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Safety Talk and Safety Culture: Discursive Repertoires as Indicators of Workplace Safety and Health Practice and Readiness to Change.

ABSTRACT: Background:Small construction businesses (SCBs) account for a disproportionate share of occupational injuries, days lost, and fatalities in the US and other modern economies. Owner/managers of SCBs confront risks associated with their own and workers' safety and business survival, and their occupational safety and health (OSH) related values and practices are key drivers of safety and business outcomes. Given owner/mangers are the key to understanding and affecting change in smaller firms, as well as the pressing need for improved OSH in small firms particularly in construction, there is a critical need to better understand SCB owners' readiness to improve or adopt enhanced OSH activities in their business. Unfortunately, the social expectation to support safety can complicate efforts to evaluate owners' readiness. Objectives:To get a more accurate understanding of the OSH values and practices of SCBs and the factors shaping SCB owners' readiness and intent to implement or improve safety and health programming by comparing their discourse on safety with their self-rated level of stage of change. Methods:In-depth, semi-structured interviews were conducted with 30 SCB owner managers. Respondents were asked to self-rate their safety program activity on a 5-point scale from unaware or ignorant ('haven't thought about it at all') to actively vigilant ('well-functioning safety and health program for at least 6 months'). They were also asked to discuss the role and meaning of OSH within their trade and company, as well as attitudes and inclinations toward improving or enhancing business safety practices. Analysis and results:Respondents' self-rating of safety program activity was compared and contrasted with results from discourse analysis of their safety talk, or verbal descriptions of their safety values and activities. Borrowing from normative and stage theories of safety culture and behavioral change, these sometimes contradictory descriptions were taxonomized along a safety culture continuum and a range of safety cultures and stages of readiness for change were found. These included descriptions of strong safety cultures with intentions for improvement as well as descriptions of safety cultures with more reactive and pathological approaches to OSH, with indications of no intentions for improvement. Some owner/managers rated themselves as having an effective OSH program in place, yet described a dearth of OSH activity and/or value for OSH in their business. Conclusion:Assessing readiness to change is key to improving OSH performance, and more work is needed to effectively assess SCB OSH readiness and thus enable greater adoption of best practices.

SUBMITTER: Cunningham TR

PROVIDER: S-EPMC6314285 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Safety Talk and Safety Culture: Discursive Repertoires as Indicators of Workplace Safety and Health Practice and Readiness to Change.

Cunningham Thomas R TR Jacobson C Jeffrey CJ

Annals of work exposures and health 20180901 suppl_1

<h4>Background</h4>Small construction businesses (SCBs) account for a disproportionate share of occupational injuries, days lost, and fatalities in the US and other modern economies. Owner/managers of SCBs confront risks associated with their own and workers' safety and business survival, and their occupational safety and health (OSH) related values and practices are key drivers of safety and business outcomes. Given owner/mangers are the key to understanding and affecting change in smaller firm ...[more]

PMID: 30212880

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Project description:Introduction:Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. Methods:We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15?months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Results:Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (-0.39) and interventions sites (-0.29) from baseline to 15?months, while context did not change for either. Only wellness program effort at 15?months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15?months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites over time and (2) intervention sites exhibited significantly higher changes in wellness program effort relative to control sites. Discussion:Contrary to our hypothesis, change commitment declined significantly at both Healthlinks and control sites, even as wellness-program effort increased significantly at HealthLinks sites. Regression to the mean may explain the decline in change commitment. Future research needs to assess whether baseline commitment is an independent predictor of wellness-program effort or an effect modifier of the HealthLinks intervention.

Project description:BackgroundLay press investigations have been published that describe pharmacist errors and the workplace environment in the community pharmacy setting. However, recent studies that explore pharmacists' perceptions of patient safety in the workplace are limited.Objectives1) To describe pharmacists' perceptions of workplace patient safety; 2) To compare pharmacists' perceptions of workplace patient safety across practice setting type, pharmacist roles, average hours worked per shift, and average hours worked per week.MethodsActively licensed Tennessee pharmacists were recruited from January 1 and June 30, 2019 to complete a 13-item survey of workplace patient safety perceptions ( N =1391). Descriptive statistics were calculated, and nonparametric statistical tests employed to compare differences in perceptions across practice setting type, pharmacist roles, and hours worked per shift and per week.ResultsStatistically significant differences in workplace patient safety perceptions were noted across practice setting type (p values <.001) and pharmacist roles (p values <.001). The extent to which pharmacists agreed/strongly agreed that their employer provides a work environment that allows for safe patient care ranged from 29.7% of chain community pharmacists to 85% of compounding pharmacists. Fifty-two percent of staff pharmacists, 56.5% of relief pharmacists, and 58.5% of managers/pharmacists in charge agreed or strongly agreed that their employer provides a work environment that allows for safe patient care, whereas 89.3% of regional managers/directors/vice-presidents and 72.5% of clinical/specialty pharmacists indicated the same. Average hours per shift was inversely correlated with perceptions of workplace patient safety (p values <.001).ConclusionTennessee pharmacists' perceptions of workplace patient safety varied widely across practice setting type and pharmacist roles. Perceptions of safety were notably lower in the chain community pharmacy setting. Additional research is warranted to better understand the relationship between pharmacist perceptions and quantifiable patient safety metrics, particularly in the chain community pharmacy setting.

