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Safety Culture/Safety Climate and the Impact on Employee Safety in the Health Care Environment

Safety Culture/Safety Climate and the Impact on Employee Safety in the Health Care Environment. Robyn R.M. Gershon, MT, MHS, DrPH Mailman School of Public Health Columbia University. Funding provided by CDC/NIOSH. Co-Authors. Patricia W. Stone, M.P.H., Ph.D, RN David M. DeJoy, Ph.D.

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Safety Culture/Safety Climate and the Impact on Employee Safety in the Health Care Environment

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  1. Safety Culture/Safety Climate and the Impact on Employee Safety in the Health Care Environment Robyn R.M. Gershon, MT, MHS, DrPH Mailman School of Public Health Columbia University Funding provided by CDC/NIOSH

  2. Co-Authors • Patricia W. Stone, M.P.H., Ph.D, RN • David M. DeJoy, Ph.D

  3. Presentation Outline • Introduction • What is safety culture/safety climate? • How are they measured? • Why are these concepts important in healthcare? • Research Findings • Data supporting the significance of safety culture • Practical Implications for Improvement

  4. IntroductionSafety Culture/Safety Climate Definitions Organizational Culture Patients Ethical Culture Staff Visitors Racial Culture of Diversity Gender Religion Sexual Orientation Applied Research Culture Basic Safety Culture

  5. IntroductionHow is Culture Formed? Organizational values Organizational Attributes • Leadership Vision • Goals • Objectives • Styles Exogenous Factors Organizational Culture • Market Factors • Type of Service Offered • Clientele Variables • Staff Values • Perceptions • Behaviors

  6. IntroductionHow is Culture Measured? • Ethnographic Interviews • In-depth Interviews • Focus Groups • Document Reviews • Site Surveys, Walk-throughs • Indirectly-by measuring climate

  7. IntroductionWhat is Climate? • “The personality of an organization” • The prevailing norms, feelings, attitudes and perceptions of employees about a workplace • “the psychological atmosphere of an organization”

  8. IntroductionOrganizational ClimateSubconstructs • Perceptions of …… • Leadership Styles • Group behaviors & relationships • Communication channels • Quality of worklife variables

  9. IntroductionHow is Climate Measured? In-depth Interviews Focus Groups Observations Qualitative Research Surveys Outcomes Research Quantitative Research

  10. IntroductionHow do Culture & Climate Relate to each other? Organizational Culture Organizational Climate

  11. IntroductionWhy is Culture/Climate so important? • Organizational Culture • Values • Attributes • Organizational Climate • Employees Perceptions • Organizational Outcomes • Patient Outcomes • Worker Outcomes • Productivity Outcomes

  12. Influence of Safety Climate

  13. Research What Predicts Bloodborne Pathogen Safety Climate?

  14. Research in Safety Climate: Bloodborne Pathogens • Subconstructs • Availability of PPE/Engineering Controls • Management Support for BBP safety • Absence of Job hindrances • Feedback & Training • Cleanliness, Orderliness • Communication/Group Conflict

  15. Research • Methods Sample 789 Hospital HCWs (60% Response) • Mailed Questionnaire

  16. Research Results • Demographics • 75% female • 75% RNs • Mean age 37 • 8-year Tenure

  17. Research Results Cleanliness & orderliness O.R. = 3.3 Management Support O.R. = 2.3 Safe Work Practices Cleanliness & Orderliness O.R. = O.5 Feedback/training O.R = O.5 Exposure

  18. Research Results Safety Climate only accounts for about 25% of these Other causes are: • Safe Work Practices • Conflict of interest variables • Risk-taking personality • Risk-perception • Influence of co-workers • Maladaptive fear response • Exposure • Procedure variables • Patient variables • Availability of engineering controls • Safe work practices

  19. Practical Implications • To Target Safety Climate • Change the culture • Power in #’s • Power in power • Power in outcomes data • To Target Other Risk Factors • Training & Education managers & staff • Peer Support • Opinion leader support • Accountability – managers & staff • Engineer out risk to fullest extent

  20. Conclusions & Recommendations • Measure safety climate • Measure outcomes • Evaluate Interventions (pre/post tests) • Target “culture” – start at “micro-culture” level if necessary (i.e., at the Department Level)

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