Testing safety commitment in organizations through interpretations of safety artifacts

Problem

Safety culture relates to injuries and safety incidents in organizations, but is difficult to asses and measure. We describe a preliminary test of assessing an organization's safety culture by examining employee interpretations of organizational safety artifacts (safety signs).

Method

We collected data in three organizations using a new safety culture assessment tool that we label the Safety Artifact Interpretation (SAI) scale; we then crossed these data with safety climate and leadership evaluations.

Results

SAI were interpreted by employees in accordance with two conceptually distinct themes that are salient in the literature on organizational safety culture: safety compliance and commitment to safety. A significant correlation exists between SAI scores and the organizational safety climate. A similar (though insignificant) relationship was observed between SAI scores and leadership ratings.

Impact on industry

Employee perceptions and interpretations of safety artifacts can facilitate assessments of safety culture and can ultimately lead to understanding of and improvements in the level of organizational safety.     

[Case Study] CityCenter and Cosmopolitan Construction Projects, Las Vegas, Nevada: Lessons learned from the use of multiple sources and mixed methods in a safety needs assessment

Problem

The present study describes a response to eight tragic deaths over an eighteen month times span on a fast track construction project on the largest commercial development project in U.S. history.

Methods

Four versions of a survey were distributed to workers, foremen, superintendents, and senior management. In addition to standard Likert-scale safety climate scale items, an open-ended item was included at the end of the survey.

Results

Safety climate perceptions differed by job level. Specifically, management perceived a more positive safety climate as compared to workers. Content analysis of the open-ended item was used to identify important safety and health concerns which might have been overlooked with the qualitative portion of the survey.

Discussion

The surveys were conducted to understand workforce issues of concern with the aim of improving site safety conditions. Such efforts can require minimal investment of resources and time and result in critical feedback for developing interventions affecting organizational structure, management processes, and communication.

Summary

The most important lesson learned was that gauging differences in perception about site safety can provide critical feedback at all levels of a construction organization.

Impact on the Industry

Implementation of multi-level organizational perception surveys can identify major safety issues of concern. Feedback, if acted upon, can potentially result in fewer injuries and fatal events.     

Effects of safety climate on safety norm violations: exploring the mediating role of attitudinal ambivalence toward personal protective equipment

Problem

Research on the role of organizational and psychosocial factors in influencing risk behaviors and the likelihood of injury at work showed that safety climate also has great impact on workers’ behavior. However, the mechanisms through which this impact operates are still partially unclear.

Method

In order to explore the role that attitudinal ambivalence toward wearing PPE might play in mediating the impact of safety climate on safety norm violations, a questionnaire was administered to 345 Italian workers.

Results

Three dimensions of safety climate (i.e., company safety concern, senior managers’ safety concern, supervisors’ attitudes towards safety) were found to be positively associated with the individual ambivalence level, whereas the fourth one (i.e., work pressure) was negatively correlated with it. In turn, low levels of ambivalence were associated with a lower tendency to break the safety norms, even though the perception of a good safety climate also maintained a direct effect on unsafe behaviors.

Impact on industry

Designers of training program for the prevention of work related injuries must pay great attention to the psycho-social factors (such as the effects of the safety climate perception by employees on their attitudes and behaviors), and include specific contents into the prevention programs in order to improve workers compliance with safety norms.     

Acciphilia on the road: An analysis of severe collisions

Introduction

Although prior studies of road traffic accidents have found between-group differences in risk, little attention has been given to the encounter between drivers involved in severe collisions.

Method

The present study empirically evaluates two different possible causes of "social accidents," which are defined as collisions between two or more drivers where some faulty social interaction might be assumed, and which are the most prevalent cause of road injuries. The analyses use merged Israeli collision records from 1983 to 2004 with data from two national censuses, thus providing an unprecedented empirical basis to study the social foundations of car accidents. The data are used to adjudicate between two alternative hypotheses: the heterogeneity hypothesis (socially different drivers tend to collide) versus the homogeneity hypothesis (socially similar drivers tend to collide).

