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Macroergonomic Approach to Safety Culture/Climate: A Healthcare Facility Case Study

A long-term care facility in the Upper Midwest was experiencing a high rate of injuries, primarily due to caregiver-patient interactions. A grounded theory case study was conducted to collect top management, supervisor, and caregiver perceptions of work system elements (centered on the caregiver job), and then compare their responses to identify discrepancies. Any discrepancies in perceptions between organizational levels are a potential point for miscommunication, poor relations, injuries, or other negative outcome. Results indicate that although management believes that injuries can be avoided by following work rules, some workers believe that getting injured is, “ just part of my job” and that overexertion and “hurrying” is expected. Organizational and social issues need to be understood before sustainable change can occur. Implications for a macroergonomic approach to safety culture assessment are discussed.