Culture of Safety: What Is It and What It Is Not

Safety culture is the foundation for effective, sustainable patient safety improvements. Safety culture is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that contribute to an organization’s safety management. Addressing key components of safety culture provides support for effective improvement work. Some key elements of safety culture include psychological safety and Just Culture. Psychological safety helps all healthcare team members feel free to speak up to address safety concerns. Just Culture shifts traditionally blame-oriented responses to error to an emphasis on curiosity about why an error occurred. Tools that support tracking safety data reinforce safety culture, including reporting systems, reporting misses, and safety huddles. Streamlining reporting systems can facilitate higher reporting rates for errors and near misses. Incentivizing reporting near misses through a Good Catch Program can counterbalance healthcare team members’ fear about the liability of reporting an error or near miss. Making quality data transparent in quality dashboards can provide positive feedback to frontline workers as patient safety outcome data improves. Safety huddles can support transparency of sharing safety concerns in real time. There are several reliable and valid tools to measure safety culture so a team can track its progress over time.