitted a medical error report in the past 12 months (OR, 1.4; 95% CI, 1.1-1.7; P = 0.004). In contrast, pharmacists with higher communication feedback scores were not any more likely than those with lower scores to have filed or submitted a medical report in the past 12 months (OR, 1.0; 95% CI, 0.8-1.3; P = 0.97). Hospital work climates that encourage pharmacists to freely communicate about problems related to patient safety is conducive to medical error reporting. The presence of feedback infrastructures about error may not be sufficient to induce error-reporting behavior.

Development of the SaFETy Score: A Clinical Screening Tool for Predicting Future Firearm Violence Risk

PubMed Central

Goldstick, Jason E.; Carter, Patrick M.; Walton, Maureen A.; Dahlberg, Linda L.; Sumner, Steven A.; Zimmerman, Marc A.; Cunningham, Rebecca M.

2017-01-01

Background Interpersonal firearm violence among youth is a substantial public health problem, and emergency department (ED) physicians require a clinical screening tool to identify high-risk youth. Objective To derive a clinically feasible risk index for firearm violence. Design 24-month prospective cohort study. Setting Urban, level 1 ED. Participants Substance-using youths, aged 14 to 24 years, seeking ED care for an assault-related injury and a proportionately sampled group of non–assault-injured youth enrolled from September 2009 through December 2011. Measurements Firearm violence (victimization/perpetration) and validated questionnaire items. Results A total of 599 youths were enrolled, and presence/absence of future firearm violence during follow-up could be ascertained in 483 (52.2% were positive). The sample was randomly split into training (75%) and post–score-construction validation (25%) sets. Using elastic-net penalized logistic regression, 118 baseline predictors were jointly analyzed; the most predictive variables fell predominantly into 4 domains: violence victimization, community exposure, peer influences, and fighting. By selection of 1 item from each domain, the 10-point SaFETy (Serious fighting, Friend weapon carrying, community Environment, and firearm Threats) score was derived. SaFETy was associated with firearm violence in the validation set (odds ratio [OR], 1.47 [95% CI, 1.23 to 1.79]); this association remained (OR, 1.44 [CI, 1.20 to 1.76]) after adjustment for reason for ED visit. In 5 risk strata observed in the training data, firearm violence rates in the validation set were 18.2% (2 of 11), 40.0% (18 of 45), 55.8% (24 of 43), 81.3% (13 of 16), and 100.0% (6 of 6), respectively. Limitations The study was conducted in a single ED and involved substance-using youths. SaFETy was not externally validated. Conclusion The SaFETy score is a 4-item score based on clinically feasible questionnaire items and is associated with firearm

Testing the effects of safety climate and disruptive children behavior on school bus drivers performance: A multilevel model.

PubMed

Zohar, Dov; Lee, Jin

2016-10-01

The study was designed to test a multilevel path model whose variables exert opposing effects on school bus drivers' performance. Whereas departmental safety climate was expected to improve driving safety, the opposite was true for in-vehicle disruptive children behavior. The driving safety path in this model consists of increasing risk-taking practices starting with safety shortcuts leading to rule violations and to near-miss events. The study used a sample of 474 school bus drivers in rural areas, driving children to school and school-related activities. Newly developed scales for measuring predictor, mediator and outcome variables were validated with video data taken from inner and outer cameras, which were installed in 29 buses. Results partially supported the model by indicating that group-level safety climate and individual-level children distraction exerted opposite effects on the driving safety path. Furthermore, as hypothesized, children disruption moderated the strength of the safety rule violation-near miss relationship, resulting in greater strength under high disruptiveness. At the same time, the hypothesized interaction between the two predictor variables was not supported. Theoretical and practical implications for studying safety climate in general and distracted driving in particular for professional drivers are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

School safe driving climate: Theoretical and practical considerations for promoting teen driver safety in school settings.

PubMed

Mirman, Jessica H; Roche, Brianne; Higgins-D'Alessandro, Ann

2018-06-21

The aims of this study were to extend the current literature on school climate that is focused on understanding how teacher, administrator, and student perceptions about driving-focused aspects of the social, educational, and institutional climate of schools can affect students' achievement, behavior, and adjustment towards the development of the concept of school safe driving climate (SSDC) and initiate the development of tools and processes for assessing SSDC. A mixed-methods approach was used to develop an initial version of a survey-based measure of SSDC that involved self-report surveys (students) and in-depth interviews (teachers). Exploratory factor analytic procedures identified SSDC constructs and a regression framework was used to examine associations among SSDC constructs and self-reported driver behaviors. Qualitative data were subjected to inductive analysis, with a goal of elucidating teachers' perspectives on SSDC and an SSDC intervention. The study sample consisted of 947 adolescents (48% male) from one large high school and 44 teacher advisors. Participants were recruited from a school participating in a state-wide effort to promote transportation safety through peer-led programming. Two SSDC factors were identified: Administrative Contributions to School Safety and Value of School Safety, which were associated with adolescents' perceptions of their driving behaviors. Adolescents' perceived that the intervention affected administrative safety. Teacher interviews contextualized these results and provided guidance on program revisions. Safe driving climate may be an important, modifiable, and measurable aspect of school climate. Additional research is needed to refine the assessment tool and to use it in longitudinal and experimental studies.

Climate change in safety assessment of a surface disposal facility

NASA Astrophysics Data System (ADS)

Leterme, B.

2012-04-01

The Belgian Agency for Radioactive Waste and Enriched Fissile Materials (ONDRAF/NIRAS) aims to develop a surface disposal facility for LILW-SL in Dessel (North-East of Belgium). Given the time scale of interest for the safety assessment (several millennia), a number of parameters in the modelling chain near field - geosphere - biosphere may be influenced by climate change. The present study discusses how potential climate change impact was accounted for the following quantities: (i) near field infiltration through the repository earth cover, (ii) partial pressure of CO2 in the water infiltrating the cover and draining the concrete, and (iii) groundwater recharge in the vicinity of the site. For these three parameters, the impact of climate change is assessed using climatic analogue stations, i.e. stations presently under climatic conditions corresponding to a given climate state. Results indicate that : (i) Using Gijon (Spain) as representative analogue station for the next millennia, infiltration at the bottom of the soil layer towards the modules of the facility is expected to increase (from 346 to 413 mm/y) under a subtropical climate. Although no colder climate is foreseen in the next 10 000 years, the approach was also tested with analogue stations for a colder climate state. Using Sisimiut (Greenland) as representative analogue station, infiltration is expected to decrease (109 mm/y). (ii) Due to changes of the partial pressure of CO2 in the soil water, cement degradation is estimated to occur more rapidly under a warmer climate. (iii) A decrease of long-term annual average groundwater recharge by 12% was simulated using Gijon representative analogue (from 314 to 276 mm), although total rainfall was higher (947 mm) in the warmer climate compared to the current temperate climate (899 mm). For a colder climate state, groundwater recharge simulated for the representative analogue Sisimiut showed a decrease by 69% compared to current climate conditions. The

Patient safety climate in general public hospitals in China: differences associated with department and job type based on a cross-sectional survey.

PubMed

Zhou, Ping; Bai, Fei; Tang, Hui-Qin; Bai, Jie; Li, Min-Qi; Xue, Di

2018-04-17

This study analysed differences in the perceived patient safety climate among different working departments and job types in public general hospitals in China. Cross-sectional survey. Eighteen tertiary hospitals and 36 secondary hospitals from 10 areas in Shanghai, Hubei Province and Gansu Province, China. Overall, 4753 staff, including physicians, nurses, medical technicians and managers, were recruited from March to June 2015. The Patient Safety Climate in Healthcare Organisations (PSCHO) tool and the percentages of 'problematic responses' (PPRs) were used as outcome measures. Multivariable two-level random intercept models were applied in the analysis. A total of 4121 valid questionnaires were collected. Perceptions regarding the patient safety climate varied among departments and job types. Physicians responded with relatively more negative evaluations of 'organisational resources for safety', 'unit recognition and support for safety efforts', 'psychological safety', 'problem responsiveness' and overall safety climate. Paediatrics departments, intensive care units, emergency departments and clinical auxiliary departments require more attention. The PPRs for 'fear of blame and punishment' were universally significantly high, and the PPRs for 'fear of shame' and 'provision of safe care' were remarkably high, especially in some departments. Departmental differences across all dimensions and the overall safety climate primarily depended on job type. The differences suggest that strategies and measures for improving the patient safety climate should be tailored by working department and job type. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study.

PubMed

Erestam, Sofia; Haglind, Eva; Bock, David; Andersson, Annette Erichsen; Angenete, Eva

2017-01-01

Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention. At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure. There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed. NCT02329691.

Creating an environment for patient safety and teamwork training in the operating theatre: A quasi-experimental study.

PubMed

Wallin, Carl-Johan; Kalman, Sigridur; Sandelin, Annika; Färnert, May-Lena; Dahlstrand, Ursula; Jylli, Leena

2015-03-01

Positive safety and a teamwork climate in the training environment may be a precursor for successful teamwork training. This pilot project aimed to implement and test whether a new interdisciplinary and team-based approach would result in a positive training climate in the operating theatre. A 3-day educational module for training the complete surgical team of specialist nursing students and residents in safe teamwork skills in an authentic operative theatre, named Co-Op, was implemented in a university hospital. Participants' (n=22) perceptions of the 'safety climate' and the 'teamwork climate', together with their 'readiness for inter-professional learning', were measured to examine if the Co-Op module produced a positive training environment compared with the perceptions of a control group (n=11) attending the conventional curriculum. The participants' perceptions of 'safety climate' and 'teamwork climate' and their 'readiness for inter-professional learning' scores were significantly higher following the Co-Op module compared with their perceptions following the conventional curriculum, and compared with the control group's perceptions following the conventional curriculum. The Co-Op module improved 'safety climate' and 'teamwork climate' in the operating theatre, which suggests that a deliberate and designed educational intervention can shape a learning environment as a model for the establishment of a safety culture.

Climate change and food safety: an emerging issue with special focus on Europe.

PubMed

Miraglia, M; Marvin, H J P; Kleter, G A; Battilani, P; Brera, C; Coni, E; Cubadda, F; Croci, L; De Santis, B; Dekkers, S; Filippi, L; Hutjes, R W A; Noordam, M Y; Pisante, M; Piva, G; Prandini, A; Toti, L; van den Born, G J; Vespermann, A

2009-05-01

According to general consensus, the global climate is changing, which may also affect agricultural and livestock production. The potential impact of climate change on food security is a widely debated and investigated issue. Nonetheless, the specific impact on safety of food and feed for consumers has remained a less studied topic. This review therefore identifies the various food safety issues that are likely to be affected by changes in climate, particularly in Europe. Amongst the issues identified are mycotoxins formed on plant products in the field or during storage; residues of pesticides in plant products affected by changes in pest pressure; trace elements and/or heavy metals in plant products depending on changes in their abundance and availability in soils; polycyclic aromatic hydrocarbons in foods following changes in long-range atmospheric transport and deposition into the environment; marine biotoxins in seafood following production of phycotoxins by harmful algal blooms; and the presence of pathogenic bacteria in foods following more frequent extreme weather conditions, such as flooding and heat waves. Research topics that are amenable to further research are highlighted.

