An investigation of occupational subgroups with respect to patient safety culture

There are varying views about the consistency of safety culture across a given organisation or industrial sector: some view it as homogeneous, whereas others have suggested the presence of sub-cultures that vary according to the work group or worksite. This paper reports on a study in which job characteristics and safety climate ratings from a sample of British community pharmacists (N = 860) were subjected to a cluster analysis, with the aim of identifying whether discrete groups can be identified on the basis of these ratings. A four-cluster solution was obtained from the analysis. Examination of quantitative and qualitative data from each cluster led to them being identified as: (i) the disenfranchising pharmacy; (ii) the perilous pharmacy; (iii) the safety-focused pharmacy; (iv) the challenging pharmacy. On the basis of the data obtained, safety culture appears to have both characteristics generic to all community pharmacies and characteristics specific to each cluster, with a number of social and organisational factors influencing the culture in any one setting. Implications for the modelling and assessment of safety culture are discussed.     

Psychosocial safety climate: Conceptual distinctiveness and effect on job demands and worker psychological health

Psychosocial safety climate is an emerging construct that refers to shared perceptions regarding policies, practices, and procedures for the protection of worker psychological health and safety. The purpose of the research was to: (1) demonstrate that psychosocial safety climate is a construct distinct from related climate measures (i.e., physical safety climate, team psychological safety, and perceived organizational support); and (2) test the proposition that organizational psychosocial safety climate determines work conditions (i.e., job demands) and subsequently worker psychological health. We used samples from two different cultures; an Australian sample (N = 126 workers in 16 teams within a primary health care organization) and a Malaysian sample (N = 180 workers in 31 teams from different organizations and diverse industries). In both samples confirmatory factor analysis verified that psychosocial safety climate is a construct distinct from related climate measures. Using hierarchical linear modeling, psychosocial safety climate was superior to other team level climate measures in its negative relationship to both job demands and psychological health problems. Results supported a mediation process, psychosocial safety climate → job demands → psychological health problems, corroborating psychosocial safety climate as a preeminent stress risk factor, and an efficient target for intervention. We found both physical and psychosocial safety climates were stronger in the Australian, compared with the Malaysian work context. Levels of psychosocial safety climate were significantly lower than those of physical safety climate in both countries indicating a ‘universal’ lack of attention to workplace psychological health.     

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.     

The relationship between recruitment processes, familiarity, trust, perceived risk and safety

Introduction and Method

Participants′ perceptions of the safety-related aspects of their organization′s recruitment processes were examined, as were their perceptions of safety aspects associated with new recruits.

Results

One hundred and fifty-four professional fire fighters indicated the trust they held in the safety-related aspects of their organizations′ selection and pre-start training. Perceived trust in pre-start training was negatively correlated (r = -.24, p < .01) with the risk associated with new recruits, and positively correlated (r = .50, p < .01) with ratings of trust in recruits to immediately work safely. Furthermore, trust in recruits to immediately work safely was negatively correlated (r = -.21, p < .01) with crews′ safety behavior toward recruits.

Conclusions

These results are interpreted as particularly dangerous for workers, as new recruits lack familiarity with aspects of their new workplace that cannot be addressed by either selection or pre-start training, making them a risk.

Impact on Industry

Organizations should actively identify new recruits, and encourage existing team members not to immediately trust new recruits to work safely.     

Traffic culture as symbol exchange - A cross-country comparison of Russia and Norway

The core aim of the study was to gain insight into the cross-country differences in traffic risk perception and driving behaviour and also how culture and cultural differences may influence perceived risk and risk behaviour by comparing a sample of the Russian population with a sample of the Norwegian population. A new measurement instrument aimed at measuring culture as symbol exchange was applied. Self-completion questionnaire surveys were carried out among representative samples of the Norwegian (n = 247) and the Russian (n = 299) population aged 18 years and over. The results showed that culture defined as symbol exchange was weakly associated with risk perception. It is suggested that research carried out to date on the role of culture in risk research may have focused on criterion variables which are not very relevant. However, while traffic safety culture does not seem to be important for risk perception, this study shows that it seems to be relevant for drivers’ risk behaviour and thus it is still relevant and important to focus on traffic culture in risk research despite the fact that culture does not predict perceived risk. As symbol exchange, the newly developed measure of traffic safety culture is capable of predicting drivers’ risk behaviour in traffic and is therefore a valid predictor of traffic safety.     

