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.     

Towards a constructivist program in safety

This paper delves into the relationship between safety and constructivism. In the past 30 years, the constructivist discourse has become very popular but also controversial as it challenges some key categories associated with modernity, such as reason, objectivity, truth and reality. In the safety literature, several works advocate its use. This paper has three objectives. The first one is to reveal the existence of a constructivist discourse in the field of safety. It does this by bringing together scattered pieces of works from different authors who endorse and apply to various topics a position labelled as constructivist. However, and that is the paper’s second objective; it demonstrates that there is not only one constructivism, but several. In order to ground this contention, the paper proceeds with a multidisciplinary and historical approach. It is then argued that it is more appropriate not to conflate this diversity of constructivisms. The paper looks for a solution to this problem by providing a classification based on two groups of parameters: mild/strong and cognitive/social, defining four types. This step serves the third objective which consists in initiating a multifaceted constructivist program in safety composed of heterogeneous but related empirical and theoretical areas of investigations.     

Using a psychological contract of safety to predict safety climate on construction sites

Introduction: The fact that safety climate impacts safety behavior and delivers better safety outcomes is well established in construction. However, the way workers safety perception is inclined and developed is still unclear. Method: In this research, the influence of supervisors' developing safety climate and its impact on workers' safety behavior and their conceptualization of safety is explored through the lens of the ‘Psychological Contract’ (PC). More specifically, it is argued that ‘Psychological Contract of Safety’ (PCS) is a vital factor in explaining how workers attach meaning to a supervisor behavior. Extant research suggests: (a) safety climate is based on the perception of workers regarding safety; and (b) PCS is based on perceived mutual obligations between workers and supervisors. As a result, this research argues that if PCS or mutual obligations between workers and supervisors are fulfilled, then safety climate of the workers will be positively influenced. A model is presented depicting PCS as an alternative intervention in understanding how safety climate could be influenced and predicted by the level of fulfillment of mutual safety obligations. Using Structural Equation Modeling (SEM) the model of the PCS is validated with data collected from a mega-construction project in Australia. Results: The results suggest that to have a positive and strong safety climate, top-level managers must ensure that mutual safety obligations between supervisor and workers are fulfilled. This enables the PCS to be introduced as a new ‘predictor’ of safety climate. Practical applications: The novel outcome of the research could be considered as a management intervention to modify supervisors' behavior to produce better safety outcomes.     

Railway safety climate: a study on organizational development

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.     

The predictive validity of safety climate

PROBLEM: 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. METHODS: 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-level climates. Journal of Applied Psychology, 90(4), 616-628]. In addition, safety behavior and accident experience data were collected for 5 months following the survey and were statistically analyzed (structural equation modeling, confirmatory factor analysis, exploratory factor analysis, etc.) to identify correlations, associations, internal consistency, and factorial structures. RESULTS: Results revealed that the ZSCQ: (a) was psychometrically reliable and valid, (b) served as an effective predictor of safety-related outcomes (behavior and accident experience), and (c) could be trimmed to an 11 item survey with little loss of explanatory power. IMPACT ON INDUSTRY: Practitioners and researchers can use the ZSCQ with reasonable certainty of the questionnaire's reliability and validity. This provides a solid foundation for the development of meaningful organizational interventions and/or continued research into social factors affecting industrial accident experience.     

Exploratory analysis of the safety climate and safety behavior relationship

Problem: Safety climate refers to the degree to which employees believe true priority is given to organizational safety performance, and its measurement is thought to provide an “early warning” of potential safety system failure(s). However, researchers have struggled over the last 25 years to find empirical evidence to demonstrate actual links between safety climate and safety performance.Method: A safety climate measure was distributed to manufacturing employees at the beginning of a behavioral safety initiative and redistributed one year later.Results: Multiple regression analysis demonstrated that perceptions of the importance of safety training were predictive of actual levels of safety behavior. The results also demonstrate that the magnitude of change in perceptual safety climate scores will not necessarily match actual changes (r=0.56, n.s.) in employee's safety behavior.Discussion: This study obtained empirical links between safety climate scores and actual safety behavior. Confirming and contradicting findings within the extant safety climate literature, the results strongly suggest that the hypothesized climate-behavior-accident path is not as clear cut as commonly assumed.Summary: A statistical link between safety climate perceptions and safety behavior will be obtained when sufficient behavioral data is collected.Impact on Industry: The study further supports the use of safety climate measures as useful diagnostic tools in ascertaining employee's perceptions of the way that safety is being operationalized.     

