Impact of the ‘Contributing Factors in Construction Accidents’ (ConCA) model

In 2005 the ‘Contributing factors in Construction Accidents’ framework (ConCA) introduced a sociotechnical systems approach to risk management in construction. ConCA demonstrated the value of exploring distal factors and identifying underlying or latent causes: It promoted an understanding of construction accidents as systemic accidents and challenged an industry-wide culture of blaming frontline workers. A decade later the original article has been cited by research from 37 countries, shaping inquiries and initiatives to improve safety in both the UK and Australia. But to what extent has systems thinking infiltrated practitioners and policy-makers’ views? Despite broader views of contributing factors, many practitioners still view workers in a negative light, holding them responsible for accidents because of complacency, cynicism about safety, or a high-tolerance for risk. This paper evaluates the impact of the ConCA framework, updates it, and develops our understanding of the relationships between immediate circumstances and distal factors, as seen by an expert panel of participants (n = 32). A more in-depth ‘ConCA+’ framework is proposed. It challenges the negative perceptions of workers, and supports shifting the emphasis of risk management away from worker behaviors and towards resolving wider systemic issues. New directions are proposed which show how knowledge management, job design, technological innovation, empowerment and collaboration should be the focus of future work

Patient safety culture measurement in general practice. Clinimetric properties of 'SCOPE'

<p>Abstract</p> <p>Background</p> <p>A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS).</p> <p>Methods</p> <p>The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' <it>patient safety grade </it>of their practices correlated with their scores on the questionnaire.</p> <p>Results</p> <p>Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning <it>handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety </it>and <it>expectations and actions of managers</it>. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not.</p> <p>Conclusions</p> <p>The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.</p

Safety Culture Development: The Gap Between Industry Guidelines and Literature, and the Differences Amongst Industry Sectors.

Reason’s typology of safety culture (i.e. Just, Informative, Learning, Flexible and Reporting cultures) is widely used in the industry and academia. Through literature review we developed a framework including 36 markers that reflect the operationalization of Reason’s sub-cultures and general organizational prerequisites. We used the framework to assess to what extent safety culture development guidelines of seven industry sectors (i.e. aviation, railway, oil and gas, nuclear, healthcare, defense and maritime) incorporate academic references, and are similar to each other. Gap analysis and statistics showed that the guidelines include 53–69 % of the safety culture markers, with significant differences across subcultures and industry sectors. The results suggested that there is a gap between the industry guidelines and literature, as well as variant approaches to safety culture across the industry. The framework suggested in the study might be used as reference for completing existing safety culture development plans and constructing safety culture assessment instruments

The Management of Occupational Health and Safety in Vocational Education and Training

Vocational education and training (VET) providers must provide a safe and healthy learning and working environment for their students and employees. Establishing a culture with effective occupational health and safety (OHS) procedures helps VET providers in meeting this duty of care. The objective of this study was to describe the practices of sustainable OHS management in VET. The procedures were studied in six VET provider organizations; 6 workshops were arranged and 58 employees were interviewed. The procedures revealed were categorized into preventative actions, actions during the incident, and actions after the incident. Prevention is possible when sustained proactive and reactive actions are directed at the individual, team, working environment, and organization levels. The results will guide VET and other organizations toward shaping OHS policies and safety culture in the field of education. Furthermore, developing safety culture may achieve other VET providers’ goals, such as quality of education and student performance.acceptedVersionPeer reviewe