Espen Olsen

Modelling the effects of a large-scale safety culture programme: a combined qualitative and quantitative approach

In many industries it has become common to implement safety programmes aimed at improving safety behaviour and culture; however, in general little research has been conducted to understand the dynamics and causality of such programmes. This study sought to explore the effects of a large‐scale safety programme implemented by a Norwegian petroleum company using a combined methodological approach; results from qualitative interviews and fieldworks were used to develop a hypothetical structural model tested on questionnaire data (n = 1221) using structural equation modelling (SEM). Five theoretical concepts were validated before they were included in a hypothetical structural model: (1) participation in a two‐day kickoff; (2) personal programme commitment; (3) effectiveness of programme implementation; (4) safety behaviour change; and (5) safety culture change. SEM indicated that the suggested structural model fitted the data, but two of the hypothesised structures were not significantly supported. Based on this, a modified version of the model was developed and estimated, resulting in a more robust model in which all hypothesised influences were supported. Results are discussed in light of the qualitative and quantitative results, programme characteristics, and previous research. This study demonstrates the significance of developing worker commitment to programme implementation and the importance of a comprehensive implementation of programme activities to increase the likelihood of cultural and behavioural effects concerning safety.

A comparative study of safety climate differences in healthcare and the petroleum industry

Aim The aim of this article is to compare safety climate in healthcare and the petroleum industry by collecting empirical evidence of differences between the two sectors. Methods The Hospital Survey on Patient Safety Culture (HSOPSC) is used to measure the safety climate in two organisations operating in the two different sectors: (1) a large Norwegian university hospital offering a wide range of hospital services and (2) a large Norwegian petroleum company producing oil and gas worldwide. Results and discussion Statistical analyses supported the expected hypotheses that safety climate is positively related to outcome measures and that the level on safety climate and outcome measures are generally higher in the petroleum sector. Empirical findings indicate that healthcare should learn from the petroleum industry regarding safety improvement efforts, and the implication of this is discussed in the paper.

The influence of change-oriented leadership on work performance and job satisfaction in hospitals – the mediating roles of learning demands and job involvement

PURPOSE The purpose of this paper is to examine the mechanisms through which change-oriented leadership in hospitals influences job performance and employee job satisfaction. The authors examine the direct and the mediating effects of perceived learning demands and job involvement. DESIGN/METHODOLOGY/APPROACH This cross-sectional study is based on a survey of four public hospitals in a regional health authority in Norway. FINDINGS The findings illustrate how change-oriented leadership directly and indirectly influences work performance and job satisfaction. Learning demands and job involvement play mediating roles. Higher levels of change-oriented leadership decrease learning demands and increase job involvement, work performance and job satisfaction. Learning demands have a negative influence on work performance and job satisfaction. Job involvement has a positive influence on work performance and job satisfaction. The strongest relationship in the structural modelling is between change-oriented leadership and job involvement. RESEARCH LIMITATIONS/IMPLICATIONS This study is based on cross-sectional data. Future studies should therefore explore this further using a longitudinal design. PRACTICAL IMPLICATIONS The practical implication of the study is to show how leaders by change-oriented behaviour can influence work performance and job satisfaction by reducing learning demands and increasing job involvement. SOCIAL IMPLICATIONS This study illustrates different paths towards influencing job performance and job satisfaction from change-oriented leadership. It is important to use the potential of reducing learning demands and increasing job involvement, to improve job performance and job satisfaction. ORIGINALITY/VALUE The authors have developed and validated a new theoretical mediational model explaining variance in job performance and job satisfaction, and how this is related to change-oriented leadership, job involvement and learning demands. This knowledge can be used to increase the probability of successful change initiatives.

Influence from organisational factors on patient safety and safety behaviour among nurses and hospital staff

Purpose Hospital systems are expected to influence patient safety outcomes. The aim of this study was to explore organisational factors influencing patient safety and safety behaviour among nurses and other hospital staff. Design/methodology/approach Based on a theoretical model, six dimensions were selected from The Hospital Survey on Patient Safety Culture (HSOPSC). Moreover, one standardized dimension measuring safety behaviour, was included. The data were collected from 1703 hospital workers completing a cross-sectional survey. Findings Confirmatory factor analysis and supplementary statistics supported the use of measurement concepts applied in the study. A two-step statistical approach using Structural Equation Modelling resulted in a satisfactory final model illustrating direct and indirect influence of the explanatory factors used. Research limitations/implications The limitation of this study is the use of a cross sectional survey design. Practical implications The study illustrates how organisat...

Psychometric properties of the Norwegian version of the hospital survey on patient safety culture in a prehospital environment

BackgroundTo develop a culture of patient safety in a regime that strongly focuses on saving patients from emergencies may seem counter-intuitive and challenging. Little research exists on patient safety culture in the context of Emergency Medical Services (EMS), and the use of survey tools represents an appropriate approach to improve patient safety. Research indicates that safety climate studies may predict safety behavior and safety-related outcomes. In this study we apply the Norwegian versions of Hospital Survey on Patient Safety Culture (HSOPSC) and assess the psychometric properties when tested on a national sample from the EMS.MethodsThis study adopted a web based survey design. The Norwegian HSOPSC has 13 dimensions, consisting of 46 items, in addition to two single-item outcome variables. SPSS (version 21) was used for descriptive data analysis, estimating internal consistency, and performing exploratory factor analysis. Confirmatory factor analysis (CFA) was applied to test the dimensional structure of the instruments using Amos (version 21).ResultsN = 1387 (27%) EMS employees participated in the survey. Overall, acceptable psychometric properties were observed, i.e. acceptable internal consistencies and construct validity. The patient safety climate dimensions with highest scores (number of positive answers) were “teamwork within units” and “manager expectations & actions promoting patient safety”. The dimension “hospital management support for patient safety” had the lowest score.ConclusionsThe results provided a validated instrument, the Prehospital Survey on Patient Safety Culture (PreHSOPSC), for measuring patient safety climate in an EMS setting. In addition, the explanatory power was strong for several of the outcome dimensions; i.e., several of the safety climate dimensions have a strong predictive effect on outcome variables related to employees’ perceptions on patient safety and safety-related attitude.