Improving construction site safety through leader-based verbal safety communication

Background

The construction industry is one of the most injury-prone industries, in which production is usually prioritized over safety in daily on-site communication. Workers have an informal and oral culture of risk, in which safety is rarely openly expressed. This paper tests the effect of increasing leader-based on-site verbal safety communication on the level of safety and safety climate at construction sites. Method: A pre-post intervention-control design with five construction work gangs is carried out. Foremen in two intervention groups are coached and given bi-weekly feedback about their daily verbal safety communications with their workers. Foremen-worker verbal safety exchanges (experience sampling method, n = 1,693 interviews), construction site safety level (correct vs. incorrect, n = 22,077 single observations), and safety climate (seven dimensions, n = 105 questionnaires) are measured over a period of up to 42 weeks. Results: Baseline measurements in the two intervention and three control groups reveal that foremen speak with their workers several times a day. Workers perceive safety as part of their verbal communication with their foremen in only 6-16% of exchanges, and the levels of safety at the sites range from 70-87% (correct observations). Measurements from baseline to follow-up in the two intervention groups reveal that safety communication between foremen and workers increases significantly in one of the groups (factor 7.1 increase), and a significant yet smaller increase is found when the two intervention groups are combined (factor 4.6). Significant increases in the level of safety are seen in both intervention groups (7% and 12% increases, respectively), particularly in regards to 'access ways' and 'railings and coverings' (39% and 84% increases, respectively). Increases in safety climate are seen in only one of the intervention groups with respect to their 'attention to safety.' No significant trend changes are seen in the three control groups on any of the three measures. Conclusions: Coaching construction site foremen to include safety in their daily verbal exchanges with workers has a significantly positive and lasting effect on the level of safety, which is a proximal estimate for work-related accidents. It is recommended that future studies include coaching and feedback at all organizational levels and for all involved parties in the construction process. Building client regulations could assign the task of coaching to the client appointed safety coordinators or a manager/supervisor, and studies should measure longitudinal effects of coaching by following foremen and their work gangs from site to site.     

Time trends and predictive factors for safety perceptions among incoming South Australian university students

Problem

Young workers are over-represented in injury statistics. In order to develop injury prevention strategies, this study investigated time trends and predictive factors relating to safety skills, confidence, and attitudes.

Method

Annual surveys were conducted from 2006-2009 among incoming students at the University of Adelaide. The questions addressed safety training, injury experience, and health and safety perceptions.

Results

Time trends in training, perceived safety skills, confidence, and attitudes were not significant. In terms of skills and confidence, the most important correlate was safety training outside of high school (odds ratio = 1.6), especially when repeated, assessed, or in face to face mode. Feeling strongly about safety issues was best predicted by injury experience (OR = 1.7) and gender.

Discussion

These results emphasize the value of assessed training, but they are also consistent with published U.S. data, indicating no improvement over time. It is suggested that there be a more integrated approach in safety education, involving schools and workplaces.

Impact on industry

By developing an understanding of student safety perceptions and experiences, this research aims to target strategies to reduce the excess injury rate for young workers. Workplaces should be more aware of the limitations of school-based safety education and a more integrated and evidence-based approach should be developed, involving schools and workplaces.     

Cultural influences on workplace safety: An example of hospital workers’ adoption of patient lifting devices

Aims

A sociological and anthropological view of culture was used to investigate how work culture, independent of “safety culture”, may affect safety in the workplace. We explored how work cultures of nurses and physical/occupational therapists (PT/OTs) in two acute care hospitals are related to the adoption of patient lifting devices.