Association between safety leading indicators and safety climate levels

ObjectivesThe aim of this study was to evaluate the association of leading indicators for occupational health and safety, particularly safety inspections and non-compliances, with safety climate levels.MethodsNordic Occupational Safety Climate Assessment Questionnaire was employed to evaluate safety climate in cross-sectional design. The geographically diverse population of the inspection body made it possible to conduct the survey across 10 provinces in Iran. 89 completed questionnaires were obtained with a response rate of 47%. Except for management safety justice, the internal consistency of other six dimensions was found to be acceptable (α ≥ 0.7).ResultsMean scores of dimensions ranged from 3.50 in trust in the efficacy of safety systems (SD = 0.38) to 2.98 in workers' safety priority and risk non-acceptance (SD = 0.47). Tukey HSD tests indicated a statistically significant difference of mean scores among groups undergoing different number of safety inspections and those receiving different number of non-compliances (p < 0.05), with no significant differences based on safety training man-hours and sessions (p > 0.05). Spearman's rank-order correlation showed no relationship between work experience and number of non-compliances (correlation coefficient = − 0.04, p > 0.05) and between safety training man-hours and number of non-compliances (correlation coefficient = − 0.15, p > 0.05).ConclusionsOur results indicate that safety climate levels are influenced by number of safety inspections and the resultant non-compliances.Practical applicationsFindings suggest that safety non-compliances detected as a result of conducting safety inspections could be used to monitor the safety climate state. Establishing plans to conduct scheduled safety inspections and recording findings in the form of safety non-compliance and monitoring their trend could be used to monitor levels of safety climate.     

The impact of organizational climate on safety climate and individual behavior

Relatively little previous research has investigated the meechanisms by which safety climate affects safety behavior. The current study examined the effects of general organizational climate on safety climate and safety performance. As expected, general organizational climate exerted a significant impact on safety climate, and safety climate in turn was related to self-reports of compliance with safety regulations and procedures as well as participation in safety-related activities within the workplace. The effect of general organizational climate on safety performance was mediated by safety climate, while the effect of safety climate on safety performance was partially mediated by safety knowledge and motivation.     

The development of a measure of safety climate: The role of safety perceptions and attitudes

In understanding the safety climate or culture of a workplace, the perceptions and attitudes of the workforce are important factors in assessing safety needs. Safety solutions may fail if they do not take into account these prevailing attitudes and perceptions. Also, changes in attitudes and perceptions about safety are often likely outcomes of safety interventions. The aim of this study was to develop a measure of perception and attitudes about safety as an indicator of safety culture for use with working populations. After reviewing the structure and content of a number of older, related measures of safety attitudes, a 67-item questionnaire was developed. The questionnaire was distributed in a self-administered form to 1560 workers in a wide variety of types of jobs and 660 questionnaires were returned from 7 workplaces with a response rate of 42%. Items were evaluated by Cronbach alpha which showed that the item set shared considerable common variance. Scale development was approached in two ways. First items which were highly skewed were removed, resulting in removal of around half of the items, with very little loss in alpha. The remaining items were then subjected to factor analysis which revealed five factors; personal motivation for safe behaviour, positive safety practice, risk justification, fatalism and optimism. This factor structure showed acceptable psychometric properties. Second, in an effort to produce a unidimensional scale with a small, but representative set of items, additional items were removed which had high correlation with other items. This resulted in loss of around half of the remaining items. The short scale contained 17 items with again overall acceptable psychometric properties. The most striking finding in the development of this questionnaire was that there was little variation between respondents on a very large proportion of the questions originally selected. Clearly there are well-known beliefs about safety in the working community which need to be understood in order to progress the concept of safety culture.     

未确知测度模型在爆破工程安全评价中的应用

结合当前工程爆破的实际情况,从安全管理、安全技术、安全防范三方面出发,建立了一套完备的爆破工程安全评价的二级指标体系.针对指标体系中诸多因素的不确定性问题,在未确知测度理论的基础上,构建了爆破工程安全评价的未确知测度模型.通过对单指标未确知测度、多指标综合测度的计算以及指标定权等过程,实现了对爆破工程的安全综合评价.在各评价指标权重和识别准则的确定上,分别采用了信息熵和置信度识别准则,避免了模糊层次分析法中在这两方面的缺陷,使评价结果更具客观性.实例分析表明,运用未确知测度模型进行爆破工程安全评价问题的研究,理论上是可行的,评价结果是可信的,从而为爆破工程的安全综合评价提供了一种新方法.     

