Safety culture and safety climate are terms that are used often in the context of safety management but are not very well defined or differentiated. This research concentrates on safety climate, a summary concept of employee perceptions of safety management practices within their organisation. There is a common assumption that a positive safety climate results in better safety performance outcomes, yet there is little research evidence to support this notion. / Despite being defined as a summary concept, much of the research on safety climate has been empirically driven and has concentrated on identifying the number and content of the dimensions/factors that contribute to the safety climate. Due to a lack of theoretical input in the field, the use of proprietary instruments which are unavailable in the public domain and varied developmental histories of these tools, the findings of past research has been mixed. / This research addresses several of the limitations in the literature on safety climate by using the National Safety Council of Australia’s Safety Climate Survey. The research centres around two main issues; the dimensionality and factor structure of safety climate; and investigation of the applicability of a framework linking safety climate to safety performance. / The project was divided into two studies. Study I is based on archival data collected by the National Safety Council of Australia (NSCA) (N=215, N=127, N=90). Study II utilises data collected specifically for the purposes pf this research (N=226). The survey instrument was further developed for Study II to include scales that allow for a more complete investigation of a framework linking safety climate to safety performance. / A comprehensive validation of the NSCA safety climate survey was conducted. Structural Equation Modelling was utilised to examine various models of the factor structure of safety climate. It was found that safety climate is best understood as a second order concept comprised of several specific first order factors. The factor structure remained consistent across several samples however the strength of the individual factors varied in each sample. / Structural Equation Modelling was also used to investigate the framework of the relationship between safety climate and safety performance. Evidence in support of his model was obtained however some variations to the model were necessary to achieve this support. Reinforcement for the influence of general organisational climate in providing a context for safety climate was revealed. Given that it was not possible to include all aspects of the framework within the statistical model these findings provide a good impetus for further research in this field.

In the ten year period between 2004 and 2013 the UK lost 13 operational, and one non-operational, firefighters at fires, a relatively large number in relation to previous losses. These fatalities occurred during a period in which fire fatalities of members of the public were at an all‐time low but fire and rescue services (FRS) and their staff were being accused in the media of becoming risk averse. This research was focussed on investigating the risk attitudes and safety culture in the English fire and rescue services. The research question asked how the safety culture manifests itself in the English fire and rescue service and what are its implications? A mixed approach to the research was adopted utilising both quantitative and qualitative methods. The research strategy was inductive using a multiple case study. A safety culture questionnaire was designed and then piloted in one FRS with the responses being subjected to a factor analysis the results of which indicated there were four dimensions: management, procedures, competence, and work pressures. The final version of the questionnaire was then distributed across five FRSs from which 845 were returned, of which 823 were used in a series of statistical analyses. Two independent variables were used in the analysis; the first consisted of the individual FRSs, the second consisted of three groups based on Schein’s three generic subcultures of executive, designer and operator. These were aligned with principal officers (PO), senior officers (SO), and Watch based (WB) staff respectively. The analysis of the completed questionnaires indicated that the WB group had a negative attitude towards their FRS safety culture, while the SO and PO groups had a more positive attitude with the PO the most positive. All three groups were significantly different to each other. In conducting the qualitative part of the mixed methods the researcher rode with three Watches at a station in each of three FRSs to observe the behaviour of WB staff and attending SOs at incidents and during their daily activities. During the course of the fieldwork nineteen members across all of the participating FRSs were interviewed, and twenty‐four focus groups were conducted. What was clear was that the competence based training system was not popular with WB staff who believed it to be too bureaucratic, whilst SOs and POs believed that it had not fulfilled their expectations of what it would deliver. There were also concerns expressed that the promotion system, associated with the competence‐based training, was producing managers and not the leaders required on the incident ground. It was concluded that safety culture within the FRS is associated with the systems, policies and procedures reflective of FRS management’s level of risk tolerance producing a rule-based decision‐making bureaucracy; this level of risk tolerance then influences how operational firefighters operate on the incident ground. In the world of the operational firefighter a typical incident, which by its very nature is a temporary event, is laden with uncertainty, complexity and in which all the potential risks may not yet have been identified with decision‐making being focussed on problem‐solving. FRS personnel find themselves operating in a risk climate in which they build temporary command structures, construct temporary processes and controls reflecting the incident commander’s risk appetite for the purpose of moving towards operating in a safety climate in which to resolve the incident. The combination of the FRS’s safety culture and the operational firefighter’s risk climate determine what the researcher has defined as the FRS operational culture.

