Today, in 21st century healthcare at least 10% of hospitalised patients are subjected to some degree of unintended harm as a result of the treatment they receive. Despite the growing patient safety agenda there is little empirical evidence to demonstrate that patient safety is improving. Patient Safety Leadership Walk Rounds (PSLWR) were introduced to the UK, in March 2005, as a component of the Safer Patients Initiative (SPI), the first dedicated, hospital wide programme to reduce harm in hospital care. PSLWR are designed, to create a dedicated ‘conversation’ about patient safety, between frontline staff, middle level managers and senior executives. This thesis, explored the use of PSLWR, as a proactive mechanism to engage staff in patient safety discussion and detect patient harm within a Scottish healthcare system- NHS Tayside. From May 2005 to June 2006, PSLWR were held on a weekly basis within the hospital departments. A purposive sample, (n=38) of PSLWR discussions were analysed to determine: staff engagement in the process, patient safety issues disclosed; recognition of unsafe systems (latent conditions) and actions agreed for improvement. As a follow-up, 42 semi-structured interviews were undertaken to determine staff perceptions of the PSLWR system. A wide range of clinical and non-clinical staff took part (n=218) including medical staff, staff in training, porters and cleaners, nurses, ward assistants and pharmacists. Participants shared new information, not formally recorded within the hospital incident system. From the participants perspectives, PSLWR, were non threatening; were easy to take part in; demonstrated a team commitment, from the Board to the ward for patient safety and action was taken quickly as a result of the ‘conversations’. Although detecting all patient harm remains a challenge, this study demonstrates PSLWR can be a useful tool in the patient safety arsenal for NHS healthcare organisations.

Legislators are placing increased pressure on mining companies to improve their safety performance. The importance of safety leadership is highlighted by its role in safety culture and improving safety performance. The aim of this study was to develop and evaluate the impact of a coaching program on safety leadership. The main constructs namely safety culture, safety leadership and coaching was conceptualised along the humanistic paradigm, with theoretical definitions and models. In this study, safety culture is employees’ shared attitudes, beliefs, perceptions and values about safety that affect their behaviour in the workplace. Safety leadership is the interpersonal influence that a leader exercises to achieve the organisation’s safety performance goals. Coaching is an interpersonal interaction that aims to improve individual performance through increased selfawareness and action plans. A theoretical model was developed to explain the elements that constitute effective safety leadership. A coaching program was developed based on executive coaching and leadership development principles. The empirical investigation was conducted in an organisation in the South African mining industry. A nested mixed methods design was followed. In the quantitative study, a 360 degree survey was employed to assess the ratings of a purposive sample (n=54) along eight dimensions before and after the coaching. Data was analysed with descriptive and inferential analysis. Results showed statistically significant improvements on accountability, collaboration, and feedback and recognition after the coaching. The results reflected differences in 360 degree ratings according to gender, race, job level, age and geographical location. The most significant improvements were for females, Africans, management, age 51-60 years, and site 2. In the qualitative study, a semi-structured interview was employed to study four cases to investigate managers’ personal experiences and changes in attitude toward safety. Data was analysed utilising thematic analysis. The findings revealed that coaching was a positive experience and contributed to changing managers’ attitudes toward safety. The research added to the field of organisational behaviour by presenting a theoretical model that enhances the understanding of safety leadership, the development of a coaching program and providing empirical evidence that the principles of coaching and leadership development can be applied to improve safety leadership. / Industrial & Organisational Psychology / D. Admin. (Industrial and Organisational Psychology)

Legislators are placing increased pressure on mining companies to improve their safety performance. The importance of safety leadership is highlighted by its role in safety culture and improving safety performance. The aim of this study was to develop and evaluate the impact of a coaching program on safety leadership. The main constructs namely safety culture, safety leadership and coaching was conceptualised along the humanistic paradigm, with theoretical definitions and models. In this study, safety culture is employees’ shared attitudes, beliefs, perceptions and values about safety that affect their behaviour in the workplace. Safety leadership is the interpersonal influence that a leader exercises to achieve the organisation’s safety performance goals. Coaching is an interpersonal interaction that aims to improve individual performance through increased selfawareness and action plans. A theoretical model was developed to explain the elements that constitute effective safety leadership. A coaching program was developed based on executive coaching and leadership development principles. The empirical investigation was conducted in an organisation in the South African mining industry. A nested mixed methods design was followed. In the quantitative study, a 360 degree survey was employed to assess the ratings of a purposive sample (n=54) along eight dimensions before and after the coaching. Data was analysed with descriptive and inferential analysis. Results showed statistically significant improvements on accountability, collaboration, and feedback and recognition after the coaching. The results reflected differences in 360 degree ratings according to gender, race, job level, age and geographical location. The most significant improvements were for females, Africans, management, age 51-60 years, and site 2. In the qualitative study, a semi-structured interview was employed to study four cases to investigate managers’ personal experiences and changes in attitude toward safety. Data was analysed utilising thematic analysis. The findings revealed that coaching was a positive experience and contributed to changing managers’ attitudes toward safety. The research added to the field of organisational behaviour by presenting a theoretical model that enhances the understanding of safety leadership, the development of a coaching program and providing empirical evidence that the principles of coaching and leadership development can be applied to improve safety leadership. / Industrial and Organisational Psychology / D. Admin. (Industrial and Organisational Psychology)