Patient safety climate in general public hospitals in China: differences associated with department and job type based on a cross-sectional survey

PubMed Central

Zhou, Ping; Bai, Fei; Tang, Hui-qin; Bai, Jie; Li, Min-qi; Xue, Di

2018-01-01

Objective This study analysed differences in the perceived patient safety climate among different working departments and job types in public general hospitals in China. Design Cross-sectional survey. Setting Eighteen tertiary hospitals and 36 secondary hospitals from 10 areas in Shanghai, Hubei Province and Gansu Province, China. Participants Overall, 4753 staff, including physicians, nurses, medical technicians and managers, were recruited from March to June 2015. Main outcome measure The Patient Safety Climate in Healthcare Organisations (PSCHO) tool and the percentages of ‘problematic responses’ (PPRs) were used as outcome measures. Multivariable two-level random intercept models were applied in the analysis. Results A total of 4121 valid questionnaires were collected. Perceptions regarding the patient safety climate varied among departments and job types. Physicians responded with relatively more negative evaluations of ‘organisational resources for safety’, ‘unit recognition and support for safety efforts’, ‘psychological safety’, ‘problem responsiveness’ and overall safety climate. Paediatrics departments, intensive care units, emergency departments and clinical auxiliary departments require more attention. The PPRs for ‘fear of blame and punishment’ were universally significantly high, and the PPRs for ‘fear of shame’ and ‘provision of safe care’ were remarkably high, especially in some departments. Departmental differences across all dimensions and the overall safety climate primarily depended on job type. Conclusions The differences suggest that strategies and measures for improving the patient safety climate should be tailored by working department and job type. PMID:29666125

Climate resilient crops for improving global food security and safety.

PubMed

Dhankher, Om Parkash; Foyer, Christine H

2018-05-01

Food security and the protection of the environment are urgent issues for global society, particularly with the uncertainties of climate change. Changing climate is predicted to have a wide range of negative impacts on plant physiology metabolism, soil fertility and carbon sequestration, microbial activity and diversity that will limit plant growth and productivity, and ultimately food production. Ensuring global food security and food safety will require an intensive research effort across the food chain, starting with crop production and the nutritional quality of the food products. Much uncertainty remains concerning the resilience of plants, soils, and associated microbes to climate change. Intensive efforts are currently underway to improve crop yields with lower input requirements and enhance the sustainability of yield through improved biotic and abiotic stress tolerance traits. In addition, significant efforts are focused on gaining a better understanding of the root/soil interface and associated microbiomes, as well as enhancing soil properties. © 2018 The Authors Plant, Cell & Environment Published by John Wiley & Sons Ltd.

The relationship between patient safety climate and standard precaution adherence: a systematic review of the literature

PubMed Central

Hessels, Amanda; Larson, Elaine

2015-01-01

SUMMARY Standard precaution (SP) adherence is universally suboptimal, despite being a core component of healthcare-associated infection (HCAI) prevention and healthcare worker (HCW) safety. Emerging evidence suggests that patient safety climate (PSC) factors may improve HCW behaviours. Our aim was to examine the relationship between PSC and SP adherence by HCWs in acute care hospitals. A systematic review was conducted as guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Three electronic databases were comprehensively searched for literature published or available in English between 2000 and 2014. Seven of 888 articles identified were eligible for final inclusion in the review. Two reviewers independently assessed study quality using a validated quality tool. The seven articles were assigned quality scores ranging from 7 to 10 of 10 possible points. Five measured all aspects of SP and two solely measured needlestick and sharps handling. Three included a secondary outcome of HCW exposure; none included HCAIs. All reported a statistically significant relationship between better PSC and greater SP adherence and used data from self-report surveys including validated PSC measures or measures of management support and leadership. Although limited in number, studies were of high quality and confirmed that PSC and SP adherence were correlated, suggesting that efforts to improve PSC may enhance adherence to a core component of HCAI prevention and HCW safety. More clearly evident is the need for additional high-quality research. PMID:26549480

Relationships among School Climate, School Safety, and Student Achievement and Well-Being: A Review of the Literature

ERIC Educational Resources Information Center

Kutsyuruba, Benjamin; Klinger, Don A.; Hussain, Alicia

2015-01-01

School climate, safety and well-being of students are important antecedents of academic achievement. However, school members do not necessarily experience school climate in the same way; rather, their subjective perceptions of the environment and personal characteristics influence individual outcomes and behaviours. Therefore, a closer look at the…

Work environment and safety climate in the Swedish merchant fleet.

PubMed

Forsell, Karl; Eriksson, Helena; Järvholm, Bengt; Lundh, Monica; Andersson, Eva; Nilsson, Ralph

2017-02-01

To get knowledge of the work environment for seafarers sailing under the Swedish flag, in terms of safety climate, ergonomical, chemical and psychosocial exposures, and the seafarers self-rated health and work ability. A Web-based questionnaire was sent to all seafarers with a personal e-mail address in the Swedish Maritime Registry (N = 5608). Comparisons were made mainly within the study population, using Student's t test, prevalence odds ratios and logistic regressions with 95% confidence intervals. The response rate was 35% (N = 1972; 10% women, 90% men), with 61% of the respondents working on deck, 31% in the engine room and 7% in the catering/service department (1% not classifiable). Strain on neck, arm or back and heavy lifting were associated with female gender (p = 0.0001) and younger age (below or above 30 years of age, p < 0.0001). Exposures to exhausts, oils and dust were commonly reported. Major work problems were noise, risk of an accident and vibrations from the hull of the ship. The safety climate was high in comparison with that in land-based occupations. One-fourth had experienced personal harassment or bullying during last year of service. Noise, risk of accidents, hand/arm and whole-body vibrations and psychosocial factors such as harassment were commonly reported work environment problems among seafarers within the Swedish merchant fleet.

Do Safety Culture Scores in Nursing Homes Depend on Job Role and Ownership? Results from a National Survey.

PubMed

Banaszak-Holl, Jane; Reichert, Heidi; Todd Greene, M; Mody, Lona; Wald, Heidi L; Crnich, Christopher; McNamara, Sara E; Meddings, Jennifer

2017-10-01

To identify facility- and individual-level predictors of nursing home safety culture. Cross-sectional survey of individuals within facilities. Nursing homes participating in the national Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infections Project. Responding nursing home staff (N = 14,177) from 170 (81%) of 210 participating facilities. Staff responses to the Nursing Home Survey on Patient Safety Culture (NHSOPS), focused on five domains (teamwork, training and skills, communication openness, supervisor expectations, organizational learning) and individual respondent characteristics (occupation, tenure, hours worked), were merged with data on facility characteristics (from the Certification and Survey Provider Enhanced Reporting): ownership, chain membership, percentage residents on Medicare, bed size. Data were analyzed using multivariate hierarchical models. Nursing assistants rated all domains worse than administrators did (P < .001), with the largest differences for communication openness (24.3 points), teamwork (17.4 points), and supervisor expectations (16.1 points). Clinical staff rated all domains worse than administrators. Nonprofit ownership was associated with worse training and skills (by 6.0 points, P =.04) and communication openness (7.3 points, P =.004), and nonprofit and chain ownership were associated with worse supervisor expectations (5.2 points, P =.001 and 3.2 points, P =.03, respectively) and organizational learning (5.6 points, P =.009 and 4.2 points, P = .03). The percentage of variation in safety culture attributable to facility characteristics was less than 22%, with ownership having the strongest effect. Perceptions of safety culture vary widely among nursing home staff, with administrators consistently perceiving better safety culture than clinical staff who spend more time with residents. Reporting safety culture scores according to

Effects of organizational safety practices and perceived safety climate on PPE usage, engineering controls, and adverse events involving liquid antineoplastic drugs among nurses.

PubMed

DeJoy, David M; Smith, Todd D; Woldu, Henok; Dyal, Mari-Amanda; Steege, Andrea L; Boiano, James M

2017-07-01

Antineoplastic drugs pose risks to the healthcare workers who handle them. This fact notwithstanding, adherence to safe handling guidelines remains inconsistent and often poor. This study examined the effects of pertinent organizational safety practices and perceived safety climate on the use of personal protective equipment, engineering controls, and adverse events (spill/leak or skin contact) involving liquid antineoplastic drugs. Data for this study came from the 2011 National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers which included a sample of approximately 1,800 nurses who had administered liquid antineoplastic drugs during the past seven days. Regression modeling was used to examine predictors of personal protective equipment use, engineering controls, and adverse events involving antineoplastic drugs. Approximately 14% of nurses reported experiencing an adverse event while administering antineoplastic drugs during the previous week. Usage of recommended engineering controls and personal protective equipment was quite variable. Usage of both was better in non-profit and government settings, when workers were more familiar with safe handling guidelines, and when perceived management commitment to safety was higher. Usage was poorer in the absence of specific safety handling procedures. The odds of adverse events increased with number of antineoplastic drugs treatments and when antineoplastic drugs were administered more days of the week. The odds of such events were significantly lower when the use of engineering controls and personal protective equipment was greater and when more precautionary measures were in place. Greater levels of management commitment to safety and perceived risk were also related to lower odds of adverse events. These results point to the value of implementing a comprehensive health and safety program that utilizes available hazard controls and effectively communicates

Nurse characteristics, leadership, safety climate, emotional labour and intention to stay for nurses: a structural equation modelling approach.

PubMed

Liang, Hui-Yu; Tang, Fu-In; Wang, Tze-Fang; Lin, Kai-Ching; Yu, Shu

2016-12-01

The aim of this study was to propose a theoretical model and apply it to examine the structural relationships among nurse characteristics, leadership characteristics, safety climate, emotional labour and intention to stay for hospital nurses. Global nursing shortages negatively affect the quality of care. The shortages can be reduced by retaining nurses. Few studies have independently examined the relationships among leadership, safety climate, emotional labour and nurses' intention to stay; more comprehensive theoretical foundations for examining nurses' intention to stay and its related factors are lacking. Cross-sectional. A purposive sample of 414 full-time nurses was recruited from two regional hospitals in Taiwan. A structured questionnaire was used to collect data from November 2013-June 2014. Structural equation modelling was employed to test the theoretical models of the relationships among the constructs. Our data supported the theoretical model. Intention to stay was positively correlated with age and the safety climate, whereas working hours per week and emotional labour were negatively correlated. The nursing position and transformational leadership indirectly affected intention to stay; this effect was mediated separately by emotional labour and the safety climate. Our data supported the model fit. Our findings provide practical implications for healthcare organizations and administrators to increase nurses' intent to stay. Strategies including a safer climate, appropriate working hours and lower emotional labour can directly increase nurses' intent to stay. Transformational leadership did not directly influence nurses' intention to stay; however, it reduced emotional labour, thereby increasing intention to stay. © 2016 John Wiley & Sons Ltd.

Modeling the Relationship between Safety Climate and Safety Performance in a Developing Construction Industry: A Cross-Cultural Validation Study

PubMed Central

Zahoor, Hafiz; Chan, Albert P. C.; Utama, Wahyudi P.; Gao, Ran; Zafar, Irfan

2017-01-01

This study attempts to validate a safety performance (SP) measurement model in the cross-cultural setting of a developing country. In addition, it highlights the variations in investigating the relationship between safety climate (SC) factors and SP indicators. The data were collected from forty under-construction multi-storey building projects in Pakistan. Based on the results of exploratory factor analysis, a SP measurement model was hypothesized. It was tested and validated by conducting confirmatory factor analysis on calibration and validation sub-samples respectively. The study confirmed the significant positive impact of SC on safety compliance and safety participation, and negative impact on number of self-reported accidents/injuries. However, number of near-misses could not be retained in the final SP model because it attained a lower standardized path coefficient value. Moreover, instead of safety participation, safety compliance established a stronger impact on SP. The study uncovered safety enforcement and promotion as a novel SC factor, whereas safety rules and work practices was identified as the most neglected factor. The study contributed to the body of knowledge by unveiling the deviations in existing dimensions of SC and SP. The refined model is expected to concisely measure the SP in the Pakistani construction industry, however, caution must be exercised while generalizing the study results to other developing countries. PMID:28350366

Modeling the Relationship between Safety Climate and Safety Performance in a Developing Construction Industry: A Cross-Cultural Validation Study.

