GENERAL SAFETY PERFORMANCE: A TEST OF A GROUNDED THEORETICAL MODEL

Cigularov K, Chen P, Hoffmeister K, M. Gibbons A, K. Johnson S. Interactive effects of leader justice and support for safety on safety performance

Purpose

– The purpose of this paper is to examine the main and interactive effects of general and safety-specific leader justice (SSLJ) (i.e. fair treatment) and leader support for safety (LSS) on safety performance.

Design/methodology/approach

– Two independent samples of construction workers rate their leaders with regards to fair treatment and support for safety and report their own safety performance in a survey.

Findings

– In both studies, LSS significantly moderated relationships of both general and SSLJ with safety performance. In Study 1, the strength of relationship between general leader justice and safety performance increases while LSS is increased. Similar pattern was found for the relationship between SSLJ and safety performance in Study 2.

Practical implications

– Safety interventions targeting leadership should consider training for leader safety practices that are perceived as supportive and fair.

Originality/value

– The research is unique in its examination of leader justice in a safety-specific context and its interactive effects with LSS on safety performance. The present research helps to extend the reach of organizational justice theory's nomological network to include safety.

Attitude is everything? The impact of workload, safety climate, and safety tools on medical errors: a study of intensive care units

BACKGROUND

Hospitals face an increasing pressure toward efficiency and cost reduction while ensuring patient safety. This warrants a closer examination of the trade-off between production and protection posited in the literature for a high-risk hospital setting (intensive care).

PURPOSES

On the basis of extant literature and concepts on both safety management and organizational/safety culture, this study investigates to which extent production pressure (i.e., increased staff workload and capacity utilization) and safety culture (consisting of safety climate among staff and safety tools implemented by management) influence the occurrence of medical errors and if/how safety climate and safety tools interact.

METHODOLOGY/APPROACH

A prospective, observational, 48-hour cross-sectional study was conducted in 57 intensive care units. The dependent variable is the incidence of errors affecting those 378 patients treated throughout the entire observation period. Capacity utilization and workload were measured by indicators such as unit occupancy, nurse-to-patient/physician-to-patient ratios, levels of care, or NEMS scores. The safety tools considered include Critical Incidence Reporting Systems, audits, training, mission statements, SOPs/checklists, and the use of barcodes. Safety climate was assessed using a psychometrically validated four-dimensional questionnaire.Linear regression was employed to identify the effects of the predictor variables on error rate as well as interaction effects between safety tools and safety climate.

FINDINGS

Higher workload has a detrimental effect on safety, whereas safety climate-unlike the examined safety tools-has a virtually equal opposite effect. Correlations between safety tools and safety climate as well as their interaction effects on error rate are mostly nonsignificant.

PRACTICE IMPLICATIONS

Increased workload and capacity utilization increase the occurrence of medical error, an effect that can be offset by a positive safety climate but not by formally implemented safety procedures and policies.

Transformational leadership and safety performance among nurses: the mediating role of knowledge-related job characteristics

AIMS

To report the impact of transformational leadership on two dimensions of nurses' safety performance (i.e. safety compliance and safety participation) and to study the mediating role of knowledge-related job characteristics in this relationship.

BACKGROUND

Safety performance refers to the behaviours that employees exhibit to adhere to safety guidelines and to promote health and safety at their workplace. Nurses' safety performance is a major challenge for healthcare settings, urging the need to identify the key determinants and psychological mechanisms that influence it.

DESIGN

A cross-sectional survey study.

METHODS

The study was carried out in September 2010 in a large Belgian hospital. We used self-administered questionnaires; 152 nurses participated. The hypotheses were tested using hierarchical regression analyses.

RESULTS/FINDINGS

In line with our first hypothesis, the results show that transformational leadership exerted a significant positive impact on both dimensions of nurses' safety performance. This positive relation was mediated by knowledge-related job characteristics, supporting our second hypothesis.

