Culture of Safety: An Overview

Numerous studies show a link between a positive safety culture and improved patient safety within a healthcare organization (Berry et al.; Brilli et al.; Fan et al.; Huang et al.; Mardon et al.; Weaver et al.). The evidence is so convincing that the National Patient Safety Foundation (NPSF) lists leadership support for a safety culture as the most important of eight recommendations for achieving patient safety.

An organization whose leaders embrace a safety culture makes safety its number one priority. Leaders demonstrate their commitment by supporting the organization to learn about errors and near misses, investigate errors to understand their causes, develop strategies to prevent error recurrence, and share the lessons learned with staff so they recognize the value of reporting their concerns.

Risk managers are essential in helping the organization achieve a safety culture. A safety culture brings a focus on error analysis and mitigation that is fundamental to the functions of risk management.

A safety culture is not limited to healthcare. The concept is used in other high-risk industries, such as nuclear power and aviation, that seek to understand safety incidents to prevent future disasters.

Indeed, the concept of a safety culture has been around for more than two decades. In its sentinel event alert on the role of leadership in developing a safety culture, the Joint Commission references James Reason's concepts about a safety culture in his 1997 book on human error, Managing the risks of organizational accidents. Still applicable today, the three key elements of a safety...