Objective: To examine the perception of patient safety culture amongst health care workers in Libyan Hospitals. Study Design: The study adopted a mixed methods approach with 2 phases. Phase 1 was conducted prior to the Libyan revolution. This was a quantitative research study, which used the Survey of Hospital Patient Safety Culture (HSOPSC) that was developed by the US Agency for Health Care Research and Quality (AHRQ, 2004). Phase 2 was conducted post revolution and it was a qualitative research study, which used semi-structured interviews. Setting: The three largest hospitals which were located in the Northeast of Libya were involved in the study. Participants and sampling: Phase 1 of the study included a stratified sample of 346 health care workers who were working as Doctors, Nurses, Technicians, Pharmacists and Managers. Phase 2 of the study used a purposeful sample which involved 27 health care workers from those took part in the survey study. Main Outcome Measures: The survey measured twelve Patient Safety Culture dimensions. It indicated that ten of the twelve dimensions were weak and need to be improved. The interview findings also showed that the 12 patient safety culture dimensions were very weak and shed light on some of the reasons for this sub-optimal practice. Findings: The respondents who took part in the study were from different departments in the three hospitals. The survey showed the dimensions with acceptable positive ratings were teamwork within hospitals and organizational learning and continuous improvement, while those with lowest ratings included frequency of reporting errors, non-punitive response to error and communication and openness. Approximately 60% of health care workers perceived patient safety culture practice in Libya negatively. Twenty respondents (5.8%) who gave an excellent grade for patient safety in their hospitals. Furthermore, the interviews results revealed that patient safety culture dimensions were very weak. The interview explored further factors and issues of poor safety culture in the 3 hospitals; which had not been identified in the survey. These were related to results of the political changes, administrative factors, environmental issues, organisational system issues, and health care workers matters. Conclusions: The study identified that the current state of patient safety culture in Libyan hospitals is very weak and there is a need for improvement to safety practice and for promotion of this important issue amongst those health care workers and health managers working at the frontline of health care delivery. Furthermore, the study found that the level of patient safety in the 3 hospitals was below an unacceptable level according to the perceptions of the health care staff. It was noted that there was no effective patient safety system in any of the 3 hospitals to deal with patient safety issues and there were no proactive patient safety measures in place to reduce the level of risk to patients. Furthermore, the study revealed other significant aspects that represent a serious threat to patient safety in the 3 hospitals, which were mainly due to poor hospital management, ineffective emergency services and a lack of training programmes. Moreover, poor organisation of monitoring systems for the licensing of medical practice of health care workers was shown to have a significant impact on patient safety culture. Lastly, the study showed the political change in Libya had affected patients’ safety sharply as result of the military conflict and the lack of hospitals’ preparedness to cope with such emergency events.

Despite the creation of the Occupational Safety and Health Administration (OSHA) more than 30 years ago, the construction industry is in conflict with itself. It is locked in a struggle to effectively keep its workforce protected from unsafe acts, unsafe conditions, or a combination of both. According to the Bureau of Labor Statistics (BLS), nearly 6.5 million people work at approximately 252,000 construction sites across the United States every day, with the fatal injury rate for the construction industry higher than the national average when compared to all industries. There have been many studies documenting these conditions, but no study has examined leadership styles and their impact on the climate of safety. This study examined the relationship between management’s leadership style and the perception of a climate of safety; the relationship between workers’ perception of leadership style and the perception of a climate of safety; and the relationship between the size of the workforce, the manager’s leadership style, and the perception regarding the climate of safety. The outcomes contribute to the field of conflict resolution as they offer the ability to move from incongruities regarding perceived worker safety to discussions and solutions that are aimed at influencing those policies and procedures at the organizational level that will ensure that a construction worker can perform his or her job free from dangerous work conditions.

