How can leaders influence a safety culture?

May 2012

Allan Frankel
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Key points

  • A robust safety culture is the combination of attitudes and behaviours that best manages the inevitable dangers created when humans work in complex environments.
  • Great leaders know how to wield attitudinal and behavioural norms to best protect against these risks.
  • These include:
    • psychological safety – that is, an environment where no one is hesitant to voice a concern and caregivers know that they will be treated with respect when they do)
    • organisational fairness – where caregivers know that they are accountable for being capable, conscientious and not engaging in unsafe behaviour, but are not held accountable for system failures
    • a learning system in which engaged leaders hear patients and front-line caregivers’ concerns regarding defects that interfere with the delivery of safe care, and promote improvement to increase safety and reduce waste.
  • Leaders are the keepers and guardians of these attitudinal norms and the learning system.

Dr Michael Leonard and Dr Allan Frankel explore how effective leadership and organisational fairness are essential for patient safety within healthcare services. They discuss how leaders can influence their organisations to help create a robust safety culture.

At the Health Foundation, we know that effective leadership is vital for the delivery of safe patient services. For a number of years, we have been running quality improvement and leadership development programmes, and working with healthcare leaders on the front line, to strengthen leadership within healthcare in order to improve patient safety.

Health Foundation thought papers are the author’s own views. We would like to thank Dr Leonard and Dr Frankel for their work, which we hope will stimulate ideas, reflection and discussion.

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