Results

Multivariate analyses provide preliminary support for the latter hypothesis. Given an accident, there are more collisions among drivers from the same broad educational group, and the factors that influence this correlation are independent of geography. The paper thus leads to the idea that severe collisions reflect a sociological or ecological process that is akin to acciphilia.

Impact on Industry

The preliminary findings suggest that variation between drivers may be preferable to similarity, since apparently there is a greater tendency toward collisions between similar drivers.     

An ethnography of low-income mothers' safeguarding efforts

Problem

Children living in lower-income environments are at greater risk for unintentional injuries. However, little is known about the safety practices of mothers living in low-income situations.

Method

This ethnographic study explored the child safeguarding experiences of low-income mothers using in-home interviews and observations.

Results

Mothers' safeguarding efforts included cognitive and emotional work, child directed work, and work directed at the physical and social environments. Factors that influenced the women's safeguarding included the quality of the indoor space, availability of safe play space, traffic hazards, sibling interactions, child care supports, relationships with neighbors, and trust in community services.

Discussion

These findings have implications for the conceptualization of safeguarding practices and provide insight about the experiences of mothers living on low-incomes.

Impact on Industry

When developing safety interventions, program planners should consider the views and practices of mothers as well as contextual factors in the physical and social environments.     

“Safety is everyone's job:” The key to safety on a large university construction site

Problem

Construction risk management is challenging.

Method

We combined data on injuries, costs, and hours worked, obtained through a Rolling Owner-Controlled Insurance Program (ROCIP), with data from focus groups, interviews, and field observations, to prospectively study injuries and hazard control on a large university construction project.

Results

Lost-time injury rates (1.0/200,000 hours worked) were considerably lower than reported for the industry, and there were no serious falls from height. Safety was considered in the awarding of contracts and project timeline development; hazard management was iterative. A top-down management commitment to safety was clearly communicated to, and embraced by, workers throughout the site.

Discussion and Impact

A better understanding of how contracting relationships, workers' compensation, and liability insurance arrangements influence safety could shift risk management efforts from worker behaviors to a broader focus on how these programs and relationships affect incentives and disincentives for workplace safety and health.     

The development and validation of a psychological contract of safety scale

Introduction

This paper builds on previous research by the author and describes the development and validation of a new measure of the psychological contract of safety. The psychological contract of safety is defined as the beliefs of individuals about reciprocal safety obligations inferred from implicit and explicit promises.

Method

A psychological contract is established when an individual believes that perceived employer and employee safety obligations are contingent on each other. A pilot test of the measure is first undertaken with participants from three different occupations: nurses, construction workers, and meat processing workers (N = 99). Item analysis is used to refine the measure and provide initial validation of the scale. A larger validation study is then conducted with a participant sample of health care workers (N = 424) to further refine the measure and to determine the psychometric properties of the scale.

Results

Item and correlational analyses produced the final employer and employee obligations scales, consisting of 21 and 17 items, respectively. Factor analyses identified two underlying dimensions in each scale comparable to that previously established in the organizational literature. These transactional and relational-type obligations provided construct validity of the scale. Internal consistency ratings using Cronbach's alpha found the components of the psychological contract of safety measure to be reliable.

Impact on Industry

The refined and validated psychological contract of safety measure will allow investigation of the positive and negative outcomes associated with fulfilment and breach of the psychological contract of safety in future research.     

The effect of work hours on adverse events and errors in health care

Introduction

We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors.

Method

Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors.

Results

All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables.

Discussion

This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime.

Impact on Industry

Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety.     

Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

Attitudes toward a primary seat belt law among adults in a rural state with a secondary seat belt law

Problem

Enforced primary seatbelt laws can reduce morbidity and mortality associated with motor-vehicle crashes. Constituent support is an important factor associated with legislator voting behavior toward injury prevention laws. Little is known about attitudes toward a primary seat belt law among adults in rural states without a primary seat belt law.

