Safety climate and safety behavior and outcomes: a comprehensive systematic review in healthcare From the perspective of staff and patients

Objective: The study aim was to review existing research on healthcare workers’ safety climate, safety knowledge, and safety motivation as predictors of workers’ safety behaviors. A second aim was to assess existing evidence of multiple spillover effects from workers’ safety climate and safety behaviors to patient safety climate and safety behaviors and vice versa. 

Background: Research has focused on patient safety but mainly investigated from the perspective of healthcare staff. A broader model of safety is proposed, where safer healthcare provision is achievable if both workers and patients participate in safety. 

Method: A systematic literature search was conducted. A total of 15,663 articles were screened, of which 43 met the inclusion criteria. Results: The impact of workers’ safety climate could go beyond workers’ safety performance to also include patients’ safety climate, as well as their safety motivation and safety participation. Patient safety participation would, in turn, affect workers’ safety compliance. Such results highlight patients’ central role in healthcare safety for both service providers and users. 

Conclusion: This review offers a framework of safety that extends from healthcare workers to patients. It also emphasizes that patient participation can help staff safety performance, reducing the chance of errors, but it needs to be proactively encouraged by healthcare staff. 

Applications: The insights can be used to develop interventions that improve both worker and patient safety through collaboration and co-participation. The proposed framework offers ideas and practical implications for healthcare organizations, practitioners, planners and policy makers to consider.