The relationship between patient safety climate and occupational safety climate in healthcare – A multi-level investigation

IntroductionPatient safety climate/culture is attracting increasing research interest, but there is little research on its relation with organizational climates regarding other target domains.The aim of this study was to investigate the relationship between patient safety climate and occupational safety climate in healthcare.MethodThe climates were assessed using two questionnaires: Hospital Survey on Patient Safety Culture and Nordic Occupational Safety Climate Questionnaire. The final sample consisted of 1154 nurses, 886 assistant nurses, and 324 physicians, organized in 150 work units, within hospitals (117 units), primary healthcare (5 units) and elderly care (28 units) in western Sweden, which represented 56% of the original sample contacted.ResultsWithin each type of safety climate, two global dimensions were confirmed in a higher order factor analysis; one with an external focus relative the own unit, and one with an internal focus. Two methods were used to estimate the covariation between the global climate dimensions, in order to minimize the influence of bias from common method variance. First multilevel analysis was used for partitioning variances and covariances in a within unit part (individual level) and a between unit part (unit level). Second, a split sample technique was used to calculate unit level correlations based on aggregated observations from different respondents. Both methods showed associations similar in strength between the patient safety climate and the occupational safety climate domains.ConclusionsThe results indicated that patient safety climate and occupational safety climate are strongly positively related at the unit level, and that the same organizational processes may be important for the development of both types of organizational climate.Practical applicationsSafety improvement interventions should not be separated in different organizational processes, but be planned so that both patient safety and staff safety are considered concomitantly.     

Are the costs worth the benefits? Shared perception and the aggregation of organizational climate ratings

A definitional component of organizational climate is the focus on employees' shared perceptions of the focal climate domain. To operationalize the notion of sharedness, researchers typically aggregate employees' domain‐specific climate perceptions to a higher level and justify this aggregation using quantitative indices of agreement. In the current paper, I argue that although accounting for sharedness among employees can provide some valuable insight, our overreliance on sharedness obscures some of the very organizational phenomena of interest. I discuss this issue by focusing on four costs of making unfounded assumptions regarding sharedness: (a) Aggregation assumes individual differences are a function of random error; (b) aggregation assumes that social situations are uniform across employees; (c) aggregation assumes that the unit of analysis is clear‐cut; and (d) aggregation assumes the group mean is meaningful. I argue that researchers carefully need to weigh the costs of violating these assumptions against the expected benefits of aggregating employees' climate perceptions, recognizing that sometimes employees' perceptions (i.e., psychological climate) might provide greater insight into phenomena of interest. Although I discuss these costs within the context of organizational climate research, these arguments apply to other research areas where individual perceptions are aggregated (e.g., research on leadership and teams).     

Educational status and organizational safety climate: Does educational attainment influence workers’ perceptions of workplace safety?

From a practical perspective, understanding the impact of education on perceptions of workplace safety would benefit management’s decisions regarding workers’ adaptability, general work effectiveness, accident frequency, implementation of safety management policies, and handling of education-related accident characteristics. The current study thus examined the relationship between educational attainment and (i) safety perception, (ii) job satisfaction, (iii) compliance with safety management policies, and (iv) accident frequency. Participants were Ghanaian industrial workers (N = 320) categorized into four educational groups based on their responses: basic education 50% (n = 159); secondary education, n = 98 (30%); vocational/professional education, 17% (n = 56); and university education, 3% (n = 7). Workplace safety perception was assessed with Hayes et al.’s 50-item Work Safety Scale (WSS): a scale that effectively captures the dimensions identified by safety experts to influence perceptions of workplace safety. Multivariate analysis (MANOVA) was used to test for differences of statistical significance. Posterior comparison with t-test consistently revealed significant differences between the two higher-educated cohorts and their lower-educated counterparts. The results indicated a positive association between education and safety perception. Higher-educated workers recorded the best perceptions on safety, indicated the highest level of job satisfaction, were the most compliant with safety procedures and recorded the lowest accident involvement rate.     

