Social networks, teamwork, and safety climate in the acute care clinical work setting

The patient safety priority is essential for health care organizations to continue to effectively care for their communities and fulfill their mission. Despite the decades of attention to patient safety, however, ongoing action and research has resulted in little overall reduction in the rate of harm. This leaves significant opportunity for dramatically improving what we know and what we do about delivering safer care. The purpose of this study, therefore, was to apply fresh thinking about antecedents to safe care in an exploration of the relationship between social network structure and safety climate in acute care clinical work settings.;The sample for this secondary analysis consisted of 334 individuals nested within seven acute care clinical work settings within five hospitals derived from survey data collected in May through June 2013. The approach was a retrospective cross-sectional quantitative study that examined individual and group level social network properties and perceptions of teamwork climate and safety climate. Other covariates included caregiver type, gender, usual shift, and years worked in their clinical setting.;Complex adaptive systems theory informed the hypothesized relationship of a positive association between individual network centrality and group density and perceptions of teamwork climate and safety climate. Multilevel modeling was used to explore and confirm the relationship as influenced by the nested nature of the individuals within the clinical work settings.;A significant positive association was found between the individual network centrality metric of integration and perceptions of teamwork climate. There was also a significant positive association between individual integration and perceptions of safety climate. No association was found between group level density and perceptions of teamwork climate or safety climate. The small number of clinical work settings in the sample required substantial caution when interpreting study findings.;These results provide new knowledge about how social interactions and clinical team network structure can be understood and adapted to achieve goals of safer care. Future research on the contribution of social network theory and complex adaptive systems to advance safer care is recommended.