Methods

Data from the Behavioral Risk Factor Surveillance System (BRFSS) survey, a telephone survey of a representative sample of adults in Montana, were used to assess attitudes toward a primary seat belt law.

Results

Sixty-one percent of respondents supported a primary seat belt law. Using multiple logistic regression analyses, women (AOR 1.87; 95% CI 1.49-2.36), persons aged 65 years and older (1.45; 1.06-1.96), American Indians (2.71; 1.55-4.75), those with health insurance (1.51; 1.07-2.14), and those who reported always wearing their seat belt (4.05; 3.14-5.21) were more likely to support a primary seat belt law than respondents without these characteristics.

Conclusions

The majority of adults in a rural state support a primary seat belt law.     

A reporting guide for studies on individual differences in traffic safety

Problem

Studies on individual differences in traffic safety report differently on their methodologies, and use different statistics, and these are therefore difficult to compare and meta-analyze.

Method

Based upon a previous, extensive review and meta-analysis of the traffic safety literature, several recommendations are made about what features of the methodology of studies on individual differences (including evaluations) in safety need to be reported to facilitate interpretation and meta-analysis. Similarly, some basic types of statistical values are recommended.

Impact on Industry

The accumulation of knowledge about individual differences in traffic safety would be facilitated if scientific authors and journals adhered to these guidelines.     

A systems perspective of managing error recovery and tactical re-planning of operating teams in safety critical domains

Introduction

Research in human error has provided useful tools for designing procedures, training, and intelligent interfaces that trap errors at an early stage. However, this “error prevention” policy may not be entirely successful because human errors will inevitably occur. This requires that the error management process (e.g., detection, diagnosis and correction) must also be supported. Research has focused almost exclusively on error detection; little is known about error recovery, especially in the context of safety critical systems. The aim of this paper is to develop a research framework that integrates error recovery strategies employed by experienced practitioners in handling their own errors.

Method and Results

A control theoretic model of human performance was used to integrate error recovery strategies assembled from reviews of the literature, analyses of near misses from aviation and command & control domains, and observations of abnormal situations training at air traffic control facilities. The method of system dynamics has been used to analyze and compare error recovery strategies in terms of patterns of interaction, system affordances, and types of recovery plans. System dynamics offer a promising basis for studying the nature of error recovery management in the context of team interactions and system characteristics.

Impact on industry

The proposed taxonomy of error recovery strategies can help human factors and safety experts to develop resilient system designs and training solutions for managing human errors in unforeseen situations; it may also help incident investigators to explore why people's actions and assessments were not corrected at the time.     

Assessing public opinion regarding potential ATV-related policies

Problem

States with laws regarding ATV use and safety have lower mortality and injury rates than states with few or no restrictions. Our objective was to assess the attitudes of registered Ohio voters concerning potential legislation regarding ATV use and safety to determine the feasibility of its enactment.

Method

A statewide telephone survey of 838 registered Ohio voters was conducted and results were weighted by region to accurately represent all Ohio voters.

Results

Registered voters were in favor of restricting the use of ATVs by children < 16 years (81%), prohibiting passengers on ATVs (81%), requiring helmets (78%), and requiring all ATV owners and users to take a safety class (77%). ATV riders indicated that a mandatory helmet law would increase helmet use.

Impact on Industry

Assessing public opinion regarding public health and safety laws is a critical first step when considering legislation to improve ATV safety.     

What is the potential of trauma registry data to be used for road traffic injury surveillance and informing road safety policy?

Introduction

Information from hospital trauma registries is increasingly being used to support injury surveillance efforts. This research examines the potential of using trauma registry data for road traffic injury surveillance for different types of road users in terms of both the information collected and how representative trauma data are compared to two population-based road traffic injury data collections.

Methods

The three data collections were assessed against recommended variables to be collected for injury surveillance purposes and the representativeness of the distribution of road traffic-related injury data from the trauma registry was compared to hospital admission and road traffic authority data collections.