Measuring safety climate in elderly homes

IntroductionProvision of a valid and reliable safety climate dimension brings enormous benefits to the elderly home sector. The aim of the present study was to make use of the safety climate instrument developed by OSHC to measure the safety perceptions of employees in elderly homes such that the factor structure of the safety climate dimensions of elderly homes could be explored.MethodIn 2010, surveys by mustering on site method were administered in 27 elderly homes that had participated in the "Hong Kong Safe and Healthy Residential Care Home Accreditation Scheme" organized by the Occupational Safety and Health Council.ResultsSix hundred and fifty-one surveys were returned with a response rate of 54.3%. To examine the factor structure of safety climate dimensions in our study, an exploratory factor analysis (EFA) using principal components analysis method was conducted to identify the underlying factors. The results of the modified seven-factor's safety climate structure extracted from 35 items better reflected the safety climate dimensions of elderly homes. The Cronbach alpha range for this study (0.655 to 0.851) indicated good internal consistency among the seven-factor structure. Responses from managerial level, supervisory and professional level, and front-line staff were analyzed to come up with the suggestion on effective ways of improving the safety culture of elderly homes. The overall results showed that managers generally gave positive responses in the factors evaluated, such as "management commitment and concern to safety," "perception of work risks and some contributory influences," "safety communication and awareness," and "safe working attitude and participation." Supervisors / professionals, and frontline level staff on the other hand, have less positive responses. The result of the lowest score in the factors - "perception of safety rules and procedures" underlined the importance of the relevance and practicability of safety rules and procedures.ConclusionThe modified OSHC safety climate tool provided better evidence of structural validity and reliability for use by elderly homes' decision makers as an indicator of employee perception of safety in their institution.Impact on industryThe findings and suggestions in the study provide useful information for the management, supervisors/professionals and frontline level staff to cultivate the safety culture in the elderly home sector. Most important, elderly homes can use the modified safety climate scale to identify problem areas in their safety culture and safety management practices and then target these for intervention.     

Attitude to safety rules and reflexivity as determinants of safety climate

IntroductionWe present two studies that focus on the relationship between safety rules and the safety climate. It is expected that a reasoned acceptance, namely one based on an understanding of the bases for the rules and a collective management of the rules, should benefit the climate. Method: In an initial study (N = 202) employees replied to a questionnaire that measured the safety climate, the level of the relationship with the safety rules, and the understanding of their bases. The results highlighted the fact that a reasoned acceptance of the rules is associated with an understanding of their bases and predicts the level of safety. In a second study (N = 258) employees replied to a questionnaire measuring team reflexivity, the safety climate, and the level of relationship with the safety rules. We observed that collective management of the rules mediated the relation between team reflexivity and the safety climate. Results: The results are discussed from the point of view of their practical implications. Developing safety climate requires that operators are trained to understand the basis of safety rules and team reflexivity.     

Towards a method to forecast the effectiveness of national road safety programmes

During the last three decades a more rational approach to political decision making has produced an increasing demand for scientific evaluation. A common understanding of evidence-based policy is that any new measures should have been proven to be effective. At best, these kinds of methodologically sound evaluation studies show the effect of a measure in a given situation. The results are then an essential basis for the design of a broader safety policy. However, at present there is generally little understanding of the effect of the measure in another situation, or of how it would interact with other measures in a programme. Yet, it is precisely such questions that need to be answered if the requirements of policy makers are to be met. Politicians need to be able to estimate whether the expected benefits of a programme justify the investment. Therefore, evidence-based road safety policy should not rely solely on evaluation studies of single measures and ex-post assessments of safety programmes. The method outlined here is for the ex-ante estimation of the potential of a road safety programme, which takes into account existing scientific research, an estimate of the degree of implementation that can be expected at a certain point in time, and the interaction between individual measures.     