Does the Maryland graduated driver licensing law affect both 16-year-old drivers and those who share the road with them?

PROBLEM: To assess effects of the 1999 Maryland graduated driver licensing (GDL) law on both 16-year-old drivers and other road users. METHOD: Calculation and comparison of crash involvement rates and non-fatal injury rates pre-GDL (1996-1998) and post-GDL (2001-2003) by type of road user, per population, and per licensed driver, with adjustment for trends among 30-59-year-old drivers. RESULTS: Post-GDL, prevalence of licensure decreased 24% among 16-year-olds, and rates of 16-year-old drivers involved in crashes significantly decreased per 16-year-old population (corrected rate ratio (RRc) 0.82; 95% CI (0.71, 0.96)). A significant decrease also was observed for non-fatal injuries per 16-year-old population among 16-year-old drivers involved in crashes (RRc 0.63; 95% CI (0.41, 0.98)). Similarly, decreases, albeit not statistically significant, were observed among their passengers and other vehicle occupants. Per 16-year-old licensed driver, a slight non-significant increase was observed in crash involvement rates; non-fatal injury rates per 16-year-old licensed driver suggest decreased risk (non-significant) among 16-year-old drivers, their passengers, and other vehicle occupants. SUMMARY: Maryland's GDL delayed licensure and reduced crashes and non-fatal injuries among 16-year-old drivers per population. Trends in injuries among other road users involved in crashes with 16-year-old drivers were suggestive of a benefit from GDL, although observed decreases were not significant. Per licensed driver, findings were not significant, but suggested little change in crash involvement and decreased non-fatal injuries. Because one-third fewer 16-year-olds were licensed post-GDL, these results may suggest a selection effect in licensure. IMPACT ON INDUSTRY: Because Maryland had nighttime restrictions for new drivers before 1999, this study suggests other components of GDL are beneficial for drivers and possibly for other road users. States with weak GDL laws should strongly consider revising them.     

Exposure-based assessment of the effectiveness of Michigan’s graduated driver licensing nighttime driving restriction

The objective of the study is to assess the effectiveness of Michigan’s graduated driver licensing (GDL) program in terms of nighttime driving restriction. The research uses the quasi-induced exposure technique to capture and represent the exposure and accident risk change of the impacted driver groups due to the implementation of the GDL program. Six years of Michigan accident data were used, including three years before the GDL implementation and three years after. The effectiveness of Michigan’s GDL program in terms of nighttime driving is reflected in several dimensions: for the impacted drivers (16- and 17-year-olds), there is a significant reduction of exposure compared to the reference group and a decrease in the relative accident involvement ratio (thus a reduced accident risk); and examination of time of day distributions of impacted teenage drivers shows that there is a conspicuous percentage drop of impacted teenage drivers at the point where the nighttime curfew starts. With the implementation of the GDL program, the affected group tends to drive increasingly more in the several hours prior to the restricted time period to avoid violating the curfew law. As opposed to the traditional exposure measurements such as population or licensed drivers, quasi-induced exposure technique has the capability of depicting the accident propensity and quantifying exposure change from different age groups.     

What signals does procedural justice climate convey? The roles of group status,and organizational benevolence and integrity

We propose and test a theoretical framework to explore why and how procedural justice climate influences individual behaviors after controlling for the influence of individual justice perception. Two types of symbolic information conveyed by procedural justice climate are considered. We argue that procedural justice climate reflects the status of or respect for a justice recipient, a work unit within an organization in our context, which then influences the identification of its members with the work unit. Procedural justice climate also reflects the moral attributes of a justice actor, herein an organization, which then influences organizational identification and perceived job security. Consistent with these arguments, results showed that perceived respect for the work unit mediated the relationship between procedural justice climate and identification with the work unit, and both perceived organizational benevolence and integrity mediated the relationship of procedural justice climate with organizational identification and job security. The two types of social identification and perceived job security were related to several outcome variables differently. Copyright © 2013 John Wiley & Sons, Ltd.     

