The role of healthcare work environments in shaping a safety culture

Graham Lowe's feature article in the current issue of Healthcare Quarterly examines the role of healthcare work-environment factors in creating a culture of safety. In the first study of its kind undertaken in Canada, Lowe uses survey evidence from allied health professional and technical workers in Alberta to assess the links between working conditions and safety in healthcare.
Over 80 percent of respondents said it was "likely" or "very likely" that an error that put patient or client safety at risk would be reported in their work area. However, only 34 percent said this reporting would be "very likely." This finding raises two issues: What constitutes an acceptable standard of reporting? And can any uncertainty be tolerated in whether an incident will be reported?
Looking at actions flowing from the reporting of an error, between 33 and 36 percent of respondents said their team would learn from the mistake and that co-workers and managers would take appropriate action to ensure the error did not happen again. However, less than half of respondents considered these follow-up actions to be "likely." Based on these findings, the health system goal should be to increase as fast as possible the proportion of employees in the "very likely" category.
The study goes on to document that a high-quality work environment is a cornerstone of a healthcare safety culture. Teamwork, fair workplace processes, supportive and people-centred supervision and leadership, and a learning environment contribute to a culture that values safety. Furthermore, this safety culture itself is associated with positive quality of work-life outcomes for employees – they experience their work environments as healthy and safe, are more satisfied, and have pride in what they do. And employers also benefit from safety cultures because of the links to commitment and engagement.

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