Safety culture

What is safety culture?

Culture is the way we think — our values, our attitudes, our perceptions and our beliefs. It is also how we act - our habits and our typical behaviours — and is often referred to 'how we do things around here'.[1]

Safety culture is a demonstrably reliable predictor of clinical safety behaviours and patient safety outcomes. For this reason, the CEC recommends a mixed-methods approaches to safety culture assessment comprised of quantitative staff surveys (using the Safety Attitudes Questionnaire) and ward-level focus groups and interviews.

safety culture pathway

Step 1
Preparation
  • Purpose, intent and desired outcomes defined
  • Determine the sample size and which staff to survey
  • Safety culture Lead nominated
  • Staff made aware regarding why the survey is being done and what to expect from it
Step 2
Survey
  • Survey open for 3-4 weeks
  • Access to survey through web link or paper
  • The survey is voluntary
  • Safety culture Lead to aim for as high a participation rate as possible
Step 3
Feedback/Reporting
  • Data entered into excel spreadsheet
  • A suitable local process for communicating the results developed
  • Safety culture Lead reviews results and plans facilitated group discussion
Step 4
Action Planning
  • Group discussion written up and made available for all staff to review
  • Team to develop action plan based on safety improvement priorities
  • Responsibility for implementation and sustainability sits with the team

Safety culture measurement

The CEC's position on safety culture is best measured at the team-level through a mixed method approach and is always wrapped in a structured and supported improvement framework. To support teams wanting to undertake a safety culture measurement, the CEC have tested and developed a suite of tools and guidance to help plan, implement, report and develop an action plan from the results.

The CEC guidelines and tools serve as a self-contained set of instructions and templates to enable your health service to administer a safety culture survey effectively and can be adapted for local conditions.

Undertaking your safety culture measurement - Resources and tools

Getting started

Safety culture measurement

Safety culture measurement and accreditation

The importance of measuring safety culture for quality improvement is articulated in the Australian Commission for Safety and Quality in Healthcare National Safety Clinical Governance Standard, Action 1.1 Governance, leadership and culture. Engaging in a safety culture measurement process will demonstrate commitment to safety and quality improvement as well as provide evidence to support accreditation. If you have any comments or feedback please contact CEC-CapabilityAndCulture@health.nsw.gov.au.