title: Organizational climate determinants of resident safety culture in nursing homes.
abstract: OBJECTIVE
  In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes.
  
  
  METHODS
  Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures.
  
  
  RESULTS
  The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05).
  
  
  CONCLUSIONS
  Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.
authors.affiliation: Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan 48201, USA. jarnetz@med.wayne.edu
authors.forename: Judith E
authors.initials: JE
authors.lastname: Arnetz
authors.forename: Ludmila S
authors.initials: LS
authors.lastname: Zhdanova
authors.forename: Dalia
authors.initials: D
authors.lastname: Elsouhag
authors.forename: Peter
authors.initials: P
authors.lastname: Lichtenberg
authors.forename: Mark R
authors.initials: MR
authors.lastname: Luborsky
authors.forename: Bengt B
authors.initials: BB
authors.lastname: Arnetz
mesh_terms: D000058:Accidental Falls / Q000191:economics / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008508:Medication Errors / Q000191:economics / Q000517:prevention & control* / Q000706:statistics & numerical data; D008824:Michigan / Q000453:epidemiology; D009735:Nursing Homes / Q000458:organization & administration*; D009741:Nursing Staff, Hospital; D015279:Organizational Culture; D011787:Quality of Health Care / Q000592:standards*; D017751:Safety Management / Q000458:organization & administration*; D011795:Surveys and Questionnaires