Psychosocial risks in small enterprises: the mediating role of perceived working conditions in the relationship between enterprise size and workers’ anxious or depressive episodes

Purpose. The relationship between enterprise size and psychosocial working conditions has received little attention so far but some findings suggest that conditions are more favorable in small enterprises. This could have a positive impact on workers’ mental health. The objective of this study was to test the mediating effect of perceived working conditions in the relationship between enterprise size and anxious or depressive episodes. Methods. Data from the 2010 SUMER – Surveillance Médicale des Expositions aux Risques professionnels (French periodical cross-sectional survey) were analyzed; N?=?31,420 for the present study. Anxious or depressive episodes were measured with the hospital anxiety and depression scale and the perceived working conditions were psychological demand, decision latitude and social support as assessed with Karasek's job content questionnaire. The indirect effect was tested according to the method proposed by Preacher and Hayes. Results. In a multivariate logistic regression, the risk of anxious or depressive episodes was found to be lower in micro enterprises (2–9 employees). Formal tests pointed to a significant indirect effect of enterprise size on mental health through perceived working conditions, with a larger effect for psychological demand. Conclusion. This study highlights perceived working conditions as an explanation of the effects of enterprise size.     

Leading indicators of system safety – Monitoring and driving the organizational safety potential

An indicator can be considered any measure – quantitative or qualitative – that seeks to produce information on an issue of interest. Safety indicators can play a key role in providing information on organizational performance, motivating people to work on safety and increasing organizational potential for safety. We will describe the challenges of monitoring and driving system safety. Currently, the same lead indicators are used – explicitly or implicitly – for both purposes. The fact that the selection and use of safety performance indicators is always based on a certain understanding (a model) of the sociotechnical system and safety is often forgotten. We present a theoretical framework for utilizing safety performance indicators in safety–critical organizations that incorporates three types of safety performance indicators – outcome, monitor and drive indicators. We provide examples of each type of indicator and discuss the application of the framework in organizational safety management. We argue that outcome indicators are lag indicators since outcomes always follow something; they are the consequences arising from multiple other situational and contextual factors. Monitor and drive indicators are lead indicators. The main function of the drive indicators is to direct the sociotechnical activity in the organization by motivating certain safety-related activities. Monitor indicators provide a view on the dynamics of the organization: the practices, abilities, skills and motivation of the personnel – the organizational potential for safety. We conclude that organizations should better acknowledge the significance of monitor and drive indicators in safety management.     

Human and organizational factors in Chinese hazardous chemical accidents: a case study of the ‘8.12’ Tianjin Port fire and explosion using the HFACS-HC

Human and organizational factors have been proven to be the prime causes of Chinese hazardous chemical accidents (HCAs). A modified version of the Human Factors Analysis and Classification System (HFACS), namely the HFACS-Hazardous Chemicals (HC), was developed to identify the human factors involved in Chinese HCAs. The ‘8.12’ Tianjin Port fire and explosion, the costliest HCA in recent years, was reanalyzed using this framework, and the results were compared with the official accident inquiry report to determine their differences related to the identification of human and organizational factors. The study revealed that interacting human factors from different levels in Ruihai Company led to this catastrophe, and the inquiry report had limitations in the identification of human factors and the guidance for similar accident prevention. This study showed the applicability of the HFACS-HC in HCA analyses as well as the necessity to recommend this approach for future HCA investigations.     

What is the relationship between self-reported aberrant driving behaviors,mindfulness, and self-reported crashes and infringements?

Objectives: This study investigated the relationship between self-reported aberrant driving behaviors, mindfulness, and self-reported crashes and infringements.

