The Influence of Organizational and Social Work Environmental Factors on Patient Safety Climate

BACKGROUND: Patient safety climate (PSC) reflects healthcare professionals' shared perceptions of how patient safety is prioritized, managed, and enacted within healthcare organizations. While PSC is known to be associated with favorable patient outcomes, empirical evidence on how specific work environment factors shape PSC over time remains limited. Drawing on the job demands-resources theory, this study examines how organizational and social work environment factors relate to PSC in a healthcare setting.

METHODS: A two-wave panel study was conducted within a large healthcare organization in northern Sweden. Survey data were collected from employees across four departments at baseline (T1; n = 624) and six months later (T2; n = 454). Organizational factors included quantitative demands and role clarity, while social factors included teamwork and quality of leadership. PSC was measured at T2. Structural equation modeling was used to test longitudinal relationships between T1 predictors and PSC at T2.

RESULTS: In the structural model, role clarity (β = 0.23, p < 0.001) and teamwork (β = 0.32, p < 0.001) at T1 were positively associated with PSC at T2. Quantitative demands and quality of leadership showed no significant unique associations with PSC when all predictors were included simultaneously. The final model explained 32% of the variance in PSC.

CONCLUSIONS: The findings indicate that clearly defined roles and effective teamwork are key antecedents of PSC over time, whereas workload and general leadership quality may be less influential when considered alongside other work environment factors.

IMPLICATIONS FOR NURSING MANAGEMENT: Efforts to strengthen PSC may benefit from interventions targeting multiple aspects of the work environment, with role clarity and collaborative team processes emerging as particularly promising targets for nursing management.