The Safety Leadership Model

The three inner rings have to do with successful safety leadership. The outer ring represents the influence of effective leadership on the culture of the organization pivotal to business outcomes, including patient safety. 

1 Barbara Mark and David A. Hofmann, An Investigation of the Relationship between Safety Climate and Medication Errors as Well as Other Nurse and Patient Outcomes, Personnel Psychology, 59 (2006) pp. 847-869. 

2 Michael Arndt, How O Neill Got Alcoa Shining, Business Week, February 5, 2001, p. 39. 

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The model can be read two ways from the inside out, with the individual leader s personal safety ethic, leadership style, and practices emanating outward to the culture or from the outside in, with the culture of the organization affecting the individual leader. Since our interest is primarily in how leaders influence culture, we will approach the model from the inside out. From the inside, each ring leads to the next and ultimately to business results. Who the leader is (her personality and values) sets the foundation for how she influences (her style), and what she does (her practices). Leadership practices shape the organization s culture, which, in turn, shapes safety results. 

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The Safety Leadership Model (Figure 4-1) is made up of four rings ... 

At the core of the Safety Leadership Model is the leader s personal safety ethic. Culture receives and hosts the effects of a leader s values and behavioral standards— what he believes is important, what is acceptable, and what is not. Of course, what s important here is not what a leader says he values, but what he actually values—the ethics manifested in his personal behavior. 

These considerations bring us to the next aspect of the Safety Leadership Model s center—the values and emotional commitment to safety that are part of the leader s personal safety ethic. 

Valuing safety—part of the personal safety ethic at the center of the Safety Leadership Model (see Figure 4-1)—is necessary but not sufficient to create effective safety leadership. It is... 

The research literature has classified leadership style (the second ring in the Safety Leadership Model) in a number of ways. In recent years, the various dimensions and models have coalesced into two basic styles transformational leadership and transactional leadership. (A third type, laissez-faire leadership, is also mentioned, but it amounts to an abdication of leadership responsibility and is thus not desirable to safety leadership.) There is increasing evidence that transformational and transactional leadership are not mutually exclusive, but that different situations call for different styles. Great leaders are adept at using the mix that is appropriate to a given situation. ... 

Leaders build culture through their personal safety ethic (the core of the Safety Leadership Model), their leadership style, and their leadership practices. In this chapter we examined the best practices that outstanding safety leaders share. In the next chapter we introduce applied behavior analysis, a tool for systematically managing one s own behavior and the behavior of others. 

In companies with superior safety records, training is serious business. Unfortunately, safety training is often much talked and written about but poorly done. Senior management in the model companies is well-trained. It all starts here. All levels of management become aware of the risks of their businesses and acquire the necessary knowledge of the hazards management needs. They cannot be role models and provide the necessary leadership if they are not schooled in how the hazards management job is to be done. 

Heinrich s premises, and the several causation models that are based on them, are still the foundation of the work of many safety practitioners. Indeed, most causation models have focused on the behavior of the individual who is presumed to have acted unsafely. And many safety practitioners, in the prevention measures they propose, emphasize training, quality of leadership by supervisory personnel, behavior modification, and appropriate methods of discipline — a great range of activities directed toward the control of man failure. These solutions are to achieve a change in the performance of the employee who, when judged retrospectively, is deemed to have acted unsafely. 

Simon expressed the view that the culture drives the behavior and that a culture change is required for success in behavior-based safety. A culture assessment (such as the Simon Open System Culture Change Model) measures the culture process and impacts on the whole of operations —the technology, tmst, leadership, symbols of the culture, et cetera. He also advised that before a behavior-based initiative is undertaken, management leadership must have been established. That s implicit. This factor cannot be overlooked. These are excerpts from Simon s paper titled The Culture Change Model of Behavioral Safety ... 

The Swiss Cheese Model of Accident Causation is a prerequisite for understanding the dynamics of the emerging risk and organizational defenses that are necessary to improve safety. Figure 4.2 illustrates the model, using its metaphor, a wedge of Swiss cheese. The model was described in detail in Chapter Three here, a metaphorical exploration of the model amplifies its implications for accepting leadership responsibility. 

How can this leadership model facilitate the development of safety as a key component in the organizational culture of the school ... 

Even though Sinek s book targets leadership roles in organizations, I believe the principles of his Golden Circle model has numerous applications in safety, both from a safety leadership and incident investigation point of view. 

Who the leader is lies at the center of the model. The leader s personal safety ethic is at the core of safety leadership. No one can be an effective patient safety leader without genuinely valuing the safety of others. Personality, values, and emotional commitment are part of this ethic. Because our personalities are developed early in life and tend to change little in adulthood, a leader is more successful in achieving his desired ends when he understands how his personality affects his behavior and is experienced by other people. 

At every turn, this book makes tangible the intangible and helps to provide points of connection from which to advance our leadership and culture improvement initiatives. The evidence-based models and applications are unique and an example of the importance of our expanded view of the toolbox available to our industry as it goes about this important work. It is a book to be embraced by those of us who embrace the work of patient safety and for students of leadership and culture across the field. 

In the model companies, senior management assumes responsibility for safety and provides the leadership necessaiy to achieve the superior results expected. Management has ownership of safety as a part of operating responsibility. It s understood that management commitment, direction, and involvement are the sine qua non, the prime requirement for effectiveness in safety. If superior results are desired, there must be a long-term commitment to long-term goals. That s an absolute. 

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