The building blocks of a patient safety culture
We frequently discuss the importance of a ‘safety culture’ in human services – but what are the key ingredients? This scoping review synthesises evidence from multiple studies to identify key factors contributing to patient safety culture. Although the review focused on hospitals, the findings are relevant for all human service leaders seeking to build or strengthen their culture of safety.
Essential safety culture building blocks identified included:
- Leadership commitment to safety
- Open communication
- A non-punitive approach to error reporting
- Teamwork and inter-unit collaboration
- Sufficient staffing levels
- Effective handover
Most studies demonstrated a positive association between higher safety culture scores and lower rates of adverse events. Underscoring the importance of cultivating a strong safety culture to enhance patient outcomes. The authors suggest these key actions for culture development and leadership:
- Hospital leaders must visibly commit to safety initiatives and support safety-related behaviours and practices
- Encourage open and honest communication about safety issues without fear of punitive repercussions. This includes regular feedback and discussions about safety performance.
- Foster a collaborative environment where teamwork across different units is encouraged and supported. Inter-unit teamwork can significantly enhance the overall safety culture
- Promote continuous learning and improvement by regularly reviewing safety practices and implementing lessons learned from past incidents
- Establish a non-punitive reporting system for errors and near-misses to ensure staff feel safe to report incidents without fear of blame or retribution
- Strive to maintain staffing levels sufficient to meet patient needs and support a safe working environment
Developing a safety culture is a key requirement of clinical governance. An organisational culture that supports a focus on both consumer and staff safety can enhance both patient care and staff satisfaction.
All accessed 15/5/2024:
Carvalho REFLD, Bates DW, Syrowatka A, et al. Factors determining safety culture in hospitals: a scoping review BMJ Open Quality 2023;12:e002310. doi: 10.1136/bmjoq-2023-002310