Safer Systems, Cultures and Practices


Organisational safety culture – the shared beliefs, values, assumptions and patterns of attention and interaction that shape the safety of care delivery – has long been a central concern in efforts to improve patient safety and understand serious failures of care. Recently, supporting and governing safety culture has become a focus for regulators and policymakers.

A large literature has explored the characteristics of safety culture and, a primary focus in healthcare has been the development of tools to measure safety culture (Waterson, 2014). However, this approach to patient safety culture has been criticised as narrow and overly simplistic. Whilst considerable attention has been given to describing and measuring patient safety culture, the fundamental and practical issues of how culture is enacted through the ‘work’ of safety and improvement have received far less attention. There is little evidence for how safety practices are themselves culturally determined; how organisational processes and governance systems shape, enable or constrain culture in different settings; or, how cultural practices and characteristics interact or conflict across the complex organisational and care boundaries that characterise modern healthcare systems. These issues are fundamental to building and governing sustainable cultures of safety and learning.

Click on the video below to learn more about the Safer Systems, Culture and Practices Theme with Senior Research Fellow, Dr Lauren Ramsey.

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