There is a national movement to create improvements in patient safety and outcomes due to evolutionary changes in the healthcare. Many health care organizations are using the framework of a culture of safety in order to create a reliable and stable work environment that emphasizes safety and improves patient outcomes. Patient throughput, defined as the active management of the supply of patient beds (rooms for occupation) to the demand of patients to beds and the length of time it takes for this action to occur, has been identified as one of the areas in need of improvement. This study considered if the use of an interdisciplinary team to execute patient rounds improves patient throughput, helping to expedite the patient discharge process while decreasing needless readmissions to the health care organization. A quantitative longitudinal retrospective data analysis of time stamps obtained from the electronic health record was examined to determine what impact interdisciplinary rounds had on patient throughput. It was determined that a discrepancy existed between the actual planning of a patient's discharge and the execution of the discharge, which contributed to unwanted readmissions to the health care organization. A secondary factor affecting the readmission rate was excluding the patient as a member of the interdisciplinary team. The social significance of the research is how health care organizations engage patients, empowering patients to actively participate in their own care including them in the decision-making process that affects patient care and improves outcomes.

Thesis (MCom)--Stellenbosch University, 2015 / ENGLISH ABSTRACT : Organisations are rapidly discovering the invaluable influence of creativity and innovation at work. An individual’s capacity to engage creatively with his or her work is becoming increasingly recognised as integral for organisational success and competitive advantage. The quest for an increase in creative output is driven by the following question: what causes variance in creative work involvement? The purpose of this study was to address the question of variance in creative work involvement across a variety of industries. In order to do so empirically, a structural model was developed after an interrogation of the literature to present the hypothesised relationships suggested through previous research. In essence, this study explored the significance of four relationships: (1) the effect of psychological safety on creative work involvement, (2) the effect of inclusive leadership on psychological safety, (3) the effect of openness to experience on creative work involvement, and (4) the moderating effect of vitality on the relationship between psychological safety and creative work involvement. The research approach was a quantitative study in which an ex post facto correlation research design was used. A total of 39 organisations participated in the study; they are located in the Western Cape, Eastern Cape and Gauteng provinces in South Africa. An electronic self-administered survey that consisted of six sections and 39 items was distributed to employees in varying roles and across different industries. Participation was voluntary; 519 employees engaged in the survey. Multiple regression analysis was used in order to evaluate the data collected. Creative work involvement, psychological safety and vitality were measured by utilising the measurement items presented by Kark and Carmeli (2009). Inclusive leadership was measured using nine items from Carmeli, Reiter-Palmon and Ziv (2010). Lastly, openness to experience was measured using the HEXACO-60 survey (Lee & Ashton, 2004), of which only the 10 items pertaining to this construct were included in the survey presented to the participants. The findings reveal that psychological safety had a significant effect on creative work involvement, and inclusive leadership was shown to have a significant effect on psychological safety. In addition, there was a significant positive relationship between openness to