CONCLUSION

Head nurses' transformational leadership can enhance nurses' compliance with and participation in safety. Furthermore, transformational head nurses are able to influence the perception that their nurses have about the kind and amount of knowledge in their job, which can also lead to increases in both dimensions of nurses' safety performance. This study therefore demonstrates the key impact that transformational head nurses have, both directly and indirectly, on the safety performance of their nurses.

Profiling safety behaviors: exploration of the sociocognitive variables that best discriminate between different behavioral patterns

This study combines contributions from both safety climate literature and prominent social influence theories. It was developed to identify the combination of sociocognitive variables that differentiate between different profiles of safety behaviors. This empirical approach has hardly been explored in the literature on behavioral aspects related to safety. The research setting for this study was a transportation company (N = 356). The results of discriminant analysis showed that different combinations of dispositional and situational influences may lead to diverse profiles of compliance and proactive safety behaviors. Perceived behavioral control was revealed to be the variable that best differentiated the group with more safe behaviors from the others. However, results also revealed that high attitudes and perceived behavioral control are very important, but not sufficient, to promote proactive safety. Co-workers' descriptive safety norms were a major differentiating variable in proactive safety. Theoretical and practical implications of the findings are discussed.

Another look at safety climate and safety behavior: deepening the cognitive and social mediator mechanisms

In this study, safety climate literature and the theory of planned behavior were combined to explore the cognitive and social mechanisms that mediate the relationship between organizational safety climate and compliance and proactive safety behaviors. The sample consisted of 356 workers from a transportation organization. Using a multiple mediation design, the results revealed that proactive and compliance safety behaviors are explained by different patterns of combinations of individual and situational factors related to safety. On the one hand, the relationship between organizational safety climate and proactive safety behaviors was mediated by coworkers' descriptive norms and attitudes toward safety. On the other hand, supervisors' injunctive safety norms and perceived behavioral control were the mediator variables between organizational safety climate and compliance safety behaviors. Theoretical and practical implications of the findings are discussed.

Discussão sobre algumas contribuições da modelagem multinível para a investigação de desempenho no trabalho

O investimento no capital intelectual tornou-se o pilar norteador das ações de gerenciamento de pessoas. A literatura em comportamento organizacional investigada enfatiza o efeito de variáveis de contexto no desempenho dos indivíduos. Faz-se mister compreender como se dá o impacto dessas variáveis segundo seus níveis de análise. O presente artigo discute contribuições potenciais da modelagem multinível na investigação de desempenho no trabalho. Discute, ainda, a aplicação dessa modelagem para compreensão de fenômenos comumente investigados em comportamento organizacional. Tais contribuições poderão favorecer a estruturação de modelos preditivos que poderão melhor capturar o significado da inclusão de variáveis típicas do contexto laboral.

Individual safety performance in the construction industry: development and validation of two short scales

In the current research a short measure of safety performance is developed for use in the construction industry and the relationships between different components of safety performance and safety outcomes (e.g., occupational injuries and work-related pain) are explored within the construction context. This research consists of two field studies. In the first, comprehensive measures of safety compliance and safety participation were shortened and modified to be appropriate for use in construction. Evidence of reliability and validity is provided. Both safety compliance and safety participation were negatively related to occupational injuries, yet these two correlations were not statistically different. In the second study, we investigated the relationships between these two components of safety performance and work-related pain frequency, in addition to replicating Study 1. Safety compliance had a stronger negative relationship with pain than safety participation. Implications for research are discussed.

Young worker safety behaviors: development and validation of measures

We conducted four studies to develop and validate measures of workplace safety-related behaviors relevant to young workers. The conceptual basis for this set of measures is a range of behavioral responses to deteriorating conditions (e.g., exit, voice, and loyalty, Hirschman, 1970; exit, voice, loyalty/patience, and neglect, Rusbult et al., 1982). In Study 1, items were generated by young workers (n=39) who participated in focus groups. The representativeness of these items was judged in Study 2 by a separate sample of young workers (n=79). In Study 3, we found support for five factors using exploratory factor analysis with a sample of young workers (n=266). Confirmatory factor analysis was conducted in Study 4 using a separate sample (n=282) and this supported the five-factor model. Self-report data on these participants and other-report (co-worker) data on a sub-sample (n=26) of the same participants provided additional support for the validity of the scales. Overall, these studies support the validity and reliability of this set of safety-related behaviors: intentions to quit an unsafe job (exit), speaking out about safety concerns (voice), adapting to a dangerous job hoping that safety conditions improve (patience), deliberately letting safety conditions worsen (neglect), and following safety policies (compliance). This set is useful for evaluating safety interventions aimed at young workers and studying safety-related behavior in a vulnerable work population.

Safety management practices and safety behaviour: assessing the mediating role of safety knowledge and motivation

Safety management practices not only improve working conditions but also positively influence employees' attitudes and behaviours with regard to safety, thereby reducing accidents in workplace. This study measured employees' perceptions on six safety management practices and self-reported safety knowledge, safety motivation, safety compliance and safety participation by conducting a survey using questionnaire among 1566 employees belonging to eight major accident hazard process industrial units in Kerala, a state in southern part of India. The reliability and unidimesionality of all the scales were found acceptable. Path analysis using AMOS-4 software showed that some of the safety management practices have direct and indirect relations with the safety performance components, namely, safety compliance and safety participation. Safety knowledge and safety motivation were found to be the key mediators in explaining these relationships. Safety training was identified as the most important safety management practice that predicts safety knowledge, safety motivation, safety compliance and safety participation. These findings provide valuable guidance for researchers and practitioners for identifying the mechanisms by which they can improve safety of workplace.

The effects of error management climate and safety communication on safety: a multi-level study

Work in the construction industry is considered inherently dangerous, despite the technological improvements regarding the safety of work conditions and equipment. To address the urgent need to identify organizational predictors of safety performance and outcomes among construction workers, the present study examined multi-level effects of two important indicators of safety climate, namely contractor error management climate and worker safety communication, on safety behavior, injury, and pain among union construction workers. Data were collected from 235 union construction workers employed by 15 contractors in Midwest and Northwest regions of the United States. Results revealed significant main effects for safety communication and error management climate on safety behaviors and pain, but not on injuries. Our findings suggest that positive safety communication and error management climate are important contributors to improving workplace safety. Specific implications of these results for organizational safety research and practice are discussed.

Occupational safety: the role of workplace sleepiness

Workplace sleepiness refers to how sleepy a person feels at work, and it is thought to be associated with negative occupational safety outcomes such as injuries because sleepiness can lead to behavioral decrements at work. This study explored safety behavior as a mediator of the relationship between workplace sleepiness and occupational safety outcomes (e.g., occupational injuries). A survey was conducted on certified nursing assistants working in long term care facilities. The Stanford Sleepiness Scale was used to measure workplace sleepiness. Occupational injuries were assessed in multiple ways: injury frequency, injury severity, pain frequency, pain severity-duration, and pain severity-intensity. This study provided support for a negative relationship between workplace sleepiness and safety behavior and limited support for a positive relationship between workplace sleepiness and occupational injuries. Workplace sleepiness was significantly related to pain frequency and pain severity (as indexed by both duration and intensity); however, it was not significantly related to injury frequency or severity. The results of the study also suggest very limited support for safety behavior as a mediator of this relationship. The findings suggest that the relationship between workplace sleepiness and occupational injuries might be more complex than originally assumed.

Multi-institutional validation of a web-based core competency assessment system

OBJECTIVE

The Association of Program Directors in Surgery and the Division of Education of the American College of Surgeons developed and implemented a web-based system for end-of-rotation faculty assessment of ACGME core competencies of residents. This study assesses its reliability and validity across multiple programs.

METHODS

Each assessment included ratings (1-5 scale) on 23 items reflecting the 6 core competencies. A total of 4241 end-of-rotation assessments were completed for 332 general surgery residents (> or =5 evaluations each) at 5 sites during the 2004-2005 and 2005-2006 academic years. The mean rating for each resident on each item was computed for each academic year. The mean rating of items representing each competency was computed for each resident. Additional data included USMLE and ABSITE scores, PGY, and status in program (categorical, designated preliminary, and undesignated preliminary).

RESULTS

Coefficient alpha was greater than 0.90 for each competency score. Mean ratings for each competency increased significantly (p < 0.01) as a function of PGY. Mean ratings for professionalism and interpersonal/communication skills (IPC) were significantly higher than all other competencies at all PGY levels. Competency ratings of PGY 1 residents correlated significantly with USMLE Step I, ranging from (r = 0.26, p < 0.01) for Professionalism to (r = 0.41, p < 0.001) for Systems-Based Practice. Ratings of Knowledge (r = 0.31, p < 0.01), Practice-Based Learning & Improvement (PBLI; r = 0.22, p < 0.05), and Systems-Based Practice (r = 0.20, p < 0.05) correlated significantly with 2005 ABSITE Total Percentile. Ratings of all competencies correlated significantly with the 2006 ABSITE Total Percentile Score (range: r = 0.20, p < 0.05 for professionalism to r = 0.35, p < 0.001 for knowledge). Categorical and designated preliminary residents received significantly higher ratings (p < 0.05) than nondesignated preliminaries for knowledge, patient care, PBLI, and systems-based practice only.

CONCLUSIONS

Faculty ratings of core competencies are internally consistent. The pattern of statistically significant correlations between competency ratings and USMLE and ABSITE scores supports the postdictive and concurrent validity, respectively, of faculty perceptions of resident knowledge. The pattern of increased ratings as a function of PGY supports the construct validity of faculty ratings of resident core competencies.

A study of the lagged relationships among safety climate, safety motivation, safety behavior, and accidents at the individual and group levels

The authors measured perceptions of safety climate, motivation, and behavior at 2 time points and linked them to prior and subsequent levels of accidents over a 5-year period. A series of analyses examined the effects of top-down and bottom-up processes operating simultaneously over time. In terms of top-down effects, average levels of safety climate within groups at 1 point in time predicted subsequent changes in individual safety motivation. Individual safety motivation, in turn, was associated with subsequent changes in self-reported safety behavior. In terms of bottom-up effects, improvements in the average level of safety behavior within groups were associated with a subsequent reduction in accidents at the group level. The results contribute to an understanding of the factors influencing workplace safety and the levels and lags at which these effects operate.

Relative effectiveness of worker safety and health training methods

OBJECTIVES

We sought to determine the relative effectiveness of different methods of worker safety and health training aimed at improving safety knowledge and performance and reducing negative outcomes (accidents, illnesses, and injuries).

METHODS

Ninety-five quasi-experimental studies (n=20991) were included in the analysis. Three types of intervention methods were distinguished on the basis of learners' participation in the training process: least engaging (lecture, pamphlets, videos), moderately engaging (programmed instruction, feedback interventions), and most engaging (training in behavioral modeling, hands-on training).

RESULTS

As training methods became more engaging (i.e., requiring trainees' active participation), workers demonstrated greater knowledge acquisition, and reductions were seen in accidents, illnesses, and injuries. All methods of training produced meaningful behavioral performance improvements.

CONCLUSIONS

Training involving behavioral modeling, a substantial amount of practice, and dialogue is generally more effective than other methods of safety and health training. The present findings challenge the current emphasis on more passive computer-based and distance training methods within the public health workforce.

The south central center for public health preparedness training system model: a comprehensive approach

The South Central Center for Public Health Preparedness (SCCPHP) is a collaboration among the schools of public health at Tulane University and the University of Alabama at Birmingham and the state health departments in Alabama, Arkansas, Louisiana, and Mississippi. The SCCPHP provides competency-based training via distant delivery methods to prepare public health workers to plan for and rapidly respond to public health threats and emergency events. This article presents the training system model used by the SCCPHP to assess, design, develop, implement, and evaluate training that is both competency driven and practice based. The SCCPHP training system model ensures a standardized process is used across public health occupations and geographic regions, while allowing for tailoring of the content to meet the specific training needs of the workforce in the respective state and local health departments. Further, the SCCPHP training system model provides evidence of the reciprocal nature between research and practice needed to advance the area of emergency preparedness training and workforce development initiatives in public health.