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Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

The purpose of this paper is to explore the correction mechanism of resilient safety culture on new generation of construction workers (NGCWs)' unsafe behavior and test the multiple mediation effects of job crafting and perceived work meaningfulness based on the context of Chinese construction industry in order to find a new way to effectively correct the NGCWs' unsafe behavior.

A theoretical model of correction mechanism was established based on literature research and theoretical deduction. An empirical study was employed based on confirmatory factor analysis and regression analysis with a sample of 404 NGCWs in China.

The results indicated that resilient safety culture can effectively correct NGCWs' unsafe behavior through job crafting and perceived work meaningfulness. Job crafting and perceived work meaningfulness can play independent and serial mediating roles between resilient safety culture and unsafe behavior.

Research results only represent a short-term law about the correction mechanism of NGCWs' unsafe behavior based on a questionnaire study from China's construction industry. It is necessary to continue to implement a longitudinal study to test it in a relatively long period in future research. The findings also need to be verified based on the young construction workers in other countries.

This study provides a theoretical basis and feasible management reference for construction enterprises in China to correct NGCWs' unsafe behavior from the perspective of resilient safety culture. Furthermore, the construction of resilient safety culture in construction enterprises can help NGCWs better carry out job crafting and perceive the meaning of work.

This paper clarifies the correction mechanism of resilient safety culture on unsafe behavior of NGCWs, and further tests the independent mediating roles and a serial mediating role of job crafting and perceived work meaningfulness between resilient safety culture and unsafe behavior, which fills the research gap about the influence mechanism of resilient safety culture on young construction workers' unsafe behavior and enriches the theoretical system of unsafe behavior correction of construction workers.

The purpose of this article is to determine safety culture indicators that can improve the health and safety performance of small and medium-sized enterprise (SME) contractors in Ghana.

A three-round Delphi method was used. The first round consisted of 31 experts out of which 18 of them rated their agreements with a set of 87 potential safety culture indicators using a 10-point Likert scale of importance (1 = important and 10 = very important) and the 16 experts who completed the final round were given the opportunity to suggest other indicators. The 87 indicators were categorised into 14 core health and safety elements. Indicators that attained a group median value of 5–10 for 50% or more expert ratings were accepted.

At the end of the third round, a consensus was reached on the indicators when they attracted median scores of 5–10 for at least 50% or more of the health and safety experts rated the indicators between 5 and 10. Out of a total of 87 indicators at the start of the Delphi process, the consensus was reached on 70 that were retained.

The health and safety experts were not given the opportunity to add new indicators to the structured questionnaire until the third round.

This is the first study, to the best of the authors’ knowledge, to have a consensus by health and safety experts on leading indicator metrics of positive culture of construction safety in Ghana for improved SME construction company’s health and safety performance in Ghana. If these indicators are adopted and used effectively in Ghana, they would ensure positive culture of construction safety and subsequently help to protect construction workers.

This study aims to quantitatively review previous empirical studies on leadership style and safety culture using meta-analysis and identify the most influential leadership style across organizations. Further, the moderating effect of riskiness in the organizational process on the relationship between leadership style and safety culture was also done.

The authors conducted a systematic literature review and applied meta-analysis based on 24 empirical studies to calculate the effect size for the relationships between leadership style and safety culture.

A substantial effect size between leadership style and safety culture (r = 0.50). It was interesting to note the significant relationship between leadership and safety culture, irrespective of high- and low-risk organizations. Moreover, empowering leadership style (r = 0.60) emerged as the most influential leadership style across all organizations and in high-risk organizations.

The meta-analysis established leadership as an essential antecedent of safety culture and suggests implications for future research and practice related to safety and leadership.

The purpose of this paper is to identify the factor structure of safety culture construct among engineering students at university context and to examine the measurement invariance of this instrument across different socio-demographic groups in a sample of engineering students in the United Arab Emirates (UAE).

An exploratory online questionnaire was completed by 770 undergraduate and postgraduate engineering students across the UAE. Data were analyzed using a diversified multi-group and a robust and sophisticated cross-validation testing strategy. Confirmatory factor analysis (CFA) was used to test factor structures identified in previous studies. Multi-group invariance testing was conducted to determine the extent to which factor structure is comparable across groups (i.e. gender, educational and experiential background).

Three-factor model was preferred for its parsimony. The results showed that the level of safety awareness and attitude is relatively satisfactory, whereas safety behaviour is inadequate. No significant difference was showed in multi-group invariance between demographic groups.

This research is a cross-sectional study and limited to the views of engineering students (informal group). The study would benefit from both informal and formal groups in assessing safety culture at university for a robust empirical evidence. The research highlights relevant implications for policy and program development, by pointing to the need to promote safety culture and mitigate safety-related accidents among engineering students.

This paper offers insight into benefit of understanding the level of safety culture among engineering students and extend knowledge of informal group involvement in safety-related accidents at university level.

The current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety culture. This includes that local systems should seek to understand staff perceptions of the fairness and effectiveness of serious incident management. This study aims to explore the perspectives of patient safety professionals about what works well and what could be done better to support a patient safety culture at the level of Trust strategy and serious incident governance.