PubMed

Zahoor, Hafiz; Chan, Albert P C; Utama, Wahyudi P; Gao, Ran; Zafar, Irfan

2017-03-28

This study attempts to validate a safety performance (SP) measurement model in the cross-cultural setting of a developing country. In addition, it highlights the variations in investigating the relationship between safety climate (SC) factors and SP indicators. The data were collected from forty under-construction multi-storey building projects in Pakistan. Based on the results of exploratory factor analysis, a SP measurement model was hypothesized. It was tested and validated by conducting confirmatory factor analysis on calibration and validation sub-samples respectively. The study confirmed the significant positive impact of SC on safety compliance and safety participation , and negative impact on number of self-reported accidents/injuries . However, number of near-misses could not be retained in the final SP model because it attained a lower standardized path coefficient value. Moreover, instead of safety participation , safety compliance established a stronger impact on SP. The study uncovered safety enforcement and promotion as a novel SC factor, whereas safety rules and work practices was identified as the most neglected factor. The study contributed to the body of knowledge by unveiling the deviations in existing dimensions of SC and SP. The refined model is expected to concisely measure the SP in the Pakistani construction industry, however, caution must be exercised while generalizing the study results to other developing countries.

Identifying organizational cultures that promote patient safety.

PubMed

Singer, Sara J; Falwell, Alyson; Gaba, David M; Meterko, Mark; Rosen, Amy; Hartmann, Christine W; Baker, Laurence

2009-01-01

Safety climate refers to shared perceptions of what an organization is like with regard to safety, whereas safety culture refers to employees' fundamental ideology and orientation and explains why safety is pursued in the manner exhibited within a particular organization. Although research has sought to identify opportunities for improving safety outcomes by studying patterns of variation in safety climate, few empirical studies have examined the impact of organizational characteristics such as culture on hospital safety climate. This study explored how aspects of general organizational culture relate to hospital patient safety climate. In a stratified sample of 92 U.S. hospitals, we sampled 100% of senior managers and physicians and 10% of other hospital workers. The Patient Safety Climate in Healthcare Organizations and the Zammuto and Krakower organizational culture surveys measured safety climate and group, entrepreneurial, hierarchical, and production orientation of hospitals' culture, respectively. We administered safety climate surveys to 18,361 personnel and organizational culture surveys to a 5,894 random subsample between March 2004 and May 2005. Secondary data came from the 2004 American Hospital Association Annual Hospital Survey and Dun & Bradstreet. Hierarchical linear regressions assessed relationships between organizational culture and safety climate measures. Aspects of general organizational culture were strongly related to safety climate. A higher level of group culture correlated with a higher level of safety climate, but more hierarchical culture was associated with lower safety climate. Aspects of organizational culture accounted for more than threefold improvement in measures of model fit compared with models with controls alone. A mix of culture types, emphasizing group culture, seemed optimal for safety climate. Safety climate and organizational culture are positively related. Results support strategies that promote group orientation and

Investigating ethnic minorities' perceptions of safety climate in the construction industry.

PubMed

Chan, Albert P C; Wong, Francis K W; Hon, Carol K H; Lyu, Sainan; Javed, Arshad Ali

2017-12-01

An increasing number of ethnic minorities (EMs) have been employed in the construction industry to alleviate severe labor shortages in many countries. Unfortunately, statistics show that EMs have higher fatal and non-fatal occupational injury rates than their local counterparts. However, EMs are often underrepresented in safety climate (SC) research as they are difficult to reach and gauge their perception. A positive relationship has been widely found between SC and safety performance. Understanding the safety perceptions of EMs helps to reduce injuries and improve their safety performance. Based on a sample of 320 EMs from 20 companies in the construction industry, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to identify the SC factors of EMs, and validate the extracted factors, respectively. Multivariate analysis of variance was undertaken to examine mean differences in perceptions of SC by personal characteristics. Three SC factors for EMs encapsulating 16 variables were identified through EFA. The hypothesized CFA model for a three-factor structure derived from EFA showed a satisfactory goodness-of-fit, composite reliability, and construct validity. Three SC factors were identified, namely: (a) safety management commitment, safety resources, and safety communication; (b) employee's involvement and workmate's influence; and (c) perception of safety rules, procedures and risks. The perceptions of SC differed significantly by nationality, marital status, the number of family members supported, and drinking habit. This study reveals the perception of EMs toward SC. The findings highlight the areas for safety improvement and provide leading indicators for safety performance of EMs. The findings are also enlightening for countries with a number of EMs, such as the United Sates, the United Kingdom, Australia, Singapore, and the Middle East. Copyright © 2017. Published by Elsevier Ltd.

Nursing perceptions of patient safety climate in the Gaza Strip, Palestine.

PubMed

Elsous, A; Akbari Sari, A; AlJeesh, Y; Radwan, M

2017-09-01

This study was undertaken to assess the perception of nurses about patient safety culture and to test whether it is significantly affected by the nurses' position, age, experience and working hours. Patient safety has sparked the interest of healthcare mangers, yet there is limited knowledge about the current patient safety culture among nurses in the Gaza Strip. This was a descriptive cross-sectional study, administering the Arabic Safety Attitude Questionnaire (Short Form 2006) to 210 nurses in four public general hospitals. Job Satisfaction was the most highly perceived factor affecting patient safety, followed by Perception of Management. Safety culture varied across nursing position, age, work experience and working hours. Nurse Managers had more positive attitudes towards patients than frontline clinicians did. The more experience nurses had, the better their attitudes towards patient safety. Nurses who worked the minimum weekly required hours and who were 35 years and older had better attitudes towards all patient safety dimensions except for Stress Recognition. Nurses with a positive attitude had better collaboration with healthcare professionals than those without a positive attitude. Generalization is limited, as nurses who worked in private and specialized hospitals were excluded. Evaluation of the safety culture is the essential starting point to identify hindrances or drivers for safe patient care. Job Satisfaction, Perception of Management and Teamwork necessitate reinforcement, while Working Conditions, Stress Recognition and Safety Climate require improvement. Ensuring job satisfaction through adequate staffing levels, providing incentives and maintaining a collegial environment require both strategic planning and institutional policies at the higher administrative level. Creation of a non-punitive and learning environment, promoting open communication and fostering continuous education should be fundamental aspects of hospital management. A policy

Safety and operations of hydrogen fuel infrastructure in northern climates : a collaborative complex systems approach.

DOT National Transportation Integrated Search

2010-10-07

"This project examined the safety and operation of hydrogen (H2) fueling system infrastructure in : northern climates. A multidisciplinary team lead by the University of Vermont (UVM), : combined with investigators from Zhejiang and Tsinghua Universi...

Safety culture and the 5 steps to safer surgery: an intervention study.

PubMed

Hill, M R; Roberts, M J; Alderson, M L; Gale, T C E

2015-06-01

Improvements in safety culture have been postulated as one of the mechanisms underlying the association between the introduction of the World Health Organisation (WHO) Surgical Safety Checklist with perioperative briefings and debriefings, and enhanced patient outcomes. The 5 Steps to Safer Surgery (5SSS) incorporates pre-list briefings, the three steps of the WHO Surgical Safety Checklist (SSC) and post-list debriefings in one framework. We aimed to identify any changes in safety culture associated with the introduction of the 5SSS in orthopaedic operating theatres. We assessed the safety culture in the elective orthopaedic theatres of a large UK teaching hospital before and after introduction of the 5SSS using a modified version of the Safety Attitude Questionnaire - Operating Room (SAQ-OR). Primary outcome measures were pre-post intervention changes in the six safety culture domains of the SAQ-OR. We also analysed changes in responses to two items regarding perioperative briefings. The SAQ-OR survey response rate was 80% (60/75) at baseline and 74% (53/72) one yr later. There were significant improvements in both the reported frequency (P<0.001) and perceived importance (P=0.018) of briefings, and in five of the six safety culture domain scores (Working Conditions, Perceptions of Management, Job Satisfaction, Safety Climate and Teamwork Climate) of the SAQ-OR (P<0.001 in all cases). Scores in the sixth domain (Stress Recognition) decreased significantly (P=0.028). Implementation of the 5SSS was associated with a significant improvement in the safety culture of elective orthopaedic operating theatres. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A closer look at associations between hospital leadership walkrounds and patient safety climate and risk reduction: a cross-sectional study.

PubMed

Schwendimann, René; Milne, Judy; Frush, Karen; Ausserhofer, Dietmar; Frankel, Allan; Sexton, J Bryan

2013-01-01

Leadership walkrounds (WRs) are widely used in health care organizations to improve patient safety. This retrospective, cross-sectional study evaluated the association between WRs and caregiver assessments of patient safety climate and patient safety risk reduction across 49 hospitals in a nonprofit health care system. Linear regression analyses using units' participation in WRs were conducted. Survey results from 706 hospital units revealed that units with ≥ 60% of caregivers reporting exposure to at least 1 WR had a significantly higher safety climate, greater patient safety risk reduction, and a higher proportion of feedback on actions taken as a result of WRs compared with those units with <60% of caregivers reporting exposure to WRs. WR participation at the unit level reflects a frequency effect as a function of units with none/low, medium, and high leadership WR exposure.

Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions.

PubMed

Davenport, Daniel L; Henderson, William G; Mosca, Cecilia L; Khuri, Shukri F; Mentzer, Robert M

2007-12-01

Since the Institute of Medicine patient safety reports, a number of survey-based measures of organizational climate safety factors (OCSFs) have been developed. The goal of this study was to measure the impact of OCSFs on risk-adjusted surgical morbidity and mortality. Surveys were administered to staff on general/vascular surgery services during a year. Surveys included multiitem scales measuring OCSFs. Additionally, perceived levels of communication and collaboration with coworkers were assessed. The National Surgical Quality Improvement Program was used to assess risk-adjusted morbidity and mortality. Correlations between outcomes and OCSFs were calculated and between outcomes and communication/collaboration with attending and resident doctors, nurses, and other providers. Fifty-two sites participated in the survey: 44 Veterans Affairs and 8 academic medical centers. A total of 6,083 surveys were returned, for a response rate of 52%. The OCSF measures of teamwork climate, safety climate, working conditions, recognition of stress effects, job satisfaction, and burnout demonstrated internal validity but did not correlate with risk-adjusted outcomes. Reported levels of communication/collaboration with attending and resident doctors correlated with risk-adjusted morbidity. Survey-based teamwork, safety climate, and working conditions scales are not confirmed to measure organizational factors that influence risk-adjusted surgical outcomes. Reported communication/collaboration with attending and resident doctors on surgical services influenced patient morbidity. This suggests the importance of doctors' coordination and decision-making roles on surgical teams in providing high-quality and safe care. We propose risk-adjusted morbidity as an effective measure of surgical patient safety.

Work Safety Culture of Youth Farmworkers in North Carolina: A Pilot Study

PubMed Central

Kearney, Gregory D.; Rodriguez, Guadalupe; Quandt, Sara A.

2015-01-01

Objectives. We analyzed aspects of the behavioral, situational, and psychological elements of work safety culture of hired youth farmworkers in North Carolina. Methods. Data were from interviewer-administered questionnaires completed with 87 male and female hired farmworkers aged 10 to 17 years in North Carolina in 2013. We computed means, SDs, and Cronbach α values for the perceived work safety climate and safety perception summary scores. Results. Hired youth farmworkers in North Carolina described a negative work safety culture. Most engaged in unsafe general and unsafe work behaviors, few received training, and many were sexually harassed at work. They had mixed safety attitudes and knew that their employment was precarious. They reported a poor perceived work safety climate characterized by the perception that their supervisors “are only interested in doing the job fast and cheaply.” However, we could not detect statistically significant associations between work safety culture and injuries among these farmworkers. Conclusions. Increased scrutiny of agriculture as a suitable industry for workers as young as 10 years and additional regulations to protect hired youth farmworkers, if not to remove them from this environment, are warranted. Additional research is needed. PMID:25521896

Measuring organisational-level Aboriginal cultural climate to tailor cultural safety strategies.

