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This study demonstrates how becoming a high-reliability institution in health care is a priority, given the high-risk environment in which an error can result in harm. Literature conceptually supports the need for highly reliable health care facilities but does not show a comprehensive approach to operationalizing the concept into the daily workforce to support patients. The Veterans Health Administration closes the gap by documenting a case study that not only demonstrates specific actions and functions that create a high-reliability organization (HRO) for safety and improvement but also created a learning organization by spreading the knowledge to other facilities.

The authors instituted a methodology consisting of assessments, training and educational simulations to measure, establish and operationalize activities that identified and prevented harmful events. Visual communication boards were created to facilitate team huddles and discuss improvement ideas. Improvements were then measured and analyzed for purposeful outcomes and return on investment (ROI).

HRO can be operationalized successfully in health care systems. Measurable outcomes verified that psychological safety was achieved through the identification and participation of 3,184 process improvement projects over a five-year period, which yielded a US$2.8m ROI. Documented processes and activities were used for educational teachings, which were disseminated to other Veteran Affairs Medical Center’s through the Truman HRO Academy.

This case study is limited to one hospital in the Veterans Health Administration (VHA) network. As the VHA continues to deploy the methods outlined to other hospitals, the authors will perform incremental data collection and ongoing analysis for further validation of the HRO methods and operations. Hospitalists can adapt the methods in the case study for practical application in a health care setting outside of VHA. Although the model is rooted in health care, the methods may be adapted for use in other industries.

This case study overcomes the limitations within literature regarding operationalizing HRO by providing actual activities and demonstrations that can be implemented by other health care facilities.

Lean management tools are becoming increasingly applied in different types of organizations around the world. These tools have shown their significant contribution to improving business performance. In this vein, the purpose of this paper is to examine the influence of lean management on both occupational safety and operational excellence in Tunisian companies.

A survey was conducted among Tunisian companies, and it resulted in the collection of 62 responses that were analyzed using the software SPSS. In addition, a conceptual model linking the practices of the three basic concepts was designed to highlight the hypotheses of the research. Subsequently, factor analysis and structural equation method analysis were conducted to assess the validation of the assumptions.

The results obtained have shown that lean management has a significant impact on occupational safety. Similarly, occupational safety has a significant impact on operational excellence. However, lean management does not have a significant impact on operational excellence.

This work highlighted the involvement of small and medium-sized enterprise’s managers from emerging economies in the studied concepts’ practices. Likewise, it testified to the impacts of lean management on occupational safety and operational excellence in the Tunisian context.

Adverse events in health care became more evident at the beginning of the 21st century, being an emerging problem worldwide and impacting the lives of people receiving health care, contributing to preventable injuries and deaths. This evidence has motivated the development of specific training in the area of patient safety with a strong focus on the education and training of health professionals, and, more recently, it also aimed at patient, informal caregiver and all citizens. In this sense, the use of digital technology for patient safety training has been an important challenge and proves to be a good solution for training and continuous learning, both for professionals and people in general. The use of multimedia, videos, games, simulators, among others, are effectively essential resources to improve people’s health literacy and safety of care.

This chapter presents a narrative review on patient safety training and the contributions of digital technology. The experience report will also be used, presenting some examples of quality improvement projects developed by Portuguese and Brazilian entities, in training contexts, highlighting the importance of investing in the health literacy of professionals, patients/informal caregivers and civil society, through applying specific techniques and using digital technology.

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.

With increasing complexity of construction projects and new construction processes and methods are adopted, more safety hazards are emerging at construction sites, requiring the application of the modern risk management methods. As an emerging technology, digital twin has already made valuable contributions to safety risk management in many fields. Therefore, exploring the application of digital twin technology in construction safety risk management is of great significance. The purpose of this study is to explore the current research status and application potential of digital twin technology in construction safety risk management.

This study followed a four-stage literature processing approach as outlined in the systematic literature review procedure guidelines. It then combined the quantitative analysis tools and qualitative analysis methods to organize and summarize the current research status of digital twin technology in the field of construction safety risk management, analyze the application of digital twin technology in construction safety risk management and identify future research trends.

The research findings indicate that the application of digital twin technology in the field of construction safety risk management is still in its early stages. Based on the results of the literature analysis, this paper summarizes five aspects of digital twin technology's application in construction safety risk management: real-time monitoring and early warning, safety risk prediction and assessment, accident simulation and emergency response, safety risk management decision support and safety training and education. It also proposes future research trends based on the current research challenges.

This study provides valuable references for the extended application of digital twin technology and offers a new perspective and approach for modern construction safety risk management. It contributes to the enhancement of the theoretical framework for construction safety risk management and the improvement of on-site construction safety.

This study aims to improve the reliability of emergency safety barriers by using the subjective safety analysis based on evidential reasoning theory in order to develop on a framework for optimizing the reliability of emergency safety barriers.

The emergency event tree analysis is combined with an interval type-2 fuzzy-set and analytic hierarchy process (AHP) method. In order to the quantitative data is not available, this study based on interval type2 fuzzy set theory, trapezoidal fuzzy numbers describe the expert's imprecise uncertainty about the fuzzy failure probability of emergency safety barriers related to the liquefied petroleum gas storage prevent. Fuzzy fault tree analysis and fuzzy ordered weighted average aggregation are used to address uncertainties in emergency safety barrier reliability assessment. In addition, a critical analysis and some corrective actions are suggested to identify weak points in emergency safety barriers. Therefore, a framework decisions are proposed to optimize and improve safety barrier reliability. Decision-making in this framework uses evidential reasoning theory to identify corrective actions that can optimize reliability based on subjective safety analysis.