Methods: Three hundred and eighteen participants (M = 46.0 years, SD = 13.7 years; female: 81.8%) completed an online survey that assessed aberrant driving behaviors, mindfulness (including regular mindfulness meditation [MM]), and self-reported crashes and infringements during the past 2 years. Structural equation modeling (SEM) was used to examine the relationship between self-reported aberrant driving behaviors and mindfulness simultaneously, as well as with participants' age and estimated kilometers driven over the past year.

Results: The results of the SEM showed that mindfulness was negatively related to each self-reported aberrant driving behavior, with the strongest relationships being between mindfulness and driving-related lapses (?0.58) and errors (?0.46). Participants who practice MM had significantly fewer crashes in the past 2 years and reported significantly fewer driving-related violations and lapses compared to participants who did not practice MM (crashes: 9.3% vs. 18.8%, P < .05; violations: M = 6.66 [SD = 3.44] vs. M = 7.68 [SD = 4.53], P < .05; errors: M = 5.17 [SD = 3.44] vs. M = 6.19 [SD = 4.12], P < .05).

Conclusions: More research is needed to understand whether MM results in more mindful and attentive drivers or whether individuals who practice MM may have other traits or behaviors that are linked to improved safety.     

An application of the Pareto method in surveys to diagnose managers’ and workers’ perception of occupational safety and health on selected Polish construction sites

The construction industry is an important sector of the economy in Poland. According to the National Labour Inspectorate (PIP) data of 2014, the number of victims of fatal accidents in the construction sector amounted to 80 as compared with 187 injured in all other sectors of economy in Poland. This article presents the results of surveys on the impact of construction worker behaviour on the occupational safety and health outcomes. The surveys took into account the point of view of both construction site management (tactical level) and construction workers (operational level). For the analysis of results, the method of numerical taxonomy and Pareto charts was employed, which allowed the authors to identify the areas of occupational safety and health at both an operational and a tactical level, in which improvement actions needed to be proposed for workers employed in micro, small, medium and large construction enterprises.     

Investigating the relationship between person–environment fit and safety behavior: A social cognition perspective

Introduction: This study explored the relationship between person–job fit and safety behavior, as well as the mediating role played by psychological safety, from the perspective of social cognitive theory and person–environment fit theory. Method: A total of 800 employees from petroleum enterprises were recruited, with cluster random sampling used to collect data in two stages. Results: The results showed that employees’ safety behavior is higher under the condition of “high person–job fit—high person–organization fit” than under that of “low person–job fit—low person–organization fit.” In other words, the more congruent the level of person–job fit and person–organization fit for a given employee, the higher their level of safety behavior. Practical Applications: Psychological safety plays a mediating role between the congruence of both person–job fit and person–organization fit and employees’ safety behavior.     

Does longevity impact the severity of traffic crashes? A comparative study of young-older and old-older drivers

Introduction: This article analyzes the effect of driver’s age in crash severity with a particular focus on those over the age of 65. The greater frequency and longevity of older drivers around the world suggests the need to introduce a possible segmentation within this group at risk, thus eliminating the generic interval of 65 and over as applied today in road safety data and in the automobile insurance sector. Method: We investigate differences in the severity of traffic crashes among two subgroups of older drivers –young-older (65–75) and old-older (75+), and findings are compared with the age interval of drivers under 65. Here, we draw on data for 2016 provided by Spanish Traffic Authority. Parametric and semi-parametric regression models are applied. Results: We identified the factors related to the crash, vehicle, and driver that have a significant impact on the probability of the crash being slight, serious, or fatal for the different age groups. Conclusions: We found that crash severity and the expected costs of crashes significantly increase when the driver is over the age of 75. Practical Applications: Our results have obvious implications for regulators responsible for road safety policies – most specifically as they consider there should be specific driver licensing requirements and driving training for elderly – and for the automobile insurance industry, which to date has not examined the impact that the longevity of drivers is likely to have on their balance sheets.     