Project description:BACKGROUND:This study aimed to identify clinical nurses' evidence-based practice (EBP) knowledge, beliefs, organizational readiness, and EBP implementation levels, and to determine the factors that affect EBP implementation in order to successfully establish EBP. This study was conducted at a university-affiliated tertiary hospital located in a provincial area in Korea. The research design was based on Melnyk and Fineout-Overholt's Advancing Research & Clinical Practice through Close Collaboration model as the first step. METHODS:A descriptive and cross-sectional design was conducted and a convenience sample of 521 full-time registered nurses from an 849-bed tertiary hospital were included. Structured questionnaires were used to assess EBP knowledge, EBP beliefs, organizational culture & readiness and EBP implementation. Data were analyzed using SPSS V 25.0 by using descriptive and inferential statistics and hierarchical multiple regression was performed to determine the factors affecting the implementation of EBP. RESULTS:Our findings showed that the clinical nurses had a positive level of EBP beliefs, but the level of EBP knowledge, organizational readiness and EBP implementation were insufficient. EBP knowledge, beliefs, and organizational readiness were significantly positively correlated with EBP implementation. In the final model, EBP knowledge and organizational readiness were significant predictors of EBP implementation; the model predicted 22.2% of the variance in implementation. CONCLUSIONS:Based on these results, the main focus of the study was the importance of individual nurses' efforts in carrying out EBP, but above all efforts to create an organizational culture to prepare and support EBP at the nursing organization level. In the initial process of introducing and establishing EBP, nurse administrators will need to minimize expected barriers, enhance facilitators, and strive to build an infrastructure based on vision, policy-making, budgeting, excellent personnel and facilities within the organization.

Project description:ObjectivesWhile studies at the undergraduate level have begun to explore healthcare students' safety and dignity dilemmas, none have explored such dilemmas with multiple stakeholders at the postgraduate level. The current study therefore explores the patient and staff safety and dignity narratives of multiple stakeholders to better understand the healthcare workplace learning culture.DesignA qualitative interview study using narrative interviewing.SettingTwo sites in the UK ranked near the top and bottom for raising concerns according to the 2013 General Medical Council National Training Survey.ParticipantsUsing maximum variation sampling, 39 participants were recruited representing four different groups (10 public representatives, 10 medical trainees, 8 medical trainers and 11 nurses and allied health professionals) across the two sites.MethodsWe conducted 1 group and 35 individual semistructured interviews. Data collection was completed in 2015. Framework analysis was conducted to identify themes. Theme similarities and differences across the two sites and four groups were established.ResultsWe identified five themes in relation to our three research questions (RQs): (1) understandings of safety and dignity (RQ1); (2) experiences of safety and dignity dilemmas (RQ2); (3) resistance and/or complicity regarding dilemmas encountered (RQ2); (4) factors facilitating safety and/or dignity (RQ3); and (5) factors inhibiting safety and/or dignity (RQ3). The themes were remarkably similar across the two sites and four stakeholder groups.ConclusionsWhile some of our findings are similar to previous research with undergraduate healthcare students, our findings also differ, for example, illustrating higher levels of reported resistance in the postgraduate context. We provide educational implications to uphold safety and dignity at the level of the individual (eg, stakeholder education), interaction (eg, stakeholder communication and teamwork) and organisation (eg, institutional policy).

Dataset Information

Safety Talk and Safety Culture: Discursive Repertoires as Indicators of Workplace Safety and Health Practice and Readiness to Change.

Publications

Safety Talk and Safety Culture: Discursive Repertoires as Indicators of Workplace Safety and Health Practice and Readiness to Change.

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