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Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.

The purpose of this paper is to provide a comprehensive model of safety culture for the US fire service.

Based upon a modified version of Cooper’s Reciprocal Determinism Model, the research uses two sets of exogenous variables, labeled Safety Management System and Safety Related Behaviors, to explain a dependent variable called Organizational Safety Climate. The model has been used successfully to improve safety performance in other high risk, high performance organizations. Using survey data collected from over 1,000 firefighters in three medium‐sized US municipalities, the theoretical model is tested.

Results from multiple regression analyses provide strong support for the hypothesis that individual perceptions of safety management and safety behavior predict individual perceptions of safety climate, both at the “fire service” organizational level and at the individual department level.

Limitations of the study include a cross‐sectional design, the use of self‐reported perceptions for the variables, and the fact that the three mid‐sized US fire departments from which data were gathered self‐selected to participate in the study.

A practical feature of the theoretical model tested is the ability to create “safety report cards” for each of the 12 dimensions that define the three variables used in the study.

This model holds the promise of reducing firefighter injuries and deaths by identifying managerial and behavioral safety improvement areas within US fire departments.

To the authors’ knowledge, this research represents the first attempt to both identify and test empirically a safety culture model for the US fire service.

The purpose of this paper is to examine the relationship between safety culture and the organizational identity of safety management system (SMS), in order to provide more awareness of how airline employees perceive organizational identity and safety culture as they successfully implement SMS.

A conceptual path model analysis is tested using data analysis research design.

The findings show that safety culture has been strengthened as the result of the implementation of a SMS. Furthermore, the loyalty factor of organizational identity is found to positively and significantly predict the performance of SMS through safety culture.

This paper is intended to provide some introductory perspectives on how to successfully apply safety culture and the supporting organizational identity for implementing SMS, as well as guidance about the areas in which airlines must improve if they wish to reduce accidents and incidents.

The questionnaire survey is designed to form perceptions of flight crews and helps to maintain a focus on the key persons in aviation safety management.

This study aims to use organizational identification, organizational culture and safety culture as the intervening variables between safety mission statements and safety behavior to survey and model the process of brokering knowledge from the top strategy makers to the workers on assignments. A pilot empirical research initiative was launched to determine the linkage between safety missions and safety behavior in the airline industry.

First, descriptive statistics and independent‐sample t‐tests were used to evaluate the mean, standard deviation (SD) and the relationship between the safety mission statement, organizational identification, organizational culture, safety culture and safety behavior and the respondent's years of working for the sampled airline. In addition, Pearson correlation analysis was used to test the relationships between the five factors. Finally, path analysis was used to examine the direct effects and indirect effects between individual factors.

The findings show that organizational identification and organizational culture are two important intervening variables between the safety mission statement (knowledge brokering) and safety behavior. The results of Pearson correlation analysis indicate that five factors are highly correlated with each other, especially the safety mission statement and organizational identification; organizational culture and safety culture; organizational identification and organizational culture; and safety culture and safety behavior. Besides, the safety mission statement has a negative direct effect on the pilot's safety behavior.

To understand the process of using the safety mission statement to change safety behavior can significantly increase the benefits of brokering knowledge. Furthermore, this study has provided an overview of the flight crews' perceptions on how safety is managed in the aviation industry. Based on the findings, it is concluded that organizations in the various sectors of the airline could do better in managing safety, and in brokering the safety knowledge in the industry. At another level, this study provides an opportunity to explore the validity of causal relationships among different areas.

The purpose of this paper is to explore the relationship between organizational learning and patient safety culture in hospital pharmacy settings as determined by the learning organization survey short-form (LOS-27) and pharmacy survey on patient safety culture instruments, and to further explore how dimensions of organizational learning relate to dimensions of pharmacy patient safety culture.

This study is a cross-sectional study. Data were obtained from three public hospital pharmacies and three private hospital pharmacies in Kuwait. Partial least square structural equation modeling was used to analyze the data.

A total of 272 surveys (59.1 percent response rate) were completed and returned. The results indicated a significant positive relationship between organizational learning and patient safety culture in hospital pharmacy settings (path coefficient of 0.826, p-value <0.05 and R² of 0.683). Several dimensions of the organizational learning showed significant links to the various dimensions of the pharmacy patient safety culture. Specifically, training (TRN), management that reinforces learning (MRL) and supportive learning environment (SLE) had the strongest effects on the pharmacy patient safety culture dimensions. Moreover, these effects indicated that MRL, SLE and TRN were associated with improvements in most dimensions of pharmacy patient safety culture.

To the best of the authors’ knowledge, this is the first attempt to assess the relationship between organizational learning, patient safety culture and their dimensions in hospital pharmacy settings.

This article aims to encourage healthcare administrators to consider the learning organization concept and foster collaborative learning among teams in their attempt to improve patient safety.

