Culture of Safety
Hospitals and health systems must go beyond “patient” safety and foster a culture of safety for all, including the workforce. Integrating worker and patient safety means monitoring and reducing workplace violence and injury. Clinicians and staff cannot make the environment safer for patients if they do not feel safe and valued (LLI, 2013). Physical and psychological harm can result from occupational hazards such as blood borne pathogens and needle sticks, patient handling, staff-to-staff violence and patient-to-staff violence. Worker safety issues also contribute to turnover, litigation and lost work hours.

An organization with a fair and just culture does not quickly assign blame for medical errors, but encourages employees to report unsafe conditions and adverse events and seeks to understand the underlying cause of variability (Sculli & Hemphill, 2013). James Reason’s Unsafe Acts Algorithm is often used to help determine accountability when an adverse event occurs, distinguishing between individual negligence and systemic failure. By setting organizational aims and developing reporting systems and policies, leadership plays a crucial role in cultivating a culture of safety. However, culture is also local and can differ from unit to unit, which speaks to the need for initiatives such as the Comprehensive Unit-Based Safety Program and TeamSTEPPS.

Employees across the organization should be recognized for not only their technical expertise, but their ability to work effectively within a team (Frankel, Leonard & Denham, 2006). High reliability principles acknowledge human fallibility and the opportunity for error in complex systems and emphasize the importance of systems engineering, continuous organizational learning and front-line expertise (Weick & Sutcliffe, 2001). Surveys, such as the Hospital Survey on Patient Safety Culture, can be used to assess strengths and identify areas for improvement. Learn more about the impact of errors on clinicians and how a system’s approach can change safety culture.


HRET Culture of Safety Change Package
HRET Culture of Safety Top Ten Checklist
HRET Culture of Safety Webinars
Additional Culture of Safety Resources