experience and creative work involvement. Moreover, vitality was shown not to have a significant moderating effect on the relationship between psychological safety and creative work involvement. It also was found that the relationship between vitality and creative work involvement was significant. The discussions and implications of this research suggest a number of implementations with which managers can engage in order to stimulate creative behaviour and further encourage creative work involvement through strategic decision making at a variety of organisational levels. Greater levels of creative work engagement can be achieved for the overall success of the organisation, which could have an impact on the global community at large. / AFRIKAANSE OPSOMMING : Organisasies besef toenemend die onskatbare waarde van kreatiwiteit en innovasie in die werkplek. ’n Individu se vermoë om kreatief met sy of haar werk om te gaan, word toenemend erken as noodsaaklik vir ’n organisasie se sukses en mededingende voordeel (Florida & Goodnight, 2005, soos Bissola & Imperatori, 2011). Die soeke na ’n toename in kreatiewe uitset/produksie/opbrengs/vermoë word gedryf deur die volgende vraag: wat veroorsaak variansie in kreatiewe werksbetrokkenheid? Die doel van hierdie studie was om die vraag oor variansie in kreatiewe werksbetrokkenheid in ’n verskeidenheid industrieë aan te spreek. Om dit empiries te doen, is ’n strukturele model, na bestudering van die literatuur, ontwikkel wat die hipotetiese verhoudinge uitbeeld wat deur vorige navorsing gesuggereer is. In wese verken hierdie studie die beduidendheid van vier verhoudinge: (1) die effek van sielkundige veiligheid op kreatiewe werksbetrokkenheid, (2) die effek van inklusiewe leierskap op sielkundige veiligheid, (3) die effek van ontvanklikheid vir ervaring op kreatiewe werksbetrokkenheid, en (4) die modererende effek van lewenskragtigheid op die verhouding tussen sielkundige veiligheid en kreatiewe werksbetrokkenheid. Die navorsingswerkswyse is ‘n kwantitatiewe studie waarin ʼn ex post facto-korrelasionele navorsingsontwerp gebruik is. ’n Totaal van 39 organisasies, geleë in die Wes-Kaap, Oos-Kaap en Gauteng, het aan die studie deelgeneem. ’n Elektroniese selfgeadministreerde vraelys, bestaande uit ses afdelings en 39 items, is onder werknemers in verskeie rolle en in verskeie industrieë versprei. Deelname was vrywillig en 519 werknemers het die vraelys voltooi. Meervoudige regressie-analise is gebruik om die ingesamelde data te evalueer. Kreatiewe werksbetrokkenheid, sielkundige veiligheid en lewenskragtigheid is gemeet met behulp van die metings-items wat deur Kark and Carmeli (2009) voorgestel is. Inklusiewe leierskap is gemeet met nege items van Carmeli, Reiter-Palmon en Ziv (2010). Laastens is die ontvanklikheid vir ervaring gemeet met gebruik van die HEXACO-60 opname (Lee & Ashton, 2004), waarvan slegs die 10 items wat betrekking het op hierdie konstruk ingesluit is in die vraelys wat aan die deelnemers voorgelê is. Die bevindinge het getoon dat sielkundige veiligheid ’n beduidende effek op kreatiewe werksbetrokkenheid het en dat inklusiewe leierskap ‘n beduidende effek op sielkundige veiligheid het. Bykomend hiertoe is ’n beduidende positiewe verwantskap tussen ontvanklikheid vir ervaring en kreatiewe werksbetrokkenheid gevind. Verder is aangedui dat lewenskragtigheid nie ’n beduidende modererende effek op die verwantskap tussen sielkundige veiligheid en kreatiewe werksbetrokkenheid het nie. Daar is ook bevind dat die verwantskap tussen lewenskragtigheid en kreatiewe werksbetrokkenheid beduidend is. In die bespreking en implikasies van hierdie navorsing word ’n aantal voorstelle gemaak wat bestuurders kan implementeer om kreatiewe gedrag te stimuleer en kreatiewe werksbetrokkenheid verder aan te moedig deur strategiese besluitneming op ’n verskeidenheid van organisatoriese vlakke. Groter vlakke van kreatiewe werksbetrokkenheid kan bereik word wat die oorkoepelende sukses van ’n organisasie bevorder, wat dan weer ’n impak op die globale gemeenskap kan hê.