Results

Data from the trauma registry was largely not representative of the distribution of age groups or activities compared to the two population-based collections, but was representative for gender for some road user groups to at least one population-based data collection.

Conclusions

Trauma data could be used to supplement information from population-based data collections to inform road safety efforts.

Impact on Industry

Road safety policy makers should be aware of the potential and the limitations of using trauma registry data for road traffic injury surveillance.     

Social norms of accompanied young children and observed crossing behaviors

Introduction

Social norms for accompanied young children and crossing behaviors were examined in two studies conducted in an Ultra-Orthodox Jewish community in Israel.

Method

In Study 1, road behaviors of young children crossing with and without accompaniment and older children were observed, and the actual social norm for accompanied school children younger than 9-years-old was examined. In Study 2, the perceived norm of accompaniment was tested by questionnaires.

Results

Young children who crossed without accompaniment exhibited poorer crossing skills compared to older children and to young children crossing with accompaniment. In the four locations observed, the actual accompaniment rate ranged between 15%-60%. The perceived social norm for child accompaniment was lower than the actual norm.

Conclusions

The discussion refers to both theoretical issues and their practical implications.     

Injuries and risk-taking behaviours in Portuguese adolescents: Highlights from the health behaviour in school-aged children survey

Aim

Injuries in adolescence are an important public health problem and a major cause of morbidity and mortality in this age group. This study aimed to determine the behaviour profile associated to risk of injury and the differences between genders, region and ethnic origin.

Methods

A cross-sectional study design of a nationally representative sample of 1581 adolescents of the Portuguese Health Behaviour in School-Aged Children study.

Results

An occurrence of one injury-related event in the previous year was reported by 21.4% of the respondents and 5.9% referred having more than one injury-related event. Boys reported higher frequency of those events when compared to girls, and non-Portuguese subjects referred higher frequency of events. Scoring higher in violence-related behaviour and psychosomatic complaints was associated to higher chances of referring more than one injury-related event.

Conclusion

Gender, social background and behaviour profile are factors that seem to influence the risk of injuries. This information should guide those involved in the planning of injuries prevention programs in youth.     

Epidemiology of subway-related fatalities in New York City, 1990-2003

Problem

Subway transit is a relatively safe mode of transportation, yet compared to all other forms of mass transit in the United States (U.S.), subways have the highest fatality rate. The aim of this paper is to characterize subway-related fatalities in order to identify opportunities for risk reduction.

Method

Medical examiner records for all New York City (NYC) subway-related deaths (1990-2003) were reviewed. Data were abstracted on decedents' demographics and autopsy findings, including laboratory findings.

Results

There were 668 subway-related fatalities, of these, 10 (1.5%) were homicides, 343 (51.3%) were determined to be suicides, and 315 (47.2%) were accidental. Although decedent characteristics varied between fatality categories, they were not particularly informative with regard to prevention.

Conclusion

Prevention strategies that focus on structural controls are likely to be most efficacious in improving the overall safety of the NYC subway systems.

Impact on industry

These findings suggest that structural rather than individual-level interventions would be most successful in preventing subway fatalities.     

Case-control and cross-sectional methods for estimating crash modification factors: comparisons from roadway lighting and lane and shoulder width safety effect studies

Problem

While observational before-after studies are considered the industry standard for developing crash modification factors (CMFs), there are practical limitations that may preclude their use in highway safety analysis. There is a need to explore alternative methods for estimating CMFs.

Method

This paper employs case-control and cross-sectional analyses to estimate CMFs for fixed roadway lighting and the allocation of lane and shoulder widths.

Results

Based on the case-control method, the CMF for intersection lighting is 0.886, while the cross-sectional study indicates a CMF of 0.881. The CMFs developed for lane and shoulder widths are also similar when comparing the two methods.

Conclusions

This paper suggests that case-control and cross-sectional studies produce consistent results if care is taken in the study design and model development.

Impact on industry

Case-control and cross-sectional studies may provide a viable alternative to estimate CMFs when a before-after study is impractical due to data restrictions.