ABSTRACT
In recent years, the promotion of a culture of safety has, in many countries, become one of the key issues in patient care. It has been argued that a positive safety culture (or climate) is essential for minimizing the number of preventable patient injuries and their overall cost to society (e.g., Kohn, Corrigan, Donaldson, 1999; Nieva & Sorra, 2003; Zhan & Miller, 2003). At the same time, there is also an increasing recognition that it is necessary to deter mine the relationship between the effects of safety culture on health care outcome. (Gershon, Stone, Bakken, & Larson, 2004; Scott, Mannion, Davies, & Marshall, 2003a; Scott, Mannion, Marshall, & Davies, 2003b;). Efforts in this direction are, how ever, hampered in two respects: First, patient safety outcomes are hard to establish and validate across different patient populations and health care ser vices; and second, there is no generally accepted model of safety culture and climate, identifying its components and their interrelationships (Collins & Gadd, 2002; Flin, Mearns, O’Connor & Bryden, 2000; Guldenmund, 2000; see chapter on “Safety Culture in Healthcare” in this handbook).