PubMed

Gladman, Justin; Ryder, Courtney; Walters, Lucie K

2015-01-01

Australian medical schools have taken on a social accountability mandate to provide culturally safe contexts in order to encourage Aboriginal and Torres Strait Islander people to engage in medical education and to ensure that present and future clinicians provide health services that contribute to improving the health outcomes of Aboriginal and Torres Strait Islander peoples. Many programs have sought to improve cultural safety through training at an individual level; however, it is well recognised that learners tend to internalise the patterns of behaviour to which they are commonly exposed. This project aimed to measure and reflect on the cultural climate of an Australian rural clinical school (RCS) as a whole and the collective attitudes of three different professional groups: clinicians, clinical academics and professional staff. The project then drew on Mezirow's Transformative Learning theory to design strategies to build on the cultural safety of the organisation. Clinicians, academic and professional staff at an Australian RCS were invited to participate in an online survey expressing their views on Aboriginal health using part of a previously validated tool. Survey response rate was 63%. All three groups saw Aboriginal health as a social priority. All groups recognised the fundamental role of community control in Aboriginal health; however, clinical academics were considerably more likely to disagree that the Western medical model suited the health needs of Aboriginal people. Clinicians were more likely to perceive that they treated Aboriginal patients the same as other patients. There was only weak evidence of future commitments to Aboriginal health. Importantly, clinicians, academics and professional staff demonstrated differences in their cultural safety profile which indicated the need for a tailored approach to cultural safety learning in the future. Through tailored approaches to cross-cultural training opportunities we are likely to ensure

49 CFR 383.135 - Minimum passing scores.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS COMMERCIAL DRIVER'S LICENSE... score on such knowledge test. (b) To achieve a passing score on the skills test, the driver applicant...

Restaurant Inspection Scores and Foodborne Disease

PubMed Central

Pavlin, Boris I.; LaFleur, Bonnie J.; Ingram, L. Amanda; Schaffner, William

2004-01-01

Restaurants in the United States are regularly inspected by health departments, but few data exist regarding the effect of restaurant inspections on food safety. We examined statewide inspection records from January 1993 through April 2000. Data were available from 167,574 restaurant inspections. From 1993 to 2000, mean scores rose steadily from 80.2 to 83.8. Mean inspection scores of individual inspectors were 69–92. None of the 12 most commonly cited violations were critical food safety hazards. Establishments scoring <60 had a mean improvement of 16 points on subsequent inspections. Mean scores of restaurants experiencing foodborne disease outbreaks did not differ from restaurants with no reported outbreaks. A variety of factors influence the uniformity of restaurant inspections. The restaurant inspection system should be examined to identify ways to ensure food safety. PMID:15200861

Following the (Clinical Decision) Rules: Opportunities for Improving Safety and Resource Utilization With the Bacterial Meningitis Score.

PubMed

Hagedorn, Philip A; Shah, Samir S; Kirkendall, Eric S

2016-05-01

The Bacterial Meningitis Score accurately classifies children with cerebrospinal fluid (CSF) pleocytosis at very low risk (VLR) versus not very low risk (non-VLR) for bacterial meningitis. Most children with CSF pleocytosis detected during emergency department evaluation are hospitalized despite the high accuracy of this prediction rule and the decreasing incidence of bacterial meningitis. The lack of widespread use of this rule may contribute to unnecessary risk exposure and costs. This cross-sectional study included 1049 patients who, between January 2010 and May 2013, had suspicion for meningitis and underwent both a complete blood cell count and CSF studies during their emergency department evaluation. We then examined their hospitalizations to characterize exposure to drugs, radiologic studies, and the costs associated with their care to determine the safety and value repercussions of these VLR admissions. Primary outcomes include duration of antibiotics, exposure to drugs and radiology studies, safety events, and costs incurred during these VLR admissions. Twenty patients classified as VLR were admitted to the hospital. On average they received 35 hours of antibiotic therapy. There was 1 adverse drug event and 1 safety event. The VLR patients admitted to the hospital were exposed to risk and costs despite their low risk stratification. Systematic application of the Bacterial Meningitis Score could prevent these exposures and costs. Copyright © 2016 by the American Academy of Pediatrics

The culture of patient safety in an Iranian intensive care unit.

PubMed

Abdi, Zhaleh; Delgoshaei, Bahram; Ravaghi, Hamid; Abbasi, Mohsen; Heyrani, Ali

2015-04-01

To explore nurses' and physicians' attitudes and perceptions relevant to safety culture and to elicit strategies to promote safety culture in an intensive care unit. A strong safety culture is essential to ensure patient safety in the intensive care unit. This case study adopted a mixed method design. The Safety Attitude Questionnaire (SAQ-ICU version), assessing the safety climate through six domains, was completed by nurses and physicians (n = 42) in an academic intensive care unit. Twenty semi-structured interviews and document analyses were conducted as well. Interviews were analysed using a framework analysis method. Mean scores across the six domains ranged from 52.3 to 72.4 on a 100-point scale. Further analysis indicated that there were statistically significant differences between physicians' and nurses' attitudes toward teamwork (mean scores: 64.5/100 vs. 52.6/100, d = 1.15, t = 3.69, P < 0.001) and job satisfaction (mean scores: 78.2/100 vs. 57.7/100, d = 1.5, t = 4.8, P < 0.001). Interviews revealed several safety challenges including underreporting, failure to learn from errors, lack of speaking up, low job satisfaction among nurses and ineffective nurse-physician communication. The results indicate that all the domains need improvements. However, further attention should be devoted to error reporting and analysis, communication and teamwork among professional groups, and nurses' job satisfaction. Nurse managers can contribute to promoting a safety culture by encouraging staff to report errors, fostering learning from errors and addressing inter-professional communication problems. © 2013 John Wiley & Sons Ltd.

Psychological safety and error reporting within Veterans Health Administration hospitals.

PubMed

Derickson, Ryan; Fishman, Jonathan; Osatuke, Katerine; Teclaw, Robert; Ramsel, Dee

2015-03-01

In psychologically safe workplaces, employees feel comfortable taking interpersonal risks, such as pointing out errors. Previous research suggested that psychologically safe climate optimizes organizational outcomes. We evaluated psychological safety levels in Veterans Health Administration (VHA) hospitals and assessed their relationship to employee willingness of reporting medical errors. We conducted an ANOVA on psychological safety scores from a VHA employees census survey (n = 185,879), assessing variability of means across racial and supervisory levels. We examined organizational climate assessment interviews (n = 374) evaluating how many employees asserted willingness to report errors (or not) and their stated reasons. Finally, based on survey data, we identified 2 (psychologically safe versus unsafe) hospitals and compared their number of employees who would be willing/unwilling to report an error. Psychological safety increased with supervisory level (P < 0.001, η = 0.03) and was not meaningfully related to race (P < 0.001, η = 0.003). Twelve percent of employees would not report an error; retaliation fear was the most commonly mentioned deterrent. Furthermore, employees at the psychologically unsafe hospital (71% would report, 13% would not) were less willing to report an error than at the psychologically safe hospital (91% would, 0% would not). A substantial minority would not report an error and were willing to admit so in a private interview setting. Their stated reasons as well as higher psychological safety means for supervisory employees both suggest power as an important determinant. Intentions to report were associated with psychological safety, strongly suggesting this climate aspect as instrumental to improving patient safety and reducing costs.

Safety climate and the theory of planned behavior: towards the prediction of unsafe behavior.

PubMed

Fogarty, Gerard J; Shaw, Andrew

2010-09-01

The present study is concerned with the human factors that contribute to violations in aviation maintenance. Much of our previous research in this area has been based on safety climate surveys and the analysis of relations among core dimensions of climate. In this study, we tap into mainstream psychological theory to help clarify the mechanisms underlying the links between climate and behavior. Specifically, we demonstrate the usefulness of Ajzen's (1991, 2001) Theory of Planned Behavior (TPB) to understanding violation behaviors in aircraft maintenance. A questionnaire was administered to 307 aircraft maintenance workers. Constructs measured by the survey included perceptions of management attitudes to safety, own attitudes to violations, intention to violate, group norms, workplace pressures, and violations. A model based on the TPB illustrated hypothetical connections among these variables. Path analyses using AMOS suggested some theoretically justifiable modifications to the model. Fit statistics of the revised model were excellent with intentions, group norms, and personal attitudes combining to explain 50% of the variance in self-reported violations. The model highlighted the importance of management attitudes and group norms as direct and indirect predictors of violation behavior. We conclude that the TPB is a useful tool for understanding the psychological background to the procedural violations so often associated with incidents and accidents. 2009 Elsevier Ltd. All rights reserved.

An exploration of workplace social capital as an antecedent of occupational safety and health climate and outcomes in the Chinese education sector.

PubMed

Tang, Jessica Janice; Leka, Stavroula; Hunt, Nigel; MacLennan, Sara

2014-07-01

It is widely acknowledged that teachers are at greater risk of work-related health problems. At the same time, employee perceptions of different dimensions of organizational climate can influence their attitudes, performance, and well-being at work. This study applied and extended a safety climate model in the context of the education sector in Hong Kong. Apart from safety considerations alone, the study included occupational health considerations and social capital and tested their relationships with occupational safety and health (OSH) outcomes. Seven hundred and four Hong Kong teachers completed a range of questionnaires exploring social capital, OSH climate, OSH knowledge, OSH performance (compliance and participation), general health, and self-rated health complaints and injuries. Structural equation modeling (SEM) was used to analyze the relationships between predictive and outcome variables. SEM analysis revealed a high level of goodness of fit, and the hypothesized model including social capital yielded a better fit than the original model. Social capital, OSH climate, and OSH performance were determinants of both positive and negative outcome variables. In addition, social capital not only significantly predicted general health directly, but also had a predictive effect on the OSH climate-behavior-outcome relationship. This study makes a contribution to the workplace social capital and OSH climate literature by empirically assessing their relationship in the Chinese education sector.

[Analysis of the patient safety culture in hospitals of the Spanish National Health System].

PubMed

Saturno, P J; Da Silva Gama, Z A; de Oliveira-Sousa, S L; Fonseca, Y A; de Souza-Oliveira, A C; Castillo, Carmen; López, M José; Ramón, Teresa; Carrillo, Andrés; Iranzo, M Dolores; Soria, Victor; Saturno, Pedro J; Parra, Pedro; Gomis, Rafael; Gascón, Juan José; Martinez, José; Arellano, Carmen; Gama, Zenewton A Da Silva; de Oliveira-Sousa, Silvana L; de Souza-Oliveira, Adriana C; Fonseca, Yadira A; Ferreira, Marta Sobral

2008-12-01

A safety culture is essential to minimize errors and adverse events. Its measurement is needed to design activities in order to improve it. This paper describes the methods and main results of a study on safety climate in a nation-wide representative sample of public hospitals of the Spanish NHS. The Hospital Survey on Patient Safety Culture questionnaire was distributed to a random sample of health professionals in a representative sample of 24 hospitals, proportionally stratified by hospital size. Results are analyzed to provide a description of safety climate, its strengths and weaknesses. Differences by hospital size, type of health professional and service are analyzed using ANOVA. A total of 2503 responses are analyzed (response rate: 40%, (93% from professionals with direct patient contact). A total of 50% gave patient safety a score from 6 to 8 (on a 10-point scale); 95% reported < 2 events last year. Dimensions "Teamwork within hospital units" (71.8 [1.8]) and "Supervisor/Manager expectations and actions promoting safety" (61.8 [1.7]) have the highest percentage of positive answers. "Staffing", "Teamwork across hospital units", "Overall perceptions of safety" and "Hospital management support for patient safety" could be identified as weaknesses. Significant differences by hospital size, type of professional and service suggest a generally more positive attitude in small hospitals and Pharmacy services, and a more negative one in physicians. Strengths and weaknesses of the safety climate in the hospitals of the Spanish NHS have been identified and they are used to design appropriate strategies for improvement.

