Being safe means feeling safe: Safety culture’s impact on experience and outcomes

In healthcare, the impact of safety culture rarely grabs headlines, compared to shiny new cures and medical breakthroughs. But it quietly shapes the outcomes that matter—from trust and teamwork to patient experience and clinical results.

First, what do we mean by safety culture? It’