Made available in DSpace on 2014-12-17T14:47:06Z (GMT). No. of bitstreams: 1 LivaGGF_DISSERT.pdf: 1222166 bytes, checksum: 880b584c8c56e4cbea7f570ca7c755fe (MD5) Previous issue date: 2014-04-04 / Since the publication of the report "To Err is Human" by the Institute of Medicine (IOM) , which estimated that between 44.000 to 98.000 Americans die annually as a result of errors in health care, patient safety spent gaining prominence, emerging studies assess the safety culture by measuring the safety climate. In this context, the aim of this study was to identify safety culture perceived by nursing professionals working in the intensive care unit of a maternity school in Natal/RN through the Security Attitudes Questionnaire (SAQ). This was a descriptive study, cross-sectional and quantitative approach undertaken in the Intensive Care Unit Maternal and Neonatal a maternity school in Natal/RN. The project was submitted to and approved by Brazil Platform Zip/UFRN under number 309 540 and CAAE 16489713.7.0000.5537. It was used to collect data two instruments: a questionnaire in order to collect socio-demographic data of the subjects and the Question?rio Atitudes de Seguran?a , a cultural adaptation to Portuguese of the instrument of the World Health Organization titled Safety Attitudes Questionnaire - (SAQ ) Short Form 2006. The collected data were analyzed quantitatively by the organization in electronic databases in Microsoft Excel 2010 spreadsheet and exported to statistical software for free access to be coded, tabulated and analyzed using descriptive statistics. The study included a total of 50 nurses, 31 and 19 of the NICU Maternal ICU, predominantly female, mean age 35 years, median time of 10 years training and working in maternity, mostly, less than 05 anos. As a result, two articles were produced. The first refers to the first two domains of the instrument entitled "climate of teamwork" and "climate security" . The scores of the two areas were slightly higher in Maternal ICU compared to the NICU, but no sector has reached the ideal minimum score of 75: in the first domain Maternal ICU had an average of 74.77, with medians of 75 and 100, while Neonatal ICU reached an average of 69.61 with median also 75 and 100, while the second field means were 69.35 and 66.01 for Maternal and Neonatal ICUs respectively, with a median of 100 in the two sectors. The second article relates to the field "Perception Management Unit and Hospital", which 9 assessed the perception of management units and motherhood by professionals. In general, the items of the domain in question also obtained scores below the ideal minimum: 63.68 to 51.02 and maternal ICU for neonatal, featuring a clear separation between the management and the professionals who work in direct care. These findings indicate a warning sign for the institution and point to the need to implement actions aimed at patient safety / A partir da publica??o do relat?rio Errar ? Humano pelo Institute of Medicine (IOM), o qual estimou que entre 44.000 e 98.000 americanos morrem anualmente em decorr?ncia de erros da assist?ncia ? sa?de, a seguran?a do paciente passou ganhar destaque, surgindo estudos que avaliam a cultura de seguran?a atrav?s da mensura??o do clima de seguran?a. Nesse contexto, o objetivo deste estudo foi identificar a cultura de seguran?a percebida pelos profissionais de enfermagem que atuam nas unidades de terapia intensiva de uma maternidade-escola em Natal/RN, atrav?s do Question?rio Atitudes de Seguran?a (SAQ). Tratou-se de um estudo do tipo descritivo, transversal, com abordagem quantitativa, realizado nas Unidades de Terapia Intensiva Materna e Neonatal de uma maternidade-escola na cidade de Natal/RN. O projeto foi submetido ? Plataforma Brasil e aprovado pelo CEP/UFRN sob o n?mero 309.540 e CAAE 16489713.7.0000.5537. Utilizaram-se para a coleta de dados dois instrumentos: um question?rio com a finalidade de coletar dados sociodemogr?ficos dos sujeitos e o Question?rio Atitudes de Seguran?a, uma adapta??o transcultural para a l?ngua portuguesa do instrumento da Organiza??o Mundial da Sa?de intitulado Safety Attitudes Questionnaire (SAQ) Short Form 2006. Os dados coletados foram analisados quantitativamente atrav?s da organiza??o em banco de dados eletr?nico no Microsoft Excel 2010 e exportados para planilha do SPSS (Statistical Package for the social sciences) vers?o 2.0 para serem codificados, tabulados, e analisados mediante estat?stica descritiva. Participaram do estudo 50 profissionais de enfermagem, sendo 31 da UTI Neonatal e 19 da UTI Materna, predominantemente do sexo feminino, com idade m?dia de 35 anos, tempo de forma??o m?dio de 10 anos e que trabalhavam na maternidade, em sua maioria, havia menos de 5 anos. Como resultado, foram produzidos dois artigos. O primeiro refere-se aos dois primeiros dom?nios do instrumento, intitulados Clima de trabalho em equipe e Clima de seguran?a . Os escores dos dois dom?nios foram ligeiramente