Methods

Focus groups were conducted between 2006 and 2009, seven with nurse staff (n = 39) and two with PT/OT staff (n = 17), to explore issues concerning a Minimal Manual Lift Environment policy, initiated in 2004, and subsequent use of patient lift equipment. Audio recordings of the sessions were transcribed; text data were analyzed using N6-QSR. Cultural facilitators and barriers to the adoption of patient lift equipment were examined.

Results

Data revealed cultural similarities and differences between these healthcare professions. Both displayed a “patient first” approach to care-giving which may promote lift device use for patients’ benefits, not necessarily for staff safety. Also, the implied purpose of patient lifting devices clashes with the nurses’ cultural emphasis on compassion, and with PT/OTs’ cultural emphasis on independence except when use increases patients’ independence.

Conclusions

Cultural expressions regarding the nature of care-giving among healthcare professionals may affect the propensity to adopt safety measures in complex ways. The workers’ understanding of the purpose of their work, and acceptable means of conducting it, should be understood before implementing safety interventions. The utilization of lift assist teams, who are not socialized into the cultures of nursing or PT/OT, may be one means of circumventing cultural barriers to lift equipment use.     

The effect of integrated management system on safety and productivity indices: Case study; Iranian cement industries

Nowadays, with implementation of management systems and environment management and due to the influence of safety and health issues on working processes, organizations have also sought to acquire health and safety management systems. This study which aims to examine the influence of integrated management system on safety and productivity indices has retrospective experimental nature. It was conducted in Cement Factories in which three systems are used: quality, environment and safety systems. The collected data were: accident reports and the investigation of events in 6 years during 2005-2010 (3 years before and 3 years after the implementation of the system). The safety indices that used in this study are: IFR, ISR, FSI, and Safe T. Score. Then, the data analyzed with the T-test, mean and standard deviation. The results showed a significant difference between various safety indices before and after the implementation. The examination of production indices such as increasing rate of productivity and production indicates the influence of these systems on production and productivity indices. The results have showed that the safety system existence cannot ensure productivity increase. Indices definition can be helpful for the safety system effectiveness and system continual improvement. It is important to say that there might be various indices definition in different industries.     

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.     

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.     

Change in frontline supervisors’ safety leadership practices after participating in a leadership training program: Does company size matter?

Introduction: The majority of construction companies are small businesses and small business often lack the resources needed to ensure that their supervisors have the safety leadership skills to build and maintain a strong jobsite safety climate. The Foundations for Safety Leadership (FSL) training program was designed to provide frontline leaders in all sized companies with safety leadership skills. This paper examines the impact of the FSL training by size of business. Methods: Leaders, defined as foremen or other frontline supervisors, from small, medium, and large construction companies were recruited to participate in a study to evaluate the degree to which the FSL changed their understanding and use of the leadership skills, safety practices and crew reporting of safety-related conditions. We used linear mixed modeling methods to analyze pre-post training survey data. Results: Prior to the training, leaders from small and medium sized companies reported using safety leadership skills less frequently than those from large ones. After the training, regardless of business size, we observed that the FSL training improved leaders understanding of safety leadership skills from immediately before to immediately after the training. Additionally, leaders reported greater use of safety leadership skills, safety practices, and crew reporting of safety-related conditions from before to two-weeks after the training. However, those from small and medium sized companies reported the greatest improvement in their use of safety leadership skills. Conclusions: The FSL training improves safety leadership outcomes regardless of the size company for which the leader worked. However, the FSL may be even more effective at improving the safety leadership skills of leaders working for smaller sized construction companies or those with lower baseline levels of safety leadership skills. Practical applications: The majority of construction companies employ a small number of employees and therefore may not have the resources to provide their frontline leaders with the leadership training they need to be effective leaders who can create a strong jobsite safety climate. The Foundations for Safety Leadership (FSL) training can help fill this gap.     

