A number of resources are available on the National Patient Safety Agency website to allow NHS organisations to assess their progress in developing a safety culture.
The principles are based on Westrum's typography of organisational communication (1992) that was expanded by Parker and Hudson (2001) to describe five levels of increasing organisational safety culture as follows
A. Pathological - prevailing attitude is "why waste our time on safety" so that there is little or no investment in improving
B. Reactive - only think about safety after an incident
C. Bureaucratic - paper-based approaches involving ticking boxes to show to auditors and assessors
D. Proactive - place a high value on improving, actively invest in continuous improvement and reward staff who raise safety-related issues
E. Generative - the nirvana where safety is an integral part of the organisation
Andy Brazier
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