安全氛围对企业安全行为的影响研究

国外大量研究表明,安全氛围调查在改进企业的安全行为方面有积极的作用,为组织制订未来的安全政策提供依据。本研究通过查阅文献、国外类似的诊断调查工具及软件,根据所提出的理论假设,采用线性结构方程建模的方法,构建了本研究的LISREL理论模型,并设计了相应的调查问卷和量表。从所建立的安全氛围的三个构面(安全管理、安全认知、安全态度)入手探讨企业的安全氛围对企业的安全行为(两个构面:安全执行、安全处理)的影响。本研究采用问卷调查的方式采集数据,将所得资料用SPSS11.0和LISREL8.3软件来分析处理和检验研究假设,研究结果为实证单位改进企业的安全行为提供了帮助。     

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

IntroductionThis 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.MethodsAn 84-item questionnaire was developed and pilot tested on a sample of 302 Australian miners across two open cut sites.ResultsA 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.ConclusionThe 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.Practical applicationsAs 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.     

Multi-level safety climate associations with safety behaviors in the fire service

Introduction: Limited research associated with safety climate has been completed within the fire service. Given this dearth of information, the present study sought to identify a valid and reliable measure of safety climate at both the workgroup and organizational levels within the fire service. Methods: Researchers surveyed 994 firefighters in two large metropolitan fire departments. Preliminary analyses including psychometrics, confirmatory factor analyses, and shared perception analyses were completed. A linear mixed model analysis was then completed to assess the relationships between workgroup safety climate, organizational safety climate, and safety behaviors, including both safety compliance and safety citizenship behaviors. Results: Measures of safety climate at the workgroup (WGSC) and organizational levels (OSC) were derived. WGSC factors include supervisor support (α = 0.92), vertical cohesion (α = 0.89), and horizontal cohesion (α = 0.94). OSC factors include management commitment (α = 0.91), safety programs/policies (α = 0.89), perceived fairness (α = 0.86) and incident command (α = 0.90). Confirmatory factor analyses confirmed our multi-factor models were a good fit to the data. The linear mixed model analysis found that WGSC positively predicted safety compliance behavior (B = 0.13, p < .001) and safety citizenship behavior (B = 0.22, p < .001) and OSC positively predicted safety compliance behavior (B = 0.16, p < .001) and safety citizenship behavior (B = 0.15, p < .001). Conclusions: This work presents reliable and valid measures of both workgroup and organizational safety climate, which have positive relationships with safety behavior outcomes. Practical application: The measures, which were developed through an extensive multi-method process, provide a means for researchers and practitioners to assess safety climate in the fire service and provides guidance for future safety climate research, including informing intervention research, which could potentially bolster safety climate and enhance safety in the fire service.     

Deriving the factor structure of safety climate scales

Since the original formulation of the notion of safety climate, many people have developed safety climate measures and conducted factor analyses to identify distinct dimensions. Typically, these analyses were based on samples of workers in a limited number of workplaces, but since they did not allow for the non-independence of the data, they are incorrect. An appropriate analysis should use a multi-level method. This flaw in the analyses to date may at least partly explain the different factor structures of safety climate reported in the literature.     

Leadership skills for strengthening jobsite safety climate

Introduction: Construction foremen may lack the leadership skills needed to create a strong jobsite safety climate. Many construction companies address this by sending their lead workers to the OSHA 30-h course; however the course does not include a leadership training module. This article describes the development and pilot testing of such a module and evaluation surveys designed to address this training gap. Methods: A 17-member curriculum development team, numerous subject matter experts, and an instructional design company helped us develop a comprehensive set of teaching resources and a set of survey instruments for evaluating the materials' effectiveness on improving safety leadership and safety climate. All materials and surveys were pilot tested with representative members of the target population. Results: Pilot surveys showed high reliability and data collected on the resulting Foundations for Safety Leadership (FSL) module indicated that the majority of foremen thought the training was helpful or valuable, particularly the discussion questions. The majority said they intended to use the skills on the jobsite. With the exception of the role-play activities, the trainers rated highly all other components, especially the videos and discussion questions. Modifications were made to the training materials and surveys based on pilot test findings. The most important result of the development and pilot testing efforts is that the OSHA Training Institute (OTI) included the FSL as an elective in the OSHA 30-h course. Conclusions: The FSL module fills a needed skills gap by providing safety leadership training to all foremen who might otherwise not have access to it through their company or union. The continued success of the FSL training will be ensured by dissemination via the OSHA 30-h course, an established nationwide safety training program. Practical applications: The FSL training module has already been widely accepted by the construction industry as a useful approach for providing construction foremen/See new abstract lead workers with the knowledge and skills they need to become more effective jobsite safety leaders.