Working in health care involves significant health and safety risks. This dissertation uses health care utilization data of Dutch employees working in health care as a starting point to investigate variation in employee health and safety across organizations. It furthermore examines the role safety climate plays in explaining these differences. Safety climate can be described as employees’ perceptions of the policies, procedures and practices as it relates to the value and importance of physical and psychological health and safety within the organization.

The results show that an organization’s safety climate is related to various outcomes at the individual level, such as employee health and behavior. At the organizational level, the results demonstrate that health care organizations with a more positive safety climate also have lower absenteeism, presenteeism and employee health care utilization rates. Based on these findings, a multifaceted safety climate intervention program was developed and empirically tested in five health care organizations. The results of this study indicate that the multifaceted safety climate intervention positively influences safety climate perceptions and behavior in the workplace. The findings furthermore reveal that attention needs to be paid to the implementation process, especially to the role of the direct supervisor and the actual changes in the workplace the intervention brings about.

This dissertation thus contributes to the scientific knowledge on the effects of safety climate and provides practical recommendations on how to improve safety climate and achieve healthy and safe workplaces in health care.

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This research is financed by Stichting IZZ, a collectivity of employees working in the Dutch health care sector.
A.J. Steijn (Bram) , L.G. Tummers (Lars)
Erasmus University Rotterdam
Department of Public Administration and Sociology (DPAS)

Bronkhorst, B. (2018, April 26). Healthy and Safe Workplaces in Health Care : examining the role of safety climate. Retrieved from