Date of Award


Degree Type


Degree Name

Master of Science


Health and Rehabilitation Sciences


Dr. Aleksandra Zecevic

Second Advisor

Dr. Anita Kothari

Third Advisor

Dr. Treena Orchard


Over the past decade, literature on healthcare safety culture has risen dramatically. The first aim of this research was to understand common definitions, measures and progress in improving safety culture within the healthcare domain by conducting a comprehensive literature review. Results indicated the study of safety culture in healthcare is characterized by a multiplicity of definitions, theoretical underpinnings, dimensions, tools to measure and assess underlying culture, and interventions to improve. In addition, the literature has placed less emphasis on long-term care (LTC) settings than acute care settings. Acknowledging this gap, a mixed methods approach was employed to gain insight into the safety culture of a single unit in a LTC home. Semi-structured interviews, a focus group, and a safety culture questionnaire were used to explore this topic. Collecting both quantitative and qualitative data brought together the strengths from both forms of research to corroborate results, and locate the unit within the safety culture maturity model. Results suggested a reactive culture, where safety systems were piecemeal and developed only in response to adverse events and/or regulatory requirements. A punitive regulatory environment, low budgets and staffing levels, heavy workloads, and poor capacity for training in resident safety were barriers to improving safety. In the future, researchers should work towards the creation of a model of safety culture acceptable for use and adoption by healthcare organizations. More in-depth observational and longitudinal research is needed to best understand safety culture in LTC, perhaps tapping into the expertise of traditional culture experts, anthropologists, to move research forward in this area.



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