mais elevados na UTI Materna se comparada ? UTI Neonatal, por?m nenhum setor atingiu o escore m?nimo ideal de 75: 7 no primeiro dom?nio a UTI Materna obteve m?dia de 74,77, com medianas de 75 e 100, e a UTI Neonatal atingiu m?dia de 69,61 com medianas tamb?m de 75 e 100; enquanto que no segundo dom?nio as m?dias foram de 69,35 e 66,01 para as UTIs Materna e Neonatal respectivamente, com mediana de 100 nos dois setores. O segundo artigo diz respeito ao dom?nio Percep??o da Ger?ncia da Unidade e do Hospital , que avaliou a percep??o da ger?ncia das unidades e da maternidade por parte dos profissionais. Em geral, os itens do dom?nio em quest?o tamb?m obtiveram escores aqu?m do m?nimo ideal: 63,68 para a UTI Materna e 51,02 para a Neonatal, caracterizando um evidente distanciamento entre a gest?o e os profissionais que atuavam na assist?ncia direta. Tais achados indicam um sinal de alerta para a institui??o e apontam para a necessidade de implementar a??es que visem a seguran?a do paciente

This thesis deals with the issue of fire protection of historical buildings in the Czech and Slovak Republics. Input information that was used in the thesis were obtained from the literature or other freely accessible sources, the Fire Brigade of the Czech Republic, the Fire and Rescue Service of the Slovak Republic and the owners or managers of buildings. The main objective is to evaluate the facilities of selected historical buildings in terms of fire protection. According the objective has been defined the research question "Are the monuments in the territory of the Czech and Slovak Republic secured in a comparable level against the risk of fire?". An integral part is also proposing possible technical and technological elements and organizational measures which may lead to increased fire safety of monuments on the territory of the two abovementioned republics. Fulfillment of goals was possible, based on our investigation, when the first identification of monuments in the Czech and Slovak Republics, whose owners, respectively. Administrators were asked to complete a questionnaire containing questions related to fourteen facilities surveyed the building fire safety equipment and material means of fire protection. The completion of that survey were also asked at the same time members of the Fire and Rescue Service geographically relevant regions of the Czech Republic and members of the Fire and Rescue Corps of the Slovak Republic. Specifically, there were members who are employed in divisions or departments of fire prevention of the competent authorities of the state fire supervision. After evaluating the data collected through questionnaires and in some cases based on electronic correspondence or telephone conversations has been possible to answer the research question. Based on available information it is apparently that the fire protection of historical buildings in the Czech and Slovak Republic are treated by the authorities, not only the state fire supervision, but also themselves owners or facility managers very seriously and the fire safety of these monuments can be described as comparable. Unfortunately, in the research failed to varify the availability of surveyed historical buildings for vehicles of emergency fire-fighting units, which was based on the results of the analysis identified as one of the most risky points of fire protection of monuments. It can therefore only consider whether the availability of objects of that type in terms driveways is satisfactory. Proposing of possible measures is done on the basis of not only the information collected from facility managers and bodies of the state fire supervision of both republics, but also on the basis of the KARS analysis, which aimed to identify the most threatening phenomena which could have a negative impact on the status quo of monuments, in terms of fire protection. Answering a defining research questions and performing the analysis using method KARS has been achieved the objective of this thesis. In addition to the methodology and outcomes of the research are in the thesis presented brief information concerning fire protection in the age of the buildings and structures construction, which are currently presents as heritage buildings, and basic information of the principles of fire protection of historical monuments under applicable laws of the Czech and Slovak Republic. Fire protection of historical buildings has been underestimated for years. Currently, in connection with the ensuing fires significant buildings of historical value, it is to safeguard of historical buildings against the emergence and spread of a fire and how to dispose of potential fire utmost importance. As in other areas or sectors, as well as in fire protection of historic buildings is particularly important in the prevention, thus adopting such a system of measures to prevent a fire, or if there is a fire that damages caused by extraordinary events are possible smallest.

