The dynamic interplay of physical and psychosocial safety climates in frontline healthcare.

Little is known about how safety climates concerning physical safety and psychosocial safety interact in the prediction of working conditions and subsequent worker health. Frontline healthcare was selected as the setting for this study on the dynamic interplay between physical and psychosocial safety climates because of a recent call for attention to working conditions in this industry. Poor safety climates for healthcare workers spill over into adverse outcomes for worker health, and when workers are compromised then so too is their provision of quality patient care. We developed an integrated model of the relationships between psychosocial and physical safety climates, working conditions, and health and safety outcomes. A multilevel model was tested (N=463 workers nested within n=60 teams), and lagged analysis was conducted across four time points, each six months apart. The combination of safety climates significantly predict objective outcomes from hospital safety system records on staff accidents, absence, and patient incidents (quality of care), suggesting a dynamic interplay in the prediction of impacts on the worker, organisation, and end-user. Integrated physical and psychosocial safety climate measures can be incorporated into hospital OHS reporting and response systems as effective lead indicators and key performance metrics for work health and safety.