A real case study of a liquefied petroleum gas storage in Algeria is presented to demonstrate the effectiveness of the proposed methodology. The results show that the proposed methodology provides the possibility to evaluate the values of the fuzzy failure probability of emergency safety barriers. In addition, the fuzzy failure probabilities using the fuzzy type-2 AHP method are the most reliable and accurate. As a result, the improved fault tree analysis can estimate uncertain expert opinion weights, identify and evaluate failure probability values for critical basic event. Therefore, suggestions for corrective measures to reduce the failure probability of the fire-fighting system are provided. The obtained results show that of the ten proposed corrective actions, the corrective action “use of periodic maintenance tests” prioritizes reliability, optimization and improvement of safety procedures.

This study helps to determine the safest and most reliable corrective measures to improve the reliability of safety barriers. In addition, it also helps to protect people inside and outside the company from all kinds of major industrial accidents. Among the limitations of this study is that the cost of corrective actions is not taken into account.

Our contribution is to propose an integrated approach that uses interval type-2 fuzzy sets and AHP method and emergency event tree analysis to handle uncertainty in the failure probability assessment of emergency safety barriers. In addition, the integration of fault tree analysis and fuzzy ordered averaging aggregation helps to improve the reliability of the fire-fighting system and optimize the corrective actions that can improve the safety practices in liquefied petroleum gas storage tanks.

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.

Effective safety communication facilitates the sharing of relevant knowledge that helps to improve safety behaviours, such as superior hazard identification and compliance. This study aims to explore channels by which construction companies can effectively communicate health and safety (H&S) among communities of their operations.

Based on a quantitative research approach, this study addressed the knowledge gap through a cross-sectional survey of 250 contractors (comprising 155 building and 95 road contractors) involved in various projects in the Ghanaian construction industry. These contractors were selected by using a stratified simple random sampling technique. Data obtained from the survey was analysed through descriptive (i.e. frequencies, mean and standard deviation) and inferential (i.e. exploratory factor analysis) statistical analyses.

The findings from the mean scores revealed that all the 12 communication channels identified in the literature, confirmed through piloting and examined by the respondents, were important channels through which construction companies can effectively communicate H&S amongst communities of their operations. The exploratory factor analysis revealed a clustering of the 12 channels of communication into 5 components: “safety demonstration in the community”; “social media”; “mass media”; “community engagement”; and “opinion leaders”.

This study offers construction project managers the means of managing one of the major stakeholders of a construction project (the community). It provides an actionable opportunity that can be leveraged strategically to integrate community members into projects to promote synergy and local content inclusion while gaining a peaceful atmosphere to achieve their project goals.

Practically, this study provides construction project managers with a means of managing one of the major stakeholders of a construction project (the community) and also demonstrates the integration of community members into projects to promote synergy and local content inclusion. This would give construction organisations a peaceful atmosphere to accomplish their project objectives.

The social implication of this study is that the study offers society a means of creating safer Ghanaian communities by offering them the knowledge of identifying hazards and avoiding risky behaviours, creating a good safety atmosphere in these communities.

This study presents construction organisations with a unique opportunity to transfer and share novel external knowledge within a different social system (the community). It contributes to the state-of-the-art knowledge in H&S communication by providing channels through which H&S can be communicated in a developing country such as Ghana.

The need to develop effective approaches for responding to healthcare incidents for the purpose of learning and improving patient safety has been recognised in current national policy. However, research into this topic is limited. This study aims to explore the perspectives of professionals in mental health trusts in England about what works well and what could be done better when implementing serious incident management systems.

This was a qualitative study using semi-structured interviews. In total, 15 participants were recruited, comprising patient safety managers, serious incident investigators and executive directors, from five mental health trusts in England. The interview data were analysed using a qualitative-descriptive approach to develop meaningful themes. Quotes were selected and presented based on their representation of the data.

Participants were dissatisfied with current systems to manage serious incidents, including the root cause analysis approach, which they felt were not adequate for assisting learning and improvement. They described concerns about the capability of serious incident investigators, which was felt to impact on the quality of investigations. Processes to support people adversely affected by serious incidents were felt to be an important part of incident management systems to maximise the learning impact of investigations.

Findings of this study provide translatable implications for mental health trusts and policymakers, informed by insights into how current approaches for learning from healthcare incidents can be transformed. Further research will build a more comprehensive understanding of mechanisms for responding to healthcare incidents.

Effective construction safety training has been considered to play a significant role in reducing the incidence of accidents. However, the current safety training methods pay less attention to the relationship between workers' personalized characteristics and their learning needs, which results in workers' low learning participation and poor training effect. The purpose of this paper is to improve the participation and effect of safety training for construction workers with a persona-based approach.

This paper presents a persona-based approach to safety tag generation and training material recommendation. By extracting the demographic characteristics and behavior patterns tags of construction workers, a neural network algorithm is introduced to calculate the learning needs tags of workers, and the collaborative filtering recommendation method is integrated to enrich the innovation of recommendation results. Offline experiments and online experiments are designed to verify the rationality of the proposed method.

The results show that the learning needs of workers are closely related to their background. The proposed method can effectively improve workers' interest in materials and the training effect compared with conventional safety training methods. The research provides a theoretical and practical reference for promoting active safety management and achieving worker-centered safety management.

First, a persona-based approach is introduced to establish a novel framework for solving the problem of personalized construction safety management. Second, an artificial intelligence algorithm is used to automatically extract the learning needs tag values and design a hybrid recommendation method for construction workers' personalized safety training. The collaborative filtering method is integrated to enrich the innovation of recommendation results.