Assessing and addressing moral distress and ethical climate, part 1.

PubMed

Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine

2014-01-01

There is minimal research exploring moral distress and its relationship to ethical climate among nurses working in acute care settings. Objectives of the study were to explore moral distress, moral residue, and perception of ethical climate among registered nurses working in an academic medical center and develop interventions to address study findings. A mixed-methods design was used. Two versions of Corley and colleagues' Moral Distress Scale, adult and pediatric/neonatal, were used in addition to Olson's Hospital Ethical Climate Survey. Participants were invited to respond to 2 open-ended questions. This article reports the results for those nurses working in adult acute and critical care units. The sample (N = 225) was predominantly female (80%); half held a bachelor of science in nursing or higher, were aged 30 to 49 years, and staff nurses (77.3%). The mean item score for moral distress intensity ranged from 3.79 (SD, 2.21) to 2.14 (SD, 2.42) with mean item score frequency ranging from 2.86 (SD, 1.88) to 0.23 (SD, 0.93). The mean score for total Hospital Ethical Climate Survey was 94.39 (SD, 18.3) ranging from 23 to 130. Qualitative comments described bullying, lateral violence, and retribution. Inadequate staffing and perceived incompetent coworkers were the most distressing items. Almost 22% left a previous position because of moral distress and perceived the current climate to be less ethical compared with other participants. Findings may potentially impact nurse retention and recruitment and negatively affect the quality and safety of patient care. Interventions developed focus on the individual nurse, including ethics education and coping skills, intraprofessional/interprofessional approaches, and administrative/policy strategies.

Psychosocial safety climate: a multilevel theory of work stress in the health and community service sector.

PubMed

Dollard, M F; McTernan, W

2011-12-01

Work stress is widely thought to be a significant problem in the health and community services sector. We reviewed evidence from a range of different data sources that confirms this belief. High levels of psychosocial risk factors, psychological health problems and workers compensation claims for stress are found in the sector. We propose a multilevel theoretical model of work stress to account for the results. Psychosocial safety climate (PSC) refers to a climate for psychological health and safety. It reflects the balance of concern by management about psychological health v. productivity. By extending the health erosion and motivational paths of the Job Demands-Resources model we propose that PSC within work organisations predicts work conditions and in turn psychological health and engagement. Over and above this, however, we expect that the external environment of the sector particularly government policies, driven by economic rationalist ideology, is increasing work pressure and exhaustion. These conditions are likely to lead to a reduced quality of service, errors and mistakes.

Non-reporting of work injuries and aspects of jobsite safety climate and behavioral-based safety elements among carpenters in Washington State.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid

2015-04-01

Declining work injury rates may reflect safer work conditions as well as under-reporting. Union carpenters were invited to participate in a mailed, cross-sectional survey designed to capture information about injury reporting practices. Prevalence of non-reporting and fear of repercussions for reporting were compared across exposure to behavioral-based safety elements and three domains of the Nordic Safety Climate Questionnaire (NOSACQ-50). The majority (>75%) of the 1,155 participants felt they could report work-related injuries to their supervisor without fear of retribution, and most felt that the majority of injuries on their jobsites got reported. However, nearly half indicated it was best not to report minor injuries, and felt pressures to use their private insurance for work injury care. The prevalence of non-reporting and fear of reporting increased markedly with poorer measures of management safety justice (NOSACQ-50). Formal and informal policies and practices on jobsites likely influence injury reporting. © 2015 Wiley Periodicals, Inc.

Worksite safety climate, smoking, and the use of protective equipment by blue collar building workers enrolled in the MassBUILT smoking cessation trial

PubMed Central

Dutra, Lauren M; Kim, Seung-Sup; Williams, David R; Kawachi, Ichiro; Okechukwu, Cassandra A

2014-01-01

Objective In order to assess potential contributors to high injury rates and smoking prevalence among construction workers, we investigated the association of safety climate with personal protective equipment (PPE) use, and smoking behaviors. Methods Logistic regression models estimated risk ratios for PPE use and smoking using data from participants in MassBUILT smoking cessation intervention (n=1,725). Results Contractor safety climate was negatively associated with use of dust masks (RR=0.88,95%CI:0.83–0.94); respirators (RR=0.82,95%CI:0.75–0.89); general equipment (RR=0.98,95%CI:0.95–1.00); and fall protection (RR=0.94,95%CI:0.91–0.98) and positively associated with current smoking (RR=1.12,95%CI:1.01–1.25) but not smoking cessation. Coworker safety climate was negatively associated with use of dust masks (RR=0.87,95%CI:0.82–0.92); respirators (RR=0.80,95%CI:0.74–0.87); general equipment (RR=0.96,95%CI:0.94–0.98); fall (RR=0.92,95%CI:0.89–0.96) and hearing (RR=0.88,95%CI:0.83–0.93) protection but not smoking. Conclusions Worksite safety climate may be important for PPE use and smoking, but further research is needed. PMID:25285831

Evaluation of a safety training program in three food service companies.

PubMed

Sinclair, Raymond C; Smith, Randall; Colligan, Michael; Prince, Mary; Nguyen, Trang; Stayner, Leslie

2003-01-01

Outcome measures for safety training effectiveness research often do not include measures such as occupational injury experience. Effectiveness mediators also receive sparse attention. A new safety training curriculum was delivered to workers in a stratified random sample of food service facilities across three companies. A similar group of facilities received usual training. We collected post-test measures of demographic variables, safety knowledge, perceptions of transfer of training climate, and workers' compensation claim data for one year after the initial training activities. Knowledge test scores were apparently higher in the new-training units than in the usual-training units. Some demographic variables were inconsistently associated with these differences. Evidence for reduction of the injury rate associated with the new training was observed from two companies but only approached significance for one company. A second company revealed a similar but non-significant trend. Knowledge scores were not significantly associated with lower injury rates. We found evidence that safety training increases knowledge and reduces injuries. We found almost no evidence of effects of training effectiveness mediators, including no relationship between safety knowledge and injury experience. Methodological issues related to conducting a large study may have influenced these results. Although safety training leads to greater knowledge and, in some cases, reduced occupational injuries, the influence of mediating variables remains to be fully explained.

Vulnerability of global food production to extreme climatic events.

PubMed

Yeni, F; Alpas, H

2017-06-01

It is known that the frequency, intensity or duration of the extreme climatic events have been changing substantially. The ultimate goal of this study was to identify current vulnerabilities of global primary food production against extreme climatic events, and to discuss potential entry points for adaptation planning by means of an explorative vulnerability analysis. Outcomes of this analysis were demonstrated as a composite index where 118 country performances in maintaining safety of food production were compared and ranked against climate change. In order to better interpret the results, cluster analysis technique was used as a tool to group the countries based on their vulnerability index (VI) scores. Results suggested that one sixth of the countries analyzed were subject to high level of exposure (0.45-1), one third to high to very high level of sensitivity (0.41-1) and low to moderate level of adaptive capacity (0-0.59). Proper adaptation strategies for reducing the microbial and chemical contamination of food products, soil and waters on the field were proposed. Finally, availability of data on food safety management systems and occurrence of foodborne outbreaks with global coverage were proposed as key factors for improving the robustness of future vulnerability assessments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Climate Change Resilience Planning at the Department of Energy's Savannah River Site

NASA Astrophysics Data System (ADS)

Werth, D. W.; Johnson, A.

2015-12-01

The Savannah River National Laboratory (SRNL) is developing a site sustainability plan for the Department of Energy's Savannah River Site (SRS) in South Carolina in accordance with Executive Order 13693, which charges each DOE agency with "identifying and addressing projected impacts of climate change" and "calculating the potential cost and risk to mission associated with agency operations". The plan will comprise i) projections of climate change, ii) surveys of site managers to estimate the effects of climate change on site operations, and iii) a determination of adaptive actions. Climate change projections for SRS are obtained from multiple sources, including an online repository of downscaled global climate model (GCM) simulations of future climate and downscaled GCM simulations produced at SRNL. Taken together, we have projected data for temperature, precipitation, humidity, and wind - all variables with a strong influence on site operations. SRNL is working to engage site facility managers and facilitate a "bottom up" approach to climate change resilience planning, where the needs and priorities of stakeholders are addressed throughout the process. We make use of the Vulnerability Assessment Scoring Tool, an Excel-based program designed to accept as input various climate scenarios ('exposure'), the susceptibility of assets to climate change ('sensitivity'), and the ability of these assets to cope with climate change ('adaptive capacity'). These are combined to produce a series of scores that highlight vulnerabilities. Working with site managers, we have selected the most important assets, estimated their expected response to climate change, and prepared a report highlighting the most endangered facilities. Primary risks include increased energy consumption, decreased water availability, increased forest fire danger, natural resource degradation, and compromised outdoor worker safety in a warmer and more humid climate. Results of this study will aid in driving

Public and Private Hospital Nurses’ Perceptions of the Ethical Climate in Their Work Settings, Sari City, 2011

PubMed Central

Ghorbani, Ali Asghar; Hesamzadeh, Ali; Khademloo, Mohammad; Khalili, Salimeh; Hesamzadeh, Shamim; Berger, Valerie

2014-01-01

Background: Nurses’ perceptions of ethical climate patterns have certain undeniable effects on hospitals. There is little evidence of possible differences in this element between public and private hospitals and contributing factors. Objectives: This study investigated whether the perceptions of the ethical climate in nurses’ working in public hospitals differ from that of nurses in private hospitals, and which factors may affect nurses’ perceptions. Materials and Methods: A cross-sectional study of randomly selected registered nurses (n = 235), working in four public hospitals affiliated to Mazandaran University of Medical Sciences, and three private hospitals, was conducted in Sari City, Iran. A self-administered questionnaire, containing demographic characteristics and the Hospital Ethical Climate Survey (HECS), were used to assess registered nurses’ perceptions of public and private hospitals ethical climate. An independent t-test and one-way ANOVA were used to analyze the data. Results: Across the five factors of HECS, the highest and lowest mean scores pertained to managers and physicians, respectively, in both public and private hospitals. Nurses who had a conditional employment situation and those working in pediatric intensive care units showed significantly more positive perceptions of the ethical work climate when compared to their peers (P < 0.05). Although the mean score of ethical work climate in private hospitals (3.82 ± 0.61) was higher than that in public hospitals (3.76 ± 0.54), no significant difference was found (P = 0.44). Conclusions: Hospital managers need to discover better ways to promote safety and health programs for their staff according to nurses’ area of work and their type of units. They should also encourage greater levels of participation in safety-enhancing initiatives in the hospital’s ethical climate, especially in the areas of nurses’ perceptions of their physician colleagues, and for nurses with a conditional

Influence of climate on landscape characteristics in safety assessments of repositories for radioactive wastes.

