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Incentives are effective at enhancing productivity, but research also suggests that performance incentives can have “unintended negative consequences” including increases in hazard/injuries, increases in errors, and reduction in cooperation, prosocial behaviors, and creativity. Relatively overlooked is whether, when, and how incentives can be designed to prevent such negative consequences. The authors review literature in several disciplines (construction, healthcare delivery, economics, psychology, and [some] management) on this issue. This chapter, in toto, sheds a generally positive light and suggests that, beyond productivity, incentives can be used to improve other outcomes such as safety, quality, prosocial behaviors, and creativity, particularly when the incentives are thoughtfully designed. The review concludes with several potential fruitful areas for future research such as investigations of incentive-effect duration.

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.

This chapter presents a theoretical framework of the industrial relations (IR) system in China’s coal mining industry, combining the roles of management organizations, workers, and trade unions, as well as government agencies. It is one of the first empirical attempts to investigate the relationship between human resource (HR) practices, labor relations, and occupational safety in China’s coal mining industry over the past 60 years, based on the secondary data on coal mining accidents and case studies of two state-owned coal mines in a northern city in Anhui Province, China. The fluctuating occupational safety has been affected by government regulations over different time spans, marked by key political agendas, and by coal mining firms taking concrete measures to respond to these regulations, while exhibiting differing safety performance in state-owned versus township-and-village-owned mines. The field studies compared a safety-oriented to a cost-control-oriented HR and labor relations system, and their influences on safety performance. Coal mining firms and practitioners are advised to shift the traditional personnel management paradigm to a modern HR management system. In addition, although workers are often blamed directly for accidents, it is suggested that workers’ participation and voice in various processes of decision-making and policy implementation, and trade unions’ active involvement in protecting workers from occupational hazards, be encouraged.

Medical errors in obstetric departments are commonly reported and may involve both mother and neonate. The complexity of obstetric care, the interactions between various disciplines, and the inherent limitations of human performance make it critically important for these departments to provide patient-safe and friendly working environments that are open to learning and participative safety. Obstetric care involves stressful work, and health care professionals are prone to develop burnout, this being associated with unsafe practices and lower probability for reporting safety concerns. This study aims to test the mediating role of burnout in the relationship of patient-safe and friendly working environment with unsafe performance. The full population of professionals working in an obstetrics department in Malta was invited to participate in a cross-sectional study, with 73.6% (n = 184) of its members responding. The research tool was adapted from the Sexton et al.’s Safety Attitudes Questionnaire – Labor and Delivery version and surveyed participants on their working environment, burnout, and perceived unsafe performance. Analysis was done using Structural Equation Modeling. Results supported the relationship between the lack of a perceived patient-safe and friendly working environment and unsafe performance that is mediated by burnout. Creating a working environment that ensures patient safety practices, that allows communication, and is open to learning may protect employees from burnout. In so doing, they are more likely to perceive that they are practicing safely. This study contributes to patient safety literature by relating working environment, burnout, and perceived unsafe practice with the intention of raising awareness of health managers’ roles in ensuring optimal clinical working environment for health care employees.

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.

Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.

This introductory chapter provides an overview of the South African mining sector’s contribution to the national economy. It also discusses the socio-economic challenges that the sector has faced in terms of operational efficiency, productivity and safety. The chapter then briefly discusses the formal and informal organisational aspects of restructuring work processes in the South African mining industry. It concludes with a synopsis of each of the chapters of this book.

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.

This chapter examines group communication in medical teams through psychological safety and simulation training research. Research has shown that medical teams are challenged by established hierarchies, power/status differences, temporal stability, changing team memberships, and deeply held beliefs that emphasize individual responsibility. A review of 47 studies (29 psychological safety, 18 simulation) was conducted to understand key findings in relationship to group communication. Results indicate that team leadership promotes team psychological safety, voice, and relationship quality while status differences and hierarchy continue to affect psychological safety within medical teams. Simulation training facilitated interprofessional relationships, attitudes toward teamwork, self-efficacy, and group communication. The findings of this review suggest that psychological safety may be developed through simulation training. The quality of patient care is improved when all members of medical teams have the ability and motivation to communicate effectively.