Safety leadership and safety behavior in container terminal operations

IntroductionThe importance of leadership for effective safety management has been the focus of research attention in industry for a few years. However, safety leadership in relation to self-reported safety behavior has rarely been examined. This research empirically evaluates the crucial dimensions of safety leadership in the context of container terminal operations.MethodUsing survey data collected from 336 respondents working for five major container terminal companies in Taiwan engaged in container terminal operation, tally, and stevedore activities at international ports on the island. Hierarchical regression analysis was used to examine the effects of safety leadership dimensions on self-reported safety behavior.ResultsConfirmatory factor analysis identified three main dimensions of safety leadership, as measured on a safety leadership scale: safety motivation, safety policy, and safety concern. The results suggest that safety motivation and safety concern positively affect self-reported safety behavior, such as safety compliance and safety participation, and the safety policy dimension has a positive influence on safety participation. The study findings also reveal positive associations between safety training and self-reported safety behavior. The findings implications for increasing safety in container terminal operations and their contribution to the development of safety leadership are discussed.     

Perceived organizational support and perceived safety climate from the perspective of safety professionals: Testing reciprocal causality using a cross-lagged panel design

Introduction: The objective of this study was to determine the reciprocal relationship between safety professionals perceived organizational support (POS) and perceived safety climate. Safety professionals are most effective when they perceive support from management and employees and they also attribute most of their success to support from the organization. Their work directly improves safety climate, and organizations with a high safety climate show a higher value for the safety professional. The causal direction of this relationship is, however, unclear. Method: Using a sample of 162 safety professionals, we conducted a cross-lagged panel study over one year to examine whether safety professionals’ POS improves their perceived safety climate and/or whether safety climate also increases POS over time. Data were collected at two points and, after testing for measurement invariance, a cross-lagged SEM was conducted to analyze the reciprocal relationship. Results: Our findings show that safety professionals’ POS was positively related to perceived safety climate over time. Perceived safety climate, however, did not contribute to safety professionals’ POS. Conclusions: This study significantly adds to the discussion about the factors influencing safety professionals’ successful inclusion in organizations, enabling them to perform their work and, thus, improve occupational safety. Practical Applications: Since safety climate increases in organizations in which safety professionals feel supported, this study points out the kind of support that contributes to improved organizational safety. Support for safety professionals may come in classical forms such as approval, pay, job enrichment, and information on or influence over organizational policies.     

Safety leadership and safety performance in petrochemical industries: The mediating role of safety climate

This study examines the relationship among three latent variables: safety leadership, safety climate, and safety performance. Employees from 23 plants in seven departments of a petrochemical company in central Taiwan completed a questionnaire survey. From this, a sample of 521 responses was randomly selected. Structural equation modeling (SEM) analysis using the AMOS 5.0 was employed to test the hypothesized model relating the above-mentioned variables. The results indicate that the model was supported, and that safety climate mediated the relationship between safety leadership and performance. Practical implications of these results for process safety management in the petrochemical industries are discussed.     

A safety culture maturity model for petrochemical companies in Brazil

A framework to measure safety culture maturity in the Brazilian oil and gas companies was formulated based on the model of Hudson (2001). Following a review of the safety culture literature, a questionnaire was designed to measure five aspects of organisational safety indicative of five levels of cultural maturity. The questionnaire was completed by the safety managers of 23 petrochemical companies based in Camacari, Bahia, Brazil and they were interviewed one month later. The reliability of the questionnaire was tested by asking the same questions in an interview and comparing the results (alternate forms reliability). The correlation coefficients between the questionnaire and interview scores on each dimension ranged from r = 0.7 to 0.9, demonstrating good reliability of the measures used. The research findings demonstrated that the 23 companies studied showed characteristics of different levels of safety culture maturity. Most scores were at the level of proactive. The model of Hudson (2001) and the revised framework and questionnaire were found to be practical to use, making it possible to identify levels of safety culture maturity in the context of the Brazilian petrochemical industry.