PubMed

Becker, J K; Lindborg, T; Thorne, M C

2014-12-01

In safety assessments of repositories for radioactive wastes, large spatial and temporal scales have to be considered when developing an approach to risk calculations. A wide range of different types of information may be required. Local to the site of interest, temperature and precipitation data may be used to determine the erosional regime (which may also be conditioned by the vegetation characteristics adopted, based both on climatic and other considerations). However, geomorphological changes may be governed by regional rather than local considerations, e.g. alteration of river base levels, river capture and drainage network reorganisation, or the progression of an ice sheet or valley glacier across the site. The regional climate is in turn governed by the global climate. In this work, a commentary is presented on the types of climate models that can be used to develop projections of climate change for use in post-closure radiological impact assessments of geological repositories for radioactive wastes. These models include both Atmosphere-Ocean General Circulation Models and Earth Models of Intermediate Complexity. The relevant outputs available from these models are identified and consideration is given to how these outputs may be used to inform projections of landscape development. Issues of spatial and temporal downscaling of climate model outputs to meet the requirements of local-scale landscape development modelling are also addressed. An example is given of how climate change and landscape development influence the radiological impact of radionuclides potentially released from the deep geological disposal facility for spent nuclear fuel that SKB (the Swedish Nuclear Fuel and Waste Management Company) proposes to construct at Forsmark, Sweden. Copyright © 2014 Elsevier Ltd. All rights reserved.

Climate change and landscape development in post-closure safety assessment of solid radioactive waste disposal: Results of an initiative of the IAEA.

PubMed

Lindborg, T; Thorne, M; Andersson, E; Becker, J; Brandefelt, J; Cabianca, T; Gunia, M; Ikonen, A T K; Johansson, E; Kangasniemi, V; Kautsky, U; Kirchner, G; Klos, R; Kowe, R; Kontula, A; Kupiainen, P; Lahdenperä, A-M; Lord, N S; Lunt, D J; Näslund, J-O; Nordén, M; Norris, S; Pérez-Sánchez, D; Proverbio, A; Riekki, K; Rübel, A; Sweeck, L; Walke, R; Xu, S; Smith, G; Pröhl, G

2018-03-01

The International Atomic Energy Agency has coordinated an international project addressing climate change and landscape development in post-closure safety assessments of solid radioactive waste disposal. The work has been supported by results of parallel on-going research that has been published in a variety of reports and peer reviewed journal articles. The project is due to be described in detail in a forthcoming IAEA report. Noting the multi-disciplinary nature of post-closure safety assessments, here, an overview of the work is given to provide researchers in the broader fields of radioecology and radiological safety assessment with a review of the work that has been undertaken. It is hoped that such dissemination will support and promote integrated understanding and coherent treatment of climate change and landscape development within an overall assessment process. The key activities undertaken in the project were: identification of the key processes that drive environmental change (mainly those associated with climate and climate change), and description of how a relevant future may develop on a global scale; development of a methodology for characterising environmental change that is valid on a global scale, showing how modelled global changes in climate can be downscaled to provide information that may be needed for characterising environmental change in site-specific assessments, and illustrating different aspects of the methodology in a number of case studies that show the evolution of site characteristics and the implications for the dose assessment models. Overall, the study has shown that quantitative climate and landscape modelling has now developed to the stage that it can be used to define an envelope of climate and landscape change scenarios at specific sites and under specific greenhouse-gas emissions assumptions that is suitable for use in quantitative post-closure performance assessments. These scenarios are not predictions of the future, but

Safety climate and workplace violence prevention in state-run residential addiction treatment centers.

PubMed

Lipscomb, Jane A; London, M; Chen, Y M; Flannery, K; Watt, M; Geiger-Brown, J; Johnson, J V; McPhaul, K

2012-01-01

To examine the association between violence prevention safety climate measures and self reported violence toward staff in state-run residential addiction treatment centers. In mid-2006, 409 staff from an Eastern United States state agency that oversees a system of thirteen residential addiction treatment centers (ATCs) completed a self-administered survey as part of a comprehensive risk assessment. The survey was undertaken to identify and measure facility-level risk factors for violence, including staff perceptions of the quality of existing US Occupational Safety and Health Administration (OSHA) program elements, and ultimately to guide violence prevention programming. Key informant interviews and staff focus groups provided researchers with qualitative data with which to understand safety climate and violence prevention efforts within these work settings. The frequency with which staff reported experiencing violent behavior ranged from 37% for "clients raised their voices in a threatening way to you" to 1% for "clients pushed, hit, kicked, or struck you". Findings from the staff survey included the following significant predictors of violence: "client actively resisting program" (OR=2.34, 95% CI=1.35, 4.05), "working with clients for whom the history of violence is unknown" (OR=1.91, 95% CI=1.18, 3.09) and "management commitment to violence prevention" reported as "never/hardly ever" and "seldom or sometimes" (OR=4.30 and OR=2.31 respectively), while controlling for other covariates. We utilized a combination of qualitative and quantitative research methods to begin to describe the risk and potential for violence prevention in this setting. The prevalence of staff physical violence within the agency's treatment facilities was lower than would be predicted. Possible explanations include the voluntary nature of treatment programs; strong policies and consequences for resident behavior and ongoing quality improvement efforts. Quantitative data identified low

Predicting Circulatory Diseases from Psychosocial Safety Climate: A Prospective Cohort Study from Australia

PubMed Central

Becher, Harry; Dollard, Maureen F.; Smith, Peter

2018-01-01

Circulatory diseases (CDs) (including myocardial infarction, angina, stroke or hypertension) are among the leading causes of death in the world. In this paper, we explore for the first time the impact of a specific aspect of organizational climate, Psychosocial Safety Climate (PSC), on CDs. We used two waves of interview data from Australia, with an average lag of 5 years (excluding baseline CDs, final n = 1223). Logistic regression was conducted to estimate the prospective associations between PSC at baseline on incident CDs at follow-up. It was found that participants in low PSC environments were 59% more likely to develop new CD than those in high PSC environments. Logistic regression showed that high PSC at baseline predicts lower CD risk at follow-up (OR = 0.98, 95% CI 0.96–1.00) and this risk remained unchanged even after additional adjustment for known job design risk factors (effort reward imbalance and job strain). These results suggest that PSC is an independent risk factor for CDs in Australia. Beyond job design this study implicates organizational climate and prevailing management values regarding worker psychological health as the genesis of CDs. PMID:29495533

Professional environment and patient safety in emergency departments.

PubMed

Lambrou, Persefoni; Papastavrou, Evridiki; Merkouris, Anastasios; Middleton, Nicos

2015-04-01

The purpose of this study was to examine nurses' and physicians' perceptions of professional environment and its association with patient safety in public emergency departments in Cyprus. A total of 224 professionals (174 nurses and 50 physicians) participated (rr = 81%). Data were collected using the "Revised Professional Practice Environment" (RPPE) instrument and the Safety Climate Domain of the "Emergency Medical Services Safety Attitudes Questionnaire" (EMS-SAQ). The mean overall score of RPPE was 2.79 (SD = 0.30), among physicians 2.84 (SD = 0.25) and nurses 2.73 (SD = 0.33) (P-value = 0.07). Statistically significant differences were observed between the two study groups regarding "staff relationships", "motivation" and "cultural sensitivity" (P-values < 0.05). No significant differences were observed as regards EMS-SAQ (3.25 vs. 3.16 respectively; P-value = 0.28). All 8 components of the RPPE exhibited significant association with patient safety. Linear and stepwise regression analyses showed that "leadership" explains 28% of the variance of safety. This relationship suggests improvements in professional environment with the ultimate goal of improving patient safety. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reaping the Benefits of Task Conflict in Teams: The Critical Role of Team Psychological Safety Climate

ERIC Educational Resources Information Center

Bradley, Bret H.; Postlethwaite, Bennett E.; Klotz, Anthony C.; Hamdani, Maria R.; Brown, Kenneth G.

2012-01-01

Past research suggests that task conflict may improve team performance under certain conditions; however, we know little about these specific conditions. On the basis of prior theory and research on conflict in teams, we argue that a climate of psychological safety is one specific context under which task conflict will improve team performance.…

Patient safety climate (PSC) perceptions of frontline staff in acute care hospitals: examining the role of ease of reporting, unit norms of openness, and participative leadership.

PubMed

Zaheer, Shahram; Ginsburg, Liane; Chuang, You-Ta; Grace, Sherry L

2015-01-01

Increased awareness regarding the importance of patient safety issues has led to the proliferation of theoretical conceptualizations, frameworks, and articles that apply safety experiences from high-reliability industries to medical settings. However, empirical research on patient safety and patient safety climate in medical settings still lags far behind the theoretical literature on these topics. The broader organizational literature suggests that ease of reporting, unit norms of openness, and participative leadership might be important variables for improving patient safety. The aim of this empirical study is to examine in detail how these three variables influence frontline staff perceptions of patient safety climate within health care organizations. A cross-sectional study design was used. Data were collected using a questionnaire composed of previously validated scales. The results of the study show that ease of reporting, unit norms of openness, and participative leadership are positively related to staff perceptions of patient safety climate. Health care management needs to involve frontline staff during the development and implementation stages of an error reporting system to ensure staff perceive error reporting to be easy and efficient. Senior and supervisory leaders at health care organizations must be provided with learning opportunities to improve their participative leadership skills so they can better integrate frontline staff ideas and concerns while making safety-related decisions. Finally, health care management must ensure that frontline staff are able to freely communicate safety concerns without fear of being punished or ridiculed by others.

A Systematic Review of Primary Care Safety Climate Survey Instruments: Their Origins, Psychometric Properties, Quality, and Usage.

PubMed

Curran, Ciara; Lydon, Sinéad; Kelly, Maureen; Murphy, Andrew; Walsh, Chloe; OʼConnor, Paul

2018-06-01

Safety climate (SC) measurement is a common and feasible method of proactive safety assessment in primary care. However, there is no consensus on which instrument is "best" to use. The aim of the study was to identify the origins, psychometric properties, quality, and SC domains measured by survey instruments used to assess SC in primary care settings. Systematic searches were conducted using Medline, Embase, CINAHL, and PsycInfo in February 2016. English-language, peer-reviewed studies that reported the development and/or use of a SC survey in a primary care setting were included. Two reviewers independently extracted data (survey characteristics, origins, and psychometric properties) from studies and applied the Quality Assessment Tool for Studies with Diverse Designs to assess methodological rigour. Safety climate domains within surveys were deductively analyzed and categorized into common healthcare SC themes. Seventeen SC surveys were identified, of which 16 had been adapted from 2 main U.S. hospital-based surveys. Only 1 survey was developed de novo for a primary care setting. The quantity and quality of psychometric testing varied considerably across the surveys. Management commitment to safety was the most frequently measured SC theme (87.5%). Workload was infrequently measured (25%). Valid and reliable instruments, which are context specific to the healthcare environment for intentional use, are essential to accurately assess SC. Key recommendations include further establishing the construct and criterion-related validity of existing instruments as opposed to developing additional surveys.

Comparing two safety culture surveys: safety attitudes questionnaire and hospital survey on patient safety.

PubMed

Etchegaray, Jason M; Thomas, Eric J

2012-06-01

To examine the reliability and predictive validity of two patient safety culture surveys-Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPS)-when administered to the same participants. Also to determine the ability to convert HSOPS scores to SAQ scores. Employees working in intensive care units in 12 hospitals within a large hospital system in the southern United States were invited to anonymously complete both safety culture surveys electronically. All safety culture dimensions from both surveys (with the exception of HSOPS's Staffing) had adequate levels of reliability. Three of HSOPS's outcomes-frequency of event reporting, overall perceptions of patient safety, and overall patient safety grade-were significantly correlated with SAQ and HSOPS dimensions of culture at the individual level, with correlations ranging from r=0.41 to 0.65 for the SAQ dimensions and from r=0.22 to 0.72 for the HSOPS dimensions. Neither the SAQ dimensions nor the HSOPS dimensions predicted the fourth HSOPS outcome-number of events reported within the last 12 months. Regression analyses indicated that HSOPS safety culture dimensions were the best predictors of frequency of event reporting and overall perceptions of patient safety while SAQ and HSOPS dimensions both predicted patient safety grade. Unit-level analyses were not conducted because indices did not indicate that aggregation was appropriate. Scores were converted between the surveys, although much variance remained unexplained. Given that the SAQ and HSOPS had similar reliability and predictive validity, investigators and quality and safety leaders should consider survey length, content, sensitivity to change and the ability to benchmark when selecting a patient safety culture survey.

