Understanding and improving patient safety: the psychological, social and cultural dimensions

J Health Organ Manag. 2009;23(6):581-96. doi: 10.1108/14777260911001617.


Purpose: This paper aims to provide researchers and practitioners with an overview of how organisation behaviour research (OBR) helps to understand and resolve patient safety problems in health care.

Design/methodology/approach: The paper describes psychological, sociological and other social science theories and research which help to understand the causes of patient safety problems, how to implement change effectively and how to create an organisational culture of safety.

Findings: Social science perspectives and organisational behaviour research are beginning to show why improvements in patient safety are slow, and how to make lasting and effective change.

Research limitations/implications: Social sciences and OBR have already helped make healthcare safer, but could make a greater contribution. Progress could be faster with greater awareness of the findings of this research and understanding of social science research paradigms.

Practical implications: Better implementation and safer care could result from providing implementers and decision makers with more knowledge and access to social science research. More useful social science research could be developed by research funders and proposal reviewers gaining a greater understanding of social science methods and potential, and by including this research in a field made up largely of traditional experimental medical research methods.

Originality/value: This paper provides an overview of the scientific and practical contributions of social sciences to patient safety and shows where future studies could assist understanding of current challenges and speed implementation of change.

MeSH terms

  • Behavioral Research
  • Health Personnel / psychology*
  • Humans
  • Medical Errors / prevention & control
  • Models, Theoretical
  • Organizational Culture*
  • Patients*
  • Safety Management*
  • Sociology, Medical*