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It is recognised that as with any other risk; health, safety and environment issues require an integrated management system to comprehensively and sustainably manage the risks in the workplace. However to move beyond the paper based systems, ultimately require a behavioural change that can only be achieved through a culture change that continually re-invents itself and that motivates staff (human beings) to intrinsically do the right thing every day, every time and without any overseer. This study focuses on the critical success factors for the practical implementation of a safety culture improvement initiative in South Africa.

This dissertation offers an empirical examination of the relationship between community social capital and health care safety net capacity. The ability and willingness of federally qualified health centers (FQHCs) and private physicians to serve the uninsured is crucial to ensuring that all Americans have access to a basic level of health care. Among other factors, this ability and willingness has been found to be a consequence of unique community values and traditions. This dissertation examined the extent to which the level of community social capital (community rates of participation in club meetings, projects, volunteer and civic activities) was related to three health care provider outcomes; 1) the willingness of private physicians to deliver uncompensated care; 2) the financial capacity of FQHCs to provide uncompensated care; and 3) the amount of FQHC resources directed toward the provision of largely uncompensated community-oriented services.Community and health care provider data on 1,248 FQHCs across 183 U.S. counties and 12,406 private physicians across 1,029 U.S. counties were collected from multiple data sources. Comprehensive multivariate analyses including Canonical Correlation Analysis (CCA), Ordinary Least Square (OLS) and Hierarchical Linear Modeling (HLM), and a planned comparison was conducted on these data at the community ecological and individual provider levels of analysis.Based on a literature review and the theoretical components of social capital theory, I developed a conceptual framework that proposed a relationship among social context, institutional frameworks and organizational behavior. The dissertation research sought to determine the extent to which the social context in which the organization was embedded influenced organizational behavior.I found that the relationship between community social capital and health care safety net capacity was weak and the direction of the association mixed. Among the findings was a positive and significant relationship between civic participation and FQHC grant revenues. Unexpected findings included significant correlations between community social capital and Medicaid generosity, and social capital and uninsurance. Although the data analysis suggested that unmeasured factors were largely responsible for variation in safety net capacity, it raised interesting questions that provoke future study. Important implications for theory, policy and practice are discussed.