Fatigued driver’s driving behavior and cognitive task performance: Effects of road environments and road environment changes

This study aims to explore the effects of different road environments and their changes on driving behaviors and cognitive task performance of fatigued drivers. Twenty-four participants volunteered in a 2 (road environment) × 3 (fatigue level) within-subjects factorial design simulated driving experiment. Participants were asked to perform basic numerical calculation and distance estimation of traffic signs when driving normally, and provide answers to a questionnaire on fatigue rating. Results show that fatigued drivers faced greater attention demand, were less alert, and tended to overestimate the distance to roadside traffic signs. Fatigue caused by driving in complex road environment had the greatest negative impact on driving behavior and visual distance estimation, and the fatigue transfer effect worsened significantly but differently on both driving behavior and performance of fatigued drivers when switching from a complex to a monotonous road environment and vice versa. Notably, this study shows that fatigued drivers performed relatively better in arithmetic tasks than non-fatigued ones. In addition, when switching from a monotonous to a complex road environment, drivers’ performance in visual distance estimation and arithmetic tasks improved though their driving behavior deteriorated, revealing that the fatigue effect upon drivers might be explained to some extent by their alertness and arousal levels.     

Breaking rules for the right reasons? An investigation of pro‐social rule breaking

Pro‐social rule breaking (PSRB) is a form of constructive deviance characterized by volitional rule breaking in the interest of the organization or its stakeholders. Over the course of three studies, we developed a generalizable measure of PSRB and placed it in a nomological network with personality, workplace perceptions, counterproductive behaviors, and task and contextual performance ratings made by supervisors and coworkers. Results indicate that PSRB is negatively related to task performance ratings across both sources despite its pro‐social motivation intended to help the organization. Potential directions for future research concerning reactions to constructive deviance are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

The relationship between gender and performance issues of concern to directors: correlates or institution?

This paper focuses on the influence of gender on performance issues which concern directors of publicly traded corporations in Israel. Two theoretical perspectives for the explanation of gender differences in occupations were examined. The first views gender as an individual‐level property that is correlated with occupational and job variables and the behavioral differences between men and women as the result of these correlates. According to this perspective, when the correlates of gender are controlled, these differences disappear. The second perspective treats gender not only as a property that individuals bring with them to the workplace, but also as an institutionalized characteristic of the workplace, of occupations, and of occupational environments, as embedded in formally defined rules, roles and responsibilities. Consequently, gender influences are not easily eliminated. The dependent variable was the extent to which men and women differ in their concerns regarding their roles as directors. The independent variables included human, social capital and organizational context variables, and gender. Data were collected by means of questionnaires from a representative sample of directors (98 women and 127 men). The findings lend partial support for a view of gender as a social institution and directors as a gendered occupation. Copyright © 1999 John Wiley & Sons, Ltd.     

The stress of managerial and professional women: is the price too high?

‘Live as domestic a life as possible. Have your child with you all the time. Lie down an hour after each meal. Have but two hours intellectual life a day. And never touch pen, brush or pencil as long as you live’. Dr S. Weir Mitchell, 1855 When Dr Mitchell, purportedly the greatest North American nerve specialist of his time, gave the above advice to his patient Charlotte Perkins Gilman, he almost certainly believed he was helping her get over a severe nervous condition. Fortunately, she did not take his advice. Instead she devoted herself to the study of economics and regained her health. The perspectives offered to working women by many a modern day Dr Mitchell appear to have changed somewhat in subtlety, but little in kind. For example, the August 18, 1986 cover of Fortune magazine featured a beaming mother and cherubic child illustrating the lead article, entitled ‘Why women are bailing out’. The article goes on to tell why four of the ‘best’ women MBAs had quit the workforce. One stated ‘I had to hire and fire people … I just don't want the hassle’ (of corporate life). Another having passed up a promotion at a Houston bank, ‘quit to have her first child’ and after her second had no plans to go back to work. A third complained: ‘I just couldn't do it. I watched other women sliding as they tried to juggle both career and family, making themselves crazy in the process’. And the fourth left a big accounting firm because the ‘hours were bad, and is now happier as a “part time teacher”’. While the Fortune article mentioned several reasons for women's leaving the corporate world ranging from competing family demands to discrimination, the underlying messages were clearly that mothers have to choose between children and career and that the business world is too cold, uncaring and tough for women, in a word no place for a lady. A chorus of such articles have appeared in the popular media warning against the dangers of career commitment for women, which are said to include everything from burnout, infertility, alcoholism, heart attacks to terminal spinsterhood (Faludi, 1991). More serious treatments emanating from academia have often reached similar conclusions. These dire pronouncements are especially influential to young women contemplating a professional or managerial career, but indeed those already in such careers may also wonder if they have made a bad choice. To answer such questions, this paper will explore some aspects of the relationship between career and emotional health and well-being for a group of highly successful career women.     