A total of 15 professionals with a role in serious incident management, from five mental health trusts in England, were interviewed using a semi-structured interview guide. Thematic analysis and qualitative description were used to analyse the data.

Participants felt that actions to support a patient safety culture were challenging and required long-term and clinical commitment. Broadening the scope of serious incident investigations was felt to be one way to better understand patient safety culture issues. Organisational influences during the serious incident management process were highlighted, informing approaches to maximise the fairness and objectivity of investigation findings.

The findings of this study offer original insights that the NHS safety system can use to facilitate progression of the patient safety culture agenda. In particular, local mental health trusts could consider the findings in the context of their current strategic objectives related to patient safety culture and operational delivery of serious incident management frameworks.

This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil.

Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture.

Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients.

All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents’ profiles, demographic variables were not analyzed.

This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety.

This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

Older adults living in nursing homes may become vulnerable because of errors or incidents; it is necessary to create a positive safety culture to minimise such occurrences. However, safety culture is still a prevailing issue in Indonesian nursing homes. This study aims to examine factors related to resident safety culture in nursing homes located in Indonesia.

This study used a cross-sectional research design and involved 13 nursing homes in East Java province, Indonesia. Multistage cluster samplings were used to determine the respondents of this study. The respondents included 219 employees: managers, health care, supportive and administrative staff. The Indonesian version of the Safety Attitudes Questionnaire was used to measure safety culture.

Most of the respondents (68.5%) had a positive perspective on the nursing home’s safety culture. Staffs who had worked for six to ten years in the nursing home were 17.07 times more likely to have positive perspective on safety culture with a p-value of 0.0002. Respondents who gave direct care also had a positive perception of safety culture with a p-value of 0.008.

Broader insight into safety culture needs to be provided to all staff in the nursing home. Safety topics should be included in the orientation session for new staff.

The staff’s work experience and direct care have a significant connection to safety culture.

Understanding the antecedents of patient safety culture among medical staff is essential if hospital managers are to promote explicit patient safety policies and strategies. The factors that influence patient safety culture have received little attention. The authors aim to investigate the antecedents of patient safety culture (safety climate) in relation to medical staff to develop a comprehensive approach to improve patient safety and the quality of medical care in China.

The Chinese version of the Safety Attitudes Questionnaire (CSAQ) was used to examine the attitudes toward patient safety among physicians and nurses. This medical staff was asked to submit the intra-organizational online survey via email. A total of 1780 questionnaires were issued. The final useable questionnaires were 256, yielding a response rate of 14.38%. One-way analysis of variance (ANOVA) was employed to test if different sex, supervisor/manager, age, working experience, and education result in different perceptions. Confirmatory factor analysis (CFA) was used to verify the structure of the data. Then linear regression with forward selection was performed to obtain the essential dimension(s) that affect the safety culture (safety climate).

The CFA results showed that 26 CSAQ items measured 6 safety-related dimensions. The linear regression results indicated that working conditions, teamwork climate, and job satisfaction had significant positive effects on safety culture (safety climate).

Hospital managers should put increased effort into essential elements of patient-oriented safety culture, such as working conditions, teamwork climate, and job satisfaction to develop appropriate avenues to improve the quality of delivered medical services as well as the safety of patients.

This study focused on the contribution that the antecedents of patient safety culture (safety climate) make with reference to the perspective of medical staff in a tertiary hospital in China.

The purpose of this study is to determine the interactions between factors such as organizational learning, feedback about errors, punitive response to errors and communication quality in hospitals in the Kingdom of Saudi Arabia and Colombia when adopting a culture of quality and safety (CQS) in patient care.

Based on a literature review, a self-administered questionnaire was developed and used to collect data from 417 Saudi respondents affiliated with hospitals and 483 Colombian respondents at the beginning of the pandemic. Structural equation modeling is used in this study to test the hypothesized relationships.

The results show a solid and significant predictive relationship between feedback about errors and the CQS in both countries (Colombia: b = 0.55, p < 0.001; KSA: b = 0.44, p < 0.001), but a very low and insignificant predictive relationship between no punitive response to errors and CQS (Colombia: b = –0.02, p > 0.05; KSA: b = 0.05, p > 0.05).

This study demonstrates the importance of organizational learning in fostering a CQS in the health-care sector in the Kingdom of Saudi Arabia and Colombia. Recent unprecedented policy actions motivated by the COVID-19 pandemic, such as social distancing, lockdowns and safety practices enforcement, have further highlighted this concern. Moreover, attention to the dimensions addressed in this study is required for accreditation purposes in organizations seeking to promote a CQS. Overall, this research highlights the vital role of safety and quality practices among health-care organizations, which has significant policy implications, especially in the current period of high uncertainty.

This paper contributes to the theory and practice in the health-care sector by extending the current knowledge of the impact of the quality of communications, non-punitive response to errors and feedback about errors in organizational learning and safety culture, and by presenting a novel, quantitative methodology seldom used for these topics.