Safety Climate of Commercial Vehicle Operation

DOT National Transportation Integrated Search

2010-03-01

Enhancing the safety culture within trucking and motor coach industries has become a key area of concern given the potential impact it has on crashes and overall safety. Many organizations recognize that safety is compromised if the culture within th...

Examining the validity of AHRQ's patient safety indicators (PSIs): is variation in PSI composite score related to hospital organizational factors?

PubMed

Shin, Marlena H; Sullivan, Jennifer L; Rosen, Amy K; Solomon, Jeffrey L; Dunn, Edward J; Shimada, Stephanie L; Hayes, Jennifer; Rivard, Peter E

2014-12-01

Increasing use of Agency for Healthcare Research and Quality's Patient Safety Indicators (PSIs) for hospital performance measurement intensifies the need to critically assess their validity. Our study examined the extent to which variation in PSI composite score is related to differences in hospital organizational structures or processes (i.e., criterion validity). In site visits to three Veterans Health Administration hospitals with high and three with low PSI composite scores ("low performers" and "high performers," respectively), we interviewed a cross-section of hospital staff. We then coded interview transcripts for evidence in 13 safety-related domains and assessed variation across high and low performers. Evidence of leadership and coordination of work/communication (organizational process domains) was predominantly favorable for high performers only. Evidence in the other domains was either mixed, or there were insufficient data to rate the domains. While we found some evidence of criterion validity, the extent to which variation in PSI rates is related to differences in hospitals' organizational structures/processes needs further study. © The Author(s) 2014.

Safety leadership: extending workplace safety climate best practices across health care workforces.

PubMed

McCaughey, Deirdre; Halbesleben, Jonathon R B; Savage, Grant T; Simons, Tony; McGhan, Gwen E

2013-01-01

Hospitals within the United States consistently have injury rates that are over twice the national employee injury rate. Hospital safety studies typically investigate care providers rather than support service employees. Compounding the lack of evidence for this understudied population is the scant evidence that is available to examine the relationship of support service employees'perceptions of safety and work-related injuries. To examine this phenomenon, the purpose of this study was to investigate support service employees' perceptions of safety leadership and social support as well as the relationship of safety perception to levels of reported injuries. A nonexperimental survey was conducted with the data collected from hospital support service employees (n = 1,272) and examined. (1) relationships between safety leadership (supervisor and organization) and individual and unit safety perceptions; (2) the moderating effect of social support (supervisor and coworker) on individual and unit safety perceptions; and (3) the relationship of safety perception to reported injury rates. The survey items in this study were based on the items from the AHRQ Patient Safety Culture Survey and the U.S. National Health Care Surveys. Safety leadership (supervisor and organization) was found to be positively related to individual safety perceptions and unit safety grade as was supervisor and coworker support. Coworker support was found to positively moderate the following relationships: supervisor safety leadership and safety perceptions, supervisor safety leadership and unit safety grade, and senior management safety leadership and safety perceptions. Positive employee safety perceptions were found to have a significant relationship with lower reported injury rates. These findings suggest that safety leadership from supervisors and senior management as well as coworker support has positive implications for support service employees' perceptions of safety, which, in turn, are

Safety climate in the federal fire management community: Influences of organizational, environmental, group, and individual characteristics (Abstract)

Treesearch

Brooke Baldauf McBride; Anne E. Black

2012-01-01

This study examined the effects of organizational, environmental, group and individual characteristics on five components of safety climate in the US federal fire management community (HRO Practices, Leadership, Group Culture, Learning Orientation and Mission Clarity). Multiple analyses of variance revealed that all types of characteristics had a significant effect on...

The Safety of Ovarian Preservation in Stage I Endometrial Endometrioid Adenocarcinoma Based on Propensity Score Matching.

PubMed

Hou, Ting; Sun, Yidi; Li, Junyi; Liu, Chenglin; Wang, Zhen; Li, Yixue; Lu, Yuan

2017-01-01

Most patients with early stage endometrial endometrioid adenocarcinoma (EEAC) are treated with hysterectomy and bilateral oophorectomy. But this surgical menopause leads to long-term sequelae for premenopausal women, especially for young women of childbearing age. This population-based study was to evaluate the safety of ovarian preservation in young women with stage I EEAC. Patients of age 50 or younger with stage I EEAC were explored from the Surveillance, Epidemiology and End Results program database during 2004 to 2013. Propensity score matching was used to randomize the data set and reduce the selection biases of doctors. Univariate analysis and multivariate cox proportional hazards model were utilized to estimate the safety of ovarian preservation. A total of 7183 patients were identified, and ovarian preservation was performed in 863 (12 %) patients. Compared with women treated with oophorectomy, patients with ovarian preservation significantly tend to be younger at diagnosis (P-value < 0.001) and more likely diagnosed as stage IA EEAC, to have better differentiated tumor tissues and smaller tumors, as well as less likely to undergo radiation and lymphadenectomy. 863 patients treated with oophorectomy were selected by propensity score matching. After propensity score matching, the differences of all characteristics between ovarian preservation and oophorectomy were not significant and potential confounders in the two groups decreased. In univariate analysis of matched population, ovarian preservation had no effect on overall (P-value=0.928) and cancer-specific (P-value=0.390) mortality. In propensityadjusted multivariate analysis, ovarian preservation was not significantly associated with overall (HR=0.69, 95%CI=0.41-1.68, P-value=0.611) and cancer-specific (HR=1.65, 95%CI=0.54-5.06, Pvalue= 0.379) survival. Ovarian preservation is safe for young women with stage I EEAC, which is not significantly associated with overall and cancer-specific mortality

A study to assess the influence of interprofessional point of care simulation training on safety culture in the operating theatre environment of a university teaching hospital.

PubMed

Hinde, Theresa; Gale, Thomas; Anderson, Ian; Roberts, Martin; Sice, Paul

2016-01-01

Interprofessional point of care or in situ simulation is used as a training tool in our operating theatre directorate with the aim of improving crisis behaviours. This study aimed to assess the impact of interprofessional point of care simulation on the safety culture of operating theatres. A validated Safety Attitude Questionnaire was administered to staff members before each simulation scenario and then re-administered to the same staff members after 6-12 months. Pre- and post-training Safety Attitude Questionnaire-Operating Room (SAQ-OR) scores were compared using paired sample t-tests. Analysis revealed a statistically significant perceived improvement in both safety (p < 0.001) and teamwork (p = 0.013) climate scores (components of safety culture) 6-12 months after interprofessional simulation training. A growing body of literature suggests that a positive safety culture is associated with improved patient outcomes. Our study supports the implementation of point of care simulation as a useful intervention to improve safety culture in theatres.

Staying silent about safety issues: Conceptualizing and measuring safety silence motives.

PubMed

Manapragada, Archana; Bruk-Lee, Valentina

2016-06-01

Communication between employees and supervisors about safety-related issues is an important component of a safe workplace. When supervisors receive information from employees about safety issues, they may gain otherwise-missed opportunities to correct these issues and/or prevent negative safety outcomes. A series of three studies were conducted to identify various safety silence motives, which describe the reasons that employees do not speak up to supervisors about safety-related issues witnessed in the workplace, and to develop a tool to assess these motives. Results suggest that employees stay silent about safety issues based on perceptions of altering relationships with others (relationship-based), perceptions of the organizational climate (climate-based), the assessment of the safety issue (issue-based), or characteristics of the job (job-based). We developed a 17-item measure to assess these four motives, and initial evidence was found for the construct and incremental validity of the safety silence motives measure in a sample of nurses. Copyright © 2016 Elsevier Ltd. All rights reserved.

Perceptions of patient safety culture among healthcare employees in tertiary hospitals of Heilongjiang province in northern China: a cross-sectional study.

PubMed

Li, Ying; Zhao, Yanming; Hao, Yanhua; Jiao, Mingli; Ma, Hongkun; Teng, Baijun; Yang, Kai; Sun, Tongbo; Wu, Qunhong; Qiao, Hong

2018-04-19

Assessing the patient safety culture is necessary for improving patient safety. Research on patient safety culture has attracted considerable attention. Currently, there is little research on patient safety culture in China generally, and in Heilongjiang in northern China specifically. The aim of the study is to explore the perception of healthcare employees about patient safety culture and to determine whether perception differs per sex, age, profession, years of experience, education level and marital status. Cross-sectional study. Thirteen tertiary hospitals in Heilongjiang, northern China. About 1024 healthcare employees. The perception of healthcare employees was measured using the safety attitude questionnaire, which include six dimensions. Higher scores represented more positive attitudes. An analysis of variance was used to compare socio-demographic differences per position, marital status and education; t-tests were used for sex, age and experience. A total of 1024 (85.33%) valid questionnaires were returned. The mean score of the six dimensions was 73.74/100; work conditions (80.19) had the highest score of all the dimensions, and safety climate (70.48) had the lowest. Across distinct dimensions, there were significant differences in perceptions of patient safety culture per sex, age, years of experience, position, marital status and education level (P < 0.05). The findings can help in assessing perceived patient safety culture among healthcare employees and identifying dimensions that require improvement. Interventions aimed at specific socio-demographic groups are necessary to improve patient safety culture.

Safety climate in the US federal wildland fire management community: influences of organizational, environmental, group, and individual characteristics

Treesearch

Anne E. Black; Brooke Baldauf McBride

2013-01-01

This study examined the effects of organisational, environmental, group and individual characteristics on five components of safety climate (High Reliability Organising Practices, Leadership, Group Culture, Learning Orientation and Mission Clarity) in the US federal wildland fire management community. Of particular interest were differences between perceptions based on...

Effects of a team-based assessment and intervention on patient safety culture in general practice: an open randomised controlled trial.

PubMed

Hoffmann, B; Müller, V; Rochon, J; Gondan, M; Müller, B; Albay, Z; Weppler, K; Leifermann, M; Mießner, C; Güthlin, C; Parker, D; Hofinger, G; Gerlach, F M

2014-01-01

The measurement of safety culture in healthcare is generally regarded as a first step towards improvement. Based on a self-assessment of safety culture, the Frankfurt Patient Safety Matrix (FraTrix) aims to enable healthcare teams to improve safety culture in their organisations. In this study we assessed the effects of FraTrix on safety culture in general practice. We conducted an open randomised controlled trial in 60 general practices. FraTrix was applied over a period of 9 months during three facilitated team sessions in intervention practices. At baseline and after 12 months, scores were allocated for safety culture as expressed in practice structure and processes (indicators), in safety climate and in patient safety incident reporting. The primary outcome was the indicator error management. During the team sessions, practice teams reflected on their safety culture and decided on about 10 actions per practice to improve it. After 12 months, no significant differences were found between intervention and control groups in terms of error management (competing probability=0.48, 95% CI 0.34 to 0.63, p=0.823), 11 further patient safety culture indicators and safety climate scales. Intervention practices showed better reporting of patient safety incidents, reflected in a higher number of incident reports (mean (SD) 4.85 (4.94) vs 3.10 (5.42), p=0.045) and incident reports of higher quality (scoring 2.27 (1.93) vs 1.49 (1.67), p=0.038) than control practices. Applied as a team-based instrument to assess safety culture, FraTrix did not lead to measurable improvements in error management. Comparable studies with more positive results had less robust study designs. In future research, validated combined methods to measure safety culture will be required. In addition, more attention should be paid to evaluation of process parameters. Implemented actions and incident reporting may be more appropriate target endpoints. German Clinical Trials Register (Deutsches Register

School Climate Research Summary: August 2012. School Climate Brief, Number 3

ERIC Educational Resources Information Center

Thapa, Amrit; Cohen, Jonathan; Higgins-D'Alessandro, Ann; Guffey, Shawn

2012-01-01

Over the past three decades, researchers and educators have increasingly recognized the importance of K-12 school climate. This summary report builds on previous school climate reviews and details how school climate is associated with and/or promotes safety, healthy relationships, engaged learning and teaching and school improvement efforts. In…

The traffic climate in China: The mediating effect of traffic safety climate between personality and dangerous driving behavior.

