Safety Culture and Safety Improvement

AHA Team Training Research and Evidence Base

This is a list of resources for safety culture and safety improvement. Return to the main list to explore other topic areas.


BognĂ r, A., Barach, P., Johnson, J. K., et al. (2008). Errors and the burden of errors: attitudes, perceptions, and the culture of safety in pediatric cardiac surgical teams. Annals of Thoracic Surgery 85(4) 1374-81.

Colla, J., Bracken, A., Kinney, L.m & Weeks, W. (2005). Measuring patient safety climate: A review of surveys. Quality and Safety in Health Care 14(5) 364-6.

Cooke, M. (2016). TeamSTEPPS for health care risk managers: Improving teamwork and communication. Journal of Healthcare Risk Management 36(1), 35-45.

Huang, D. T., Clermont, G., Sexton, J. B., et al. (2007). Perceptions of safety culture vary across the intensive care units of a single institution. Critical Care Medicine 31(1) 165-76.

Jones, K., Skinner, A., High, R., & Reiter-Palmon, R. (2013). A theory-driven, longitudinal evaluation of the impact of team training on safety culture in 24 hospitals. BMJ Quality & Safety 22(5), 394-404.

Kachalia, A., Sands, K., Niel, M. V., et al. (2018). Effects Of A Communication-And-Resolution Program On Hospitals’ Malpractice Claims And Costs. Health Affairs 37(11), 1836-1844.

Maxfield, D. G., Lyndon, A., Kennedy, H. P., O'Keeffe, D. F. & Zlatnik, M. G. (2013). Confronting safety gaps across labor and delivery teams. American Journal of Obstetrics and Gynecology 209(5), 402-408.e3.

Pronovost, P. J., Weast, B., Bishop, K., et al. (2004). Senior executive adopt-a-work unit: A model for safety improvement. Joint Commission Journal on Quality and Safety 30(2) 59-68.

Sexton, J. B., Berenholtz, S. M., Goeschel, C. A., et al. (2011). Assessing and improving safety climate in a large cohort of intensive care units. Critical Care Medicine 39(5) 934-9.

Sexton, J. B., Helmreich, R. L., Neilands, T. B., et al. (2006). The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Services Research 6, 44.

Sexton, J. B., Thomas, E., & Pronovost, P. J. (2005). The context of care and the patient care team: The safety attitudes questionnaire. In P. P. Reid, W.D. Compton, J. H. Grossman, G. Fanjiant (Eds.), Building a Better Delivery System: A New Engineering/Health Care Partnership (pp. 119-23). Washington, DC: National Academies Press.

Sentinel Event Alert, Issue 40: Behaviors that undermine a culture of safety. Joint Commission 2008.

Timmel, J., Kent, P. S., Holzmueller, C. G., Paine, L. A., Schulick, R. D., & Pronovost, P. J. (2010). Impact of the comprehensive unit-based safety program (CUSP) on safety culture in a surgical inpatient unit. Joint Commission Journal on Quality and Patient Safety 36(6), 252-60.

Thomas, L. & Galla, C. (2013). Building a culture of safety through team training and engagement. BMJ Quality and Safety 22(5), 425-34.

Weaver, S. J., Lyons, R., et al. (2010). The anatomy of health care team training and the state of practice: A critical review. Academy Medicine: Journal of the Association of American Medical Colleges 85(11), 1746-60.

Weaver, S. J., Lubomksi, L. H., et al. (2013). Promoting a culture of safety as a patient safety strategy: A systematic review. Annals of Intern Medicine 158(5 Pt 2), 369-74.