Socio-demographic and experience factors affecting drivers’ runoff risk along horizontal curves of two-lane rural highway

Introduction: An improper driving strategy is one of the causative factors for a high probability of runoff and overturning crashes along the horizontal curves of two-lane highways. The socio-demographic and driving experience factors of a driver do influence driving strategy. Hence, this paper explored the effect of these factors on the driver’s runoff risk along the horizontal curves. Method: The driving performance data of 48 drivers along 52 horizontal curves was recorded in a fixed-base driving simulator. The driving performance index was estimated from the weighted lateral acceleration profile of each driver along a horizontal curve. It was clustered and compared with the actual runoff events observed during the experiment. It yielded high, moderate, and low-risk clusters. Using cross-tabulation, each risk cluster was compared with the socio-demographic and experience factors. Further, generalized mixed logistic regression models were developed to predict the high-risk and high to moderate risk events. Results: The age and experience of drivers are the influencing factors for runoff crash. The high-risk event percentage for mid-age drivers decreases with an increase in driving experience. For younger drivers, it increases initially but decreases afterwards. The generalized mixed logistic regression models identified young drivers with mid and high experience and mid-age drivers with low-experience as the high-risk groups. Conclusions: The proposed index parameter is effective in identifying the risk associated with horizontal curves. Driver training program focusing on the horizontal curve negotiation skills and graduated driver licensing could help the high-risk groups. Practical applications: The proposed index parameter can evaluate driving behavior at the horizontal curves. Driving behavior of high-risk groups could be considered in highway geometric design. Motor-vehicle agencies, advanced driver assistance systems manufacturers, and insurance agencies can use proposed index parameter to identify the high-risk drivers for their perusal.     

Under what conditions does job control moderate the relationship between time pressure and employee well‐being? Investigating the role of match and personal control beliefs

Drawing upon the concept of match, this two‐wave study of 206 employees investigated job control (facets of autonomy) and personal control beliefs (locus of control, LOC) as moderators of time pressure–work engagement (WE) and the time pressure–general subjective well‐being (SWB) relationships. It was hypothesized that autonomy would accentuate the positive relationship of time pressure with WE and attenuate the negative relationship with SWB and that these moderations would occur only for employees with an internal LOC. Additionally, it was expected that a facet of job control (timing autonomy) that matched the specific demand (time pressure) would be more likely to act as a moderator than “less‐matching” facets (decision making or method autonomy). The results revealed that the interaction between time pressure, autonomy, and LOC for WE was strongest and for SWB only significant when the timing facet of autonomy served as the moderator (thus, when the autonomy facet matched the demand). However, the pattern of moderation was contrary to that expected. When time pressure increased, high autonomy became beneficial for the WE of employees with an external LOC but detrimental for the WE and SWB of employees with an internal LOC. Explanations for the unexpected findings are provided. Copyright © 2016 John Wiley & Sons, Ltd.