PubMed

Zhang, Qian; Ge, Yan; Qu, Weina; Zhang, Kan; Sun, Xianghong

2018-04-01

Traffic safety climate is defined as road users' attitudes and perceptions of traffic in a specific context at a given point in time. The current study aimed to validate the Chinese version of the Traffic Climate Scale (TCS) and to explore its relation to drivers' personality and dangerous driving behavior. A sample of 413 drivers completed the Big Five Inventory (BFI), the Chinese version of the TCS, the Dula Dangerous Driving Index (DDDI) and a demographic questionnaire. Exploratory factor analysis and confirmatory factor analysis were performed to confirm a three-factor (external affective demands, internal requirements and functionality) solution of the TCS. The reliability and validity of the Chinese version of TCS were verified. More importantly, the results showed that the effect of personality on dangerous driving behavior was mediated by traffic climate. Specifically, the functionality of the TCS mediated the effect of neuroticism on negative cognitive/emotional driving and drunk driving, while openness had an indirect impact on aggressive driving, risky driving and drunk driving based on the internal requirements of the TCS. Additionally, agreeableness had a negative direct impact on four factors of the DDDI, while neuroticism had a positive direct impact on negative cognitive/emotional driving, drunk driving and risky driving. In conclusion, the Chinese version of the TCS will be useful to evaluate drivers' attitudes towards and perceptions of the requirements of traffic environment in which they participate and will also be valuable for comparing traffic cultures and environments in different countries. Copyright © 2018 Elsevier Ltd. All rights reserved.

Teamwork and communication: an effective approach to patient safety.

PubMed

Mujumdar, Sandhya; Santos, Diana

2014-01-01

Teamwork and communication failures are leading causes of patient safety incidents in health care. Though health care providers must work in teams, they are not well-trained in teamwork and communication skills. Health care faces the problems of differences in communication styles, communication failures and poor teamwork. There is enough evidence in the literature to show that communication failure is detrimental to patient safety. It is estimated that 80% of serious medical errors worldwide take place because of miscommunication between medical providers. NUH recognizes that effective communication and teamwork are essential in the delivery of high quality safe patient care, especially in a complex organization. NUH is a good example, where there is a rich mix of nationalities and races, in staff and in patients, and there is a rapidly expanding care environment. NUH had to overcome these challenges by adopting a multi-pronged approach. The trials and tribulations of NUH in this journey were worthwhile as the patient safety climate survey scores improved over the years.

Parallels among the ``music scores'' of solar cycles, space weather and Earth's climate

NASA Astrophysics Data System (ADS)

Kolláth, Zoltán; Oláh, Katalin; van Driel-Gesztelyi, Lidia

2012-07-01

Solar variability and its effects on the physical variability of our (space) environment produces complex signals. In the indicators of solar activity at least four independent cyclic components can be identified, all of them with temporal variations in their timescales. Time-frequency distributions (see Kolláth & Oláh 2009) are perfect tools to disclose the ``music scores'' in these complex time series. Special features in the time-frequency distributions, like frequency splitting, or modulations on different timescales provide clues, which can reveal similar trends among different indices like sunspot numbers, interplanetary magnetic field strength in the Earth's neighborhood and climate data. On the pseudo-Wigner Distribution (PWD) the frequency splitting of all the three main components (the Gleissberg and Schwabe cycles, and an ~5.5 year signal originating from cycle asymmetry, i.e. the Waldmeier effect) can be identified as a ``bubble'' shaped structure after 1950. The same frequency splitting feature can also be found in the heliospheric magnetic field data and the microwave radio flux.

Living up to safety values in health care: the effect of leader behavioral integrity on occupational safety.

PubMed

Halbesleben, Jonathon R B; Leroy, Hannes; Dierynck, Bart; Simons, Tony; Savage, Grant T; McCaughey, Deirdre; Leon, Matthew R

2013-10-01

While previous research has identified that leaders' safety expectations and safety actions are important in fostering occupational safety, research has yet to demonstrate the importance of leader alignment between safety expectations and actions for improving occupational safety. We build on safety climate literature and theory on behavioral integrity to better understand the relationship between the leader's behavioral integrity regarding safety and work-related injuries. In a time-lagged study of 658 nurses, we find that behavioral integrity for high safety values is positively associated with greater reporting of fewer and less severe occupational injuries. The effects of behavioral integrity regarding safety can be better understood through the mediating mechanisms of safety compliance and psychological safety toward one's supervisor. We discuss the implications of our findings for future research on safety climate.

Development and validation of a composite scoring system for robot-assisted surgical training--the Robotic Skills Assessment Score.

PubMed

Chowriappa, Ashirwad J; Shi, Yi; Raza, Syed Johar; Ahmed, Kamran; Stegemann, Andrew; Wilding, Gregory; Kaouk, Jihad; Peabody, James O; Menon, Mani; Hassett, James M; Kesavadas, Thenkurussi; Guru, Khurshid A

2013-12-01

A standardized scoring system does not exist in virtual reality-based assessment metrics to describe safe and crucial surgical skills in robot-assisted surgery. This study aims to develop an assessment score along with its construct validation. All subjects performed key tasks on previously validated Fundamental Skills of Robotic Surgery curriculum, which were recorded, and metrics were stored. After an expert consensus for the purpose of content validation (Delphi), critical safety determining procedural steps were identified from the Fundamental Skills of Robotic Surgery curriculum and a hierarchical task decomposition of multiple parameters using a variety of metrics was used to develop Robotic Skills Assessment Score (RSA-Score). Robotic Skills Assessment mainly focuses on safety in operative field, critical error, economy, bimanual dexterity, and time. Following, the RSA-Score was further evaluated for construct validation and feasibility. Spearman correlation tests performed between tasks using the RSA-Scores indicate no cross correlation. Wilcoxon rank sum tests were performed between the two groups. The proposed RSA-Score was evaluated on non-robotic surgeons (n = 15) and on expert-robotic surgeons (n = 12). The expert group demonstrated significantly better performance on all four tasks in comparison to the novice group. Validation of the RSA-Score in this study was carried out on the Robotic Surgical Simulator. The RSA-Score is a valid scoring system that could be incorporated in any virtual reality-based surgical simulator to achieve standardized assessment of fundamental surgical tents during robot-assisted surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

Inspection Score and Grading System for Food Services in Brazil: The Results of a Food Safety Strategy to Reduce the Risk of Foodborne Diseases during the 2014 FIFA World Cup.

PubMed

da Cunha, Diogo T; Saccol, Ana L de Freitas; Tondo, Eduardo C; de Oliveira, Ana B A; Ginani, Veronica C; Araújo, Carolina V; Lima, Thalita A S; de Castro, Angela K F; Stedefeldt, Elke

2016-01-01

In 2014, Brazil hosted one of the most popular sport competitions in the world, the FIFA World Cup. Concerned about the intense migration of tourists, the Brazilian government decided to deploy a food safety strategy based on inspection scores and a grading system applied to food services. The present study aimed to evaluate the results of the food safety strategy deployed during the 2014 FIFA World Cup in Brazil. To assess food safety, an evaluation instrument was applied twice in 1927 food service establishments from 26 cities before the start of the competition. This instrument generated a food safety score for each establishment that ranged from 0.0 (no flaws observed) to 2565.95, with four possible grades: A (0.0-13.2); B (13.3-502.6); C (502.7-1152.2); and pending (more than 1152.3). Each food service received a stamp with the grade of the second evaluation. After the end of the World Cup, a study was conducted with different groups of the public to evaluate the acceptance of the strategy. To this end, 221 consumers, 998 food service owners or managers, 150 health surveillance auditors, and 27 health surveillance coordinators were enrolled. These participants completed a survey with positive and negative responses about the inspection score system through a 5-point Likert scale. A reduction in violation scores from 393.1 to 224.4 (p < 0.001) was observed between the first and second evaluation cycles. Of the food services evaluated, 38.7% received the A stamp, 41.4% the B stamp, and 13.9% the C stamp. All positive responses on "system reliability" presented a mean of 4.0 or more, indicating that the public believed this strategy is reliable for communicating risks and promoting food safety. The strategy showed positive results regarding food safety and public acceptance. The deployed strategy promoted improvements in the food safety of food services. The implementation of a permanent policy may be well accepted by the public and may greatly contribute to a

Causal Relationship Analysis of the Patient Safety Culture Based on Safety Attitudes Questionnaire in Taiwan.

PubMed

Lee, Yii-Ching; Zeng, Pei-Shan; Huang, Chih-Hsuan; Wu, Hsin-Hung

2018-01-01

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the safety attitudes questionnaire in Taiwan in order to improve the patient safety culture from experts' viewpoints. Teamwork climate, stress recognition, and perceptions of management are three causal dimensions, while safety climate, job satisfaction, and working conditions are receiving dimensions. In practice, improvements on effect-based dimensions might receive little effects when a great amount of efforts have been invested. In contrast, improving a causal dimension not only improves itself but also results in better performance of other dimension(s) directly affected by this particular dimension. Teamwork climate and perceptions of management are found to be the most critical dimensions because they are both causal dimensions and have significant influences on four dimensions apiece. It is worth to note that job satisfaction is the only dimension affected by the other dimensions. In order to effectively enhance the patient safety culture for healthcare organizations, teamwork climate, and perceptions of management should be closely monitored.

Causal Relationship Analysis of the Patient Safety Culture Based on Safety Attitudes Questionnaire in Taiwan

PubMed Central

Zeng, Pei-Shan; Huang, Chih-Hsuan

2018-01-01

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the safety attitudes questionnaire in Taiwan in order to improve the patient safety culture from experts' viewpoints. Teamwork climate, stress recognition, and perceptions of management are three causal dimensions, while safety climate, job satisfaction, and working conditions are receiving dimensions. In practice, improvements on effect-based dimensions might receive little effects when a great amount of efforts have been invested. In contrast, improving a causal dimension not only improves itself but also results in better performance of other dimension(s) directly affected by this particular dimension. Teamwork climate and perceptions of management are found to be the most critical dimensions because they are both causal dimensions and have significant influences on four dimensions apiece. It is worth to note that job satisfaction is the only dimension affected by the other dimensions. In order to effectively enhance the patient safety culture for healthcare organizations, teamwork climate, and perceptions of management should be closely monitored. PMID:29686825

Relationship of safety climate perceptions and job satisfaction among employees in the construction industry: the moderating role of age.

PubMed

Stoilkovska, Biljana Blaževska; Žileska Pančovska, Valentina; Mijoski, Goran

2015-01-01

This study examines the degree to which construction sector employees perceive that safety is important in their organizations/sites and how job satisfaction affects these perceptions when age is introduced as a moderator variable. Two-way analysis of variance demonstrated that job satisfaction has a strong effect on perceived management commitment to work safety and that this relationship was moderated by respondents' age. Job satisfaction was associated with perceived accident rate and safety inspection frequency, but the proposed role of age in this linkage was not confirmed. Consequently, the findings indicated that by increasing the level of job satisfaction, perceptions of these safety climate aspects proved to be more positive. The conclusion is that these relationships could further lead to a lower percentage of accidents and injuries in the workplace and better health among employees. A significant relationship between job satisfaction, age and perceived co-workers' commitment to work safety was not found.