Relevant healthcare, organizational behavior and human resource management literature was reviewed.

A patient safety culture, fostered by healthcare leaders, should include an organizational culture that encourages collaborative learning, replaces the blame culture, prioritizes patient safety and rewards individuals who identify serious mistakes.

As healthcare institution staffs are being asked to deliver more complex medical services with fewer resources, there is a need to understand how hospital staff can learn from other organizational settings, especially the non‐healthcare sectors.

The paper provides suggestions for improving patient safety which are drawn from the health and business management literature.

Driving for work has been identified as potentially one of the riskiest activities performed by workers within the course of their working day. Jurisdictions around the world have passed legislation and adopted policy and procedures to improve the safety of workers. However, particularly within the work driving setting, complying with legislation and the minimum safety standards and procedures is not sufficient to improve work driving safety. This chapter outlines the manner in which safety citizenship behavior can offer further improvement to work-related driving safety by acting as a complementary paradigm to improve risk management and current models and applications of safety culture.

Research on concepts associated with risk management and theoretical frameworks associated with safety culture and safety citizenship behavior are reviewed, along with their practical application within the work driving safety setting. A model incorporating safety citizenship behavior as a complementary paradigm to safety culture is proposed. It is suggested that this model provides a theoretical framework to inform future research directions aimed at improving safety within the work driving setting.

The purpose of this paper is to examine the relationship between health and safety (H&S) and organisational culture in project business, in particular to explore the validity of current cognitive emphases of linear organisational maturity towards a “safety culture”, and normative models and prescriptions.

An interpretative methodology is employed, informed by ethnography (Douglas' cultural theory) and clinical consultative (Schein's model) approaches, using case‐based analysis comprising seven project business organisations.

The cases were characterized by diverse organisational cultures and diverse H&S practices informed by habits and intuitive behaviour, as well as cognitive strategies and decisions for implementation. H&S was not the top priority for these cases. Good performance related to alignment with the prevailing culture rather than pursuit of a “safety culture”.

The term “safety culture” is misdirected; greater attention on what is, rather than normative models and prescription, is necessary. Generalisation is limited by the case‐based approach.

Practitioners need to pay more attention to organisational culture and alignment of H&S practices, to the unintended consequences of prescriptions, and robust systems.

The way activities are conducted requires awareness of the prevailing culture in order to align the structure and processes to the culture for effective operations. These implications are general, and within project business and management, Failure to do so carries increased risk of failing to satisfy business and broader stakeholder interests.

Anomalies in H&S research and practice are challenged, especially “safety culture” and normative approaches. The contribution is the combination employment of the Schein and Douglas models to understand organisational culture and H&S cultural alignment.

The purpose of this paper is to investigate the relationship between patient safety culture and two attitudinal constructs: affective organizational commitment and structural empowerment. In doing so, the main and interaction effects of the two constructs on the perception of patient safety culture were assessed using a cohort of physicians.

Affective commitment was measured with the Organizational Commitment Questionnaire, whereas structural empowerment was assessed with the Conditions of Work Effectiveness Questionnaire-II. The abbreviated versions of these surveys were administered to a cohort of 71 post-doctoral medical residents. For the data analysis, hierarchical regression analyses were performed for the main and interaction effects of affective commitment and structural empowerment on the perception of patient safety culture.

A total of 63 surveys were analyzed. The results revealed that both affective commitment and structural empowerment were positively related to patient safety culture. A potential interaction effect of the two attitudinal constructs on patient safety culture was tested but no such effect was detected.

This study suggests that there are potential benefits of promoting affective commitment and structural empowerment for patient safety culture in health care organizations. By identifying the positive associations between the two constructs and patient safety culture, this study provides additional empirical support for Kanter’s theoretical tenet that structural and organizational support together helps to shape the perceptions of patient safety culture.

Despite the wide recognition of employee empowerment and commitment in organizational research, there has still been a paucity of empirical studies specifically assessing their effects on patient safety culture in health care organizations. To the authors’ knowledge, this study is the first empirical study to examine the relationship between structural empowerment as proposed by Kanter and the culture of patient safety using physicians.

Partnerships have assumed greater importance since organisations began to downsize and concentrate their resources on core activities. Effective partnerships depend on establishing adequate levels of trust and commitment between the partners in order for each partner to achieve complementary but different objectives. The success of partnerships is dependent on the alignment and maturity of the organisations’ cultures and it has been suggested, therefore, that potential partners should assess and take account of their organisational cultures before committing to partnership arrangements. An assessment framework has been proposed that provides a measure of the maturity and alignment of organisational cultures in partnership arrangements. The utility of the framework was assessed using organisational safety cultures within three organisational settings and using employee‐employee, employee‐contractor and company‐company partnership arrangements.