Current status: The issue of medical errors has recently gotten considerable attention among organizations at the global and national levels. In its report the Institute of Medicine recommended the development of a safety culture where employees want to provide the safest health care. Assessing the current culture of safety is the first stage in the development of patient safety. Subject: The main purpose of the research was "to evaluate the safety culture in select hospitals." Method: A standardized method was chosen for the research: The AHRQ Hospital Survey on Patient Safety Culture. A quantitative method was implemented using polling. Obtained data were tested in SPSS version 16.0. For statistical testing Person's chi-square and sign scheme was elected. Research group: The research survey addressed 301 non-medical staff of Krajské zdravotní a.s. Masarykova nemocnice, o. z. (Regional Health a.s. Masaryk Hospital) in Ústí nad Labem and Krajské nemocnici Liberec, a.s. (Liberec Regional Hospital) Results: The survey results showed that the surveyed health care professionals assess the organizational culture as friendly. The respondents indicated that they are praised by the manager for conducting their work safely and that they can suggest changes in management practices. The results showed that addressed health care professionals support each other (58.1%) and cooperate better (72.4%). According to the respondents, better teamwork leads to better patient safety. An analysis of the results shows that health professionals have an active approach to safe care (82.7%) and in their opinion, errors and mistakes lead to improved patient safety (40.9%). Paramedics have confirmed that they receive feedback on reported incidents (37.9%). Based on team discussion about errors the respondents' evaluation of patient safety has significantly improved. An analysis of respondents' answers revealed a lack of reporting of adverse events. Most respondents consider the number of staff in the workplace deficient (42.5%). Conclusion: Hospital management should be involved in changing the detection of individual errors from individual to systemic. In order to improve the safety culture there should be regular supervision or teambuilding activities that support the development of teamwork. Feedback on the results of reporting errors must be given in an appropriate way to motivate staff to continue to report future errors. The results require a change in how medical staff report errors and greater consistency among management when checking reports. Complaints of work overload by medical personnel must be taken seriously. Improvements can be brought about by changes to work organization or the use of temporary workers.

Medical errors have been detrimental in the field of medicine. They have impacted both patients and doctors. While physicians recognized that error disclosure was an ethical and professional obligation, most remained silent when mistakes happened for different reasons. Guided by the theory of planned behavior and Kant's deontological theory, the purpose of this quantitative study was to investigate the perceived barriers affecting physicians' willingness to report major medical errors. An association was tested between the independent variables physician fear of disclosure of errors, organizational culture toward patient safety, physician apology, professional ethics and transparency, physician education, and the dependent variable physician willingness to disclose major medical errors. Using a cross-sectional method, 122 doctors out of 483 surveyed, completed the online and paper-based survey. Multiple linear regression and descriptive statistics models were used to analyze and summarize the data. The results showed there was a statistically significant relationship between the independent variables organizational culture toward patient safety, physician apology, professional ethics and transparency, and physician education and the dependent variable physician willingness to disclose major medical errors. There was no relationship between the independent variable fear of disclosure of errors and the dependent variable. The findings added to the knowledge base regarding barriers to physicians' medical errors disclosure. The results and recommendations could provide positive social change by helping hospitals raising doctors' awareness regarding major medical errors disclosure.