Safety culture : concept and feasibility study in Swiss health care setting

Introduction

Safety culture in health care organizations encompasses the values, beliefs, and behaviors aimed at ensuring patient safety. Research shows that a positive safety culture can reduce adverse events, improve error reporting, and enhance patient care experiences. However, various barriers—such as inadequate leadership support, punitive responses to incident reporting, resource constraints, and organizational hierarchies—challenge the development of a strong safety culture. In Switzerland, studies on safety culture have focused mainly on frontline healthcare providers, revealing that those in direct patient care tend to view safety culture less positively than those in other roles. Experts suggest that addressing these barriers requires collaborative efforts across organizational levels to create a resilient safety culture.

Project Scope

This project aims to analyze and test feasible strategies for promoting safety culture across several healthcare settings in Switzerland on mikro, meso and macro level.

Method

A scoping review identifies potential interventions for improving safety culture, and the results will be evaluated with experts and stakeholders from various healthcare settings. The context, according to the CICI framework, will be assesed by focus group interviews with stakeholders from the different settings. A 5-step implementation mapping approach will be used, involving: 1) stakeholder identification and assessment of barriers/facilitators, 2) evaluation of intervention and implementation outcomes, 3) adaptation of logic models, 4) co-design of the implementation protocol, and 5) co-design of the evaluation protocol.

The feasibility study will include 10 Swiss institutions across various settings and languages. The study will use a stepped quasi-experimental design and the RE-AIM framework to test intervention and implementation outcomes.

Expected Results

The study aims to provide data on the feasibility and acceptability of safety culture interventions, guiding potential national implementation and informing strategies across healthcare settings.