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The modern workplace contains many physical and interpersonal hazards to employee physical and psychological health/well-being. This chapter integrates the literatures on occupational safety (i.e., accidents and injuries) and mistreatment (physical violence and psychological abuse). A model is provided linking environmental (climate and leadership), individual differences (demographics and personality), motivation, behavior, and outcomes. It notes that some of the same variables have been linked to both safety and mistreatment, such as safety climate, mistreatment climate, conscientiousness, and emotional stability.

Hospitals within the United States consistently have injury rates that are over twice the national employee injury rate. Hospital safety studies typically investigate care providers rather than support service employees. Compounding the lack of evidence for this understudied population is the scant evidence that is available to examine the relationship of support service employees’ perceptions of safety and work-related injuries. To examine this phenomenon, the purpose of this study was to investigate support service employees’ perceptions of safety leadership and social support as well as the relationship of safety perception to levels of reported injuries.

A nonexperimental survey was conducted with the data collected from hospital support service employees (n=1,272) and examined: (1) relationships between safety leadership (supervisor and organization) and individual and unit safety perceptions; (2) the moderating effect of social support (supervisor and coworker) on individual and unit safety perceptions; and (3) the relationship of safety perception to reported injury rates. The survey items in this study were based on the items from the AHRQ Patient Safety Culture Survey and the U.S. National Health Care Surveys.

Safety leadership (supervisor and organization) was found to be positively related to individual safety perceptions and unit safety grade as was supervisor and coworker support. Coworker support was found to positively moderate the following relationships: supervisor safety leadership and safety perceptions, supervisor safety leadership and unit safety grade, and senior management safety leadership and safety perceptions. Positive employee safety perceptions were found to have a significant relationship with lower reported injury rates.

These findings suggest that safety leadership from supervisors and senior management as well as coworker support has positive implications for support service employees’ perceptions of safety, which, in turn, are negatively related to lower odds of reporting injuries.

Occupational injury in the health care sector in the United States rates among the highest of all industries. Specific to hospital support service workers (e.g., Food & Nutrition, Environmental Services), studies have shown that injury rates for support service workers tend to be among the highest of hospital personnel, and yet there is a shortage of research investigating the safety climate of these workers. Therefore, the purpose of this study is to examine safety perceptions of support service workers. Surveys were used to measure safety climate leadership factors (per the AHRQ's Survey of Patient Safety Culture) to determine if they are related to individual safety perceptions, as well as ratings of work unit safety. Following established safety climate research, we examined the role of the work environment (e.g., supervisor support and work unit culture) on safety perceptions. We found that both supervisor and organizational safety leadership are positively related to individual safety perceptions and supervisor support. Organizational safety leadership and work unit culture were positively related to work unit safety rating. Our findings demonstrate that the antecedent factors and pathways that promote a positive safety climate among health care providers functions in a similar manner for support service workers. These findings contribute to a better understanding of occupational safety of this understudied work group and provide evidence to hospital administration that developing a strong safety climate among support service workers is not entirely different from what is required to promote a robust safety climate across an organization.

While research on workplace safety spans across disciplines in medicine, public health, engineering, psychology, and business, research to date has not adopted a multilevel theoretical perspective that integrates theoretical issues and findings from various disciplines. In this chapter, we integrate research on workplace safety from a variety of disciplines and fields to develop a multilevel model of the processes that affect individual safety performance and safety and health outcomes. In doing so, we focus on cross-level linkages among national, organizational, and individual-level variables in relation to the exhibition of safe work behavior and occurrence of individual-level accidents, injuries, illnesses, and diseases. Our modeling of workplace safety is intended to fill a theoretical gap in our understanding of how the multitude of individual differences and situational factors interrelate across time to influence individual level safety behaviors and the consequences of these actions, and to encourage research to expand the limits of our knowledge.

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.

Hospitals in North America consistently have employee injury rates ranking among the highest of all industries. Organizations that mandate workplace safety training and emphasize safety compliance tend to have lower injury rates and better employee safety perceptions. However, it is unclear if the work environment in different national health care systems (United States vs. Canada) is associated with different employee safety perceptions or injury rates. This study examines occupational safety and workplace satisfaction in two different countries with employees working for the same organization.

Survey data were collected from environmental services employees (n = 148) at three matched hospitals (two in Canada and one in the United States). The relationships that were examined included: (1) safety leadership and safety training with individual/unit safety perceptions; (2) supervisor and coworker support with individual job satisfaction and turnover intention; and (3) unit turnover, labor usage, and injury rates.

Hierarchical regression analysis and ANOVA found safety leadership and safety training to be positively related to individual safety perceptions, and unit safety grade and effects were similar across all hospitals. Supervisor and coworker support were found to be related to individual and organizational outcomes and significant differences were found across the hospitals. Significant differences were found in injury rates, days missed, and turnover across the hospitals.

This study offers support for occupational safety training as a viable mechanism to reduce employee injury rates and that a codified training program translates across national borders. Significant differences were found between the hospitals with respect to employee and organizational outcomes (e.g., turnover). These findings suggest that work environment differences are reflective of the immediate work group and environment, and may reflect national health care system differences.

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.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care.

We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit.

We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level.

This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

Research focusing on psychological capital (PsyCap) has been mainly conducted at the individual level. However, recent research has expanded investigations to the collective level with a greater focus on team-level PsyCap. Although, as demonstrated by recent systematic reviews and meta-analyses, the relationships between individual-level PsyCap and the desirable/undesirable outcomes are fairly established in the literature, less is known about such relationships for team-level PsyCap. One of these important, yet least investigated, research areas is the research stream that focuses on the relationship between team-level PsyCap and the outcomes of health, Well-Being, and safety. This chapter aims to highlight the role of individual-level PsyCap as an important predictor of employees’ health, Well-Being, and safety outcomes, but also to go beyond that to provide insights into the potential role of team-level PsyCap in predicting such outcomes at both individual and team levels. To do so, the chapter first draws upon relevant theories to discuss the empirical research findings focusing on the relationship between individual-level PsyCap and the outcomes of health, Well-Being, and safety. It then focuses on team-level PsyCap from theoretical, conceptualization, and operationalization perspectives and provides insights into how team-level PsyCap might be related to health, Well-Being, and safety outcomes at both individual and team levels. Thus, this chapter proposes new research directions in an area of PsyCap that has been left unexplored.