Safety outcomes culture

Trust plays a central role in safety (Conchie et al. 2006). Studies have shown links between positive safety outcomes, and tmst in management (e.g., DePasquale and Geller 1999 Kath et al. 2010 Luria 2010), and tmst in co-workers (e.g., Tharaldsen et al. 2010). Tmst is also a key aspect of a positive safety culture (Bums et al. 2006), influences safety attitudes (Walker 2013), and influences the effectiveness of risk communication (Conchie and Bums 2008 Twyman et al. 2008). While there are clear safety benefits associated with tmst, safety benefits can also come from distmst (Conchie and Donald 2008), and this is likely to particularly be the case in relation to new employees in their initial period of employment. Tmst can reduce an... 

An increase in management safety culture should have the same impact on safety outcomes as an increase in worker participation in safety decision making, for similar reasons as more management resources are employed toward integrating safety within overall corporate strategy—and as more ways are foimd to minimize post-injury retum-to-work hurdles—accident costs will be reduced. To the extent this happens, the returns to safety investments increase, the level of job safety rises, and time away from work because of injuries falls. Higher values... 

Leadership is another important determinant of patient safety culture and patient safety outcomes (Katz-Navon et al. 2009 Wong and Cummings 2007). This is because leaders are often the drivers of safety culture within the organisation. They set the example for employees through their behaviours (Maierhofer et al. 2000). They also shape subordinate behaviour through the provision of rewards or punishments (Hinze 2002). When leaders take time to discuss safety with employees, employees demonstrate less unsafe behaviour (Zohar and Luria 2003). Similarly, if leaders do not make safety a priority among their team, this will be... 

Safety Culture Dimensions, Patient Safety Outcomes and Their Correlations... 

Of conrse, this approach is based on the assumption that safety culture correlates with safety outcomes. Therefore, it is of critical importance to confirm the cnltnre-ontcome link, which is one of the requirements for a safety culture scale, understood as criterion validity - a more comprehensive summary of the required properties can be found in other literature (e.g. Itoh et al. 2012). For this applied purpose of safety culture, this chapter specifically looks at dimensions of safety culture, how to measure safety outcomes, and the safety culture-outcome link through an examination of case studies, primarily drawn from Japanese hospitals. Before stating these issues in detail, we will, in the rest of this section, briefly argue notions of safety culture (and safety climate). 

In this section, results obtained in a case study (Itoh and Andersen 2008, 2010) will be reviewed to illustrate the contribution of safety culture to safety outcome. In a case study, a questioimaire-based survey concerning staff reactions after the adverse event introduced in the last section, was conducted in addition to the safety culture survey. At the same time, incident reports for three years (2004-06) submitted by nurses were obtained from one of the hospitals (Hospital M) that participated in the safety culture survey. Hospital M was a private, acute-type general hospital, located in Tokyo. This hospital covered almost all clinical specialties and, at the time of the survey in 2006, it had about 500 inpatient beds, 160 full-time doctors and 360 full-time nurses. Nurses belonged to any one of 18 clinical work units 14 inpatient wards, an outpatient clinic, operating room, kidney centre, and medical examination unit. 

Several instruments have been developed to assess hospital staff s perceptions of aspects of workplace safety culture and a number of studies have reported associations between hospital safety culture and safety outcome measures (Jackson et al. 2010). Profiling the hospital safety culture scores is relatively straightforward but finding safety outcome measures for patients or workers is more challenging (Flin 2007). Different types of safety outcome data can be collected, e.g. (i) hospital incident records for staff or patients or clinical data for patients, (ii) self-reports of incidents and injuries by workers or patients and (iii) workers safety behaviours (self-reported or observed). 

Geller provides 50 principles for establishing a strong safety culture. Some of these principles are safety should be an internally driven value, people should understand safety theory, people should teach safety, safety leaders can be developed, and the focus of safety should be safety processes not safety outcomes. These principles lead you to continually work on how to do things safely rather than just emphasizing a zero incident rate or time away from work for an incident. Geller points out that safety continually conflicts with human nature, which seeks to do those things that are convenient, comfortable, and expedient since safety can sometimes lead to discomfort, inconvenience, and inefficiency of time. 

To facilitate road safety comparisons between countries, Coimtiy Overviews were developed in DaCoTA for each countiy [AAR 12], not only presenting the current state of road safety in terms of annual number of crashes or traffic victims, but also containing information on precursors for crashes, such as behavior and policy in a countiy. This information is organized by using the Road Safety Pyramid [WEG 05] which covers all layers related to stmcture and culture, programs and measures, road safety performance, indicators, road safety outcomes and social cost. 

We have been working on organizational safety—the broad relationship between an organization s culture and leadership and its safety outcomes—since 1979. We were asked to assess NASA s culture using the tools we have developed over the years and to recommend an intervention strategy that would address the issues the board had found. We quickly discovered a reluctance... 

It s a reasonable question, Industry does have its share of slide-show-and-poster safety. But that is all a distraction. Industrial organizations have actually done incredibly good work creating a positive safety climate and an organizational culture that supports safety outcomes. Alcoa and ExxonMobil, for example, are leaders in their respective industries with regard to workplace... 

Leaders create culture with their every thought, word, and deed. In fact leadership predicts culture—and culture predicts safety outcomes. The data demonstrate these relationships (see chapters 3 and 4). Since leadership shapes culture, and culture predictably defines the likelihood of exposure to harm, leaders are obligated to... 

How do the nine critical dimensions of culture affect safety outcomes Figure 3-3 displays the nine dimensions divided into three groups organizational dimensions, team dimensions, and safety-specific dimensions. It also shows how these categories are related to each other and to safety outcomes. Each relationship shown is statistically significant, and thicker arrows denote stronger predictive relationships. For example. 

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