Creating a Culture of Safety in Hospitals

A strong safety culture can help minimize medical errors, and hospitals ’ leaders have been encouraged to take responsibility for assuring patient safety (Institute of Medicine, 2001; Joint Commission on Accreditation of Healthcare Organizations, 2003; National Quality Forum, 2002, 2003). However, leading safety researchers suggest that few chief executives have made safety a top priority or committed substantial resources toward improving safety (Leape & Berwick, 2005). At the same time, much remains to be learned about how leaders can create a strong safety culture (Flin & Yule, 2004). Drawing on a field study of eight hospitals we find that strong safety leadership requires six actions: (1) setting and communicating a clear, compelling safety vision; (2) valuing and empowering personnel, (3) engaging actively in the effort to improve patient safety; (4) leading by example, (5) focusing on system issues, and (6) continually searching for improvement opportunities. Our data suggests that substantial variation in these behaviors exist among senior hospital leaders. This paper contributes to the safety literature by describing specific mechanisms senior leaders use to create a strong safety culture, such as sharing safety-related patients ’ experiences to personalize the importance of safety