zation members report unsafe conditions and the speed with which the organization initiates remedial actions (Cooper, 2000). Other possible indicators include the following (Carnino, undated).

  • Percentage of employees who have received safety refresher training during the previous month/quarter.

  • Percentage of safety improvement proposals implemented during the previous month/quarter.

  • Percentage of improvement teams involved in determining solutions to safety-related problems.

  • Percentage of employee communication briefs that include safety information.

  • Number of safety inspections conducted by senior managers during the previous week/month.

  • Percentage of employee suggestions that relate to safety improvement.

  • Percent of routine organizational meetings with safety as an agenda item. (Carnino, undated)

The value of positive safety indicators is that they serve as a mechanism for recognizing employees who are endeavoring to improve safety by their thoughts, actions, or commitment. Recognition of achievement is a powerful motivating force to encourage continued improvement (Carnino, undated).


In light of the findings and principles set forth in this chapter, the committee makes the following recommendations:

Recommendation 7-1. HCO boards of directors, managerial leadership, and labor partners should create and sustain cultures of safety by implementing the recommendations presented previously and by:

  • Specifying short- and long-term safety objectives.

  • Continuously reviewing success in meeting these objectives and providing feedback at all levels.

  • Conducting an annual, confidential survey of nursing and other health care workers to assess the extent to which a culture of safety exists.

  • Instituting a deidentified, fair, and just reporting system for errors and near misses.

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