Workplace relationships, psychological capital, accreditation and safety culture: a new framework of analysis within healthcare organizations

This paper used Social Exchange Theory (SET), Positive Organizational Behavior (POB) and Cooper’s (Safety Science, 36(2), 111–136, 2000) frameworks to operationalize a comprehensive model of safety culture, and tests whether one SET factor (supervisor-employee relationships) and one POB factor (psychological capital) predict accreditation and safety culture in a causal chain. Surveys from 1125 Italian doctors were analyzed using Structural Equation Modeling. Supervisor-employee relationships and psychological capital accounted for two-fifths of the accreditation culture, and, in turn, explained more than half of the safety culture. Hence, effective workplace relationships between management and doctors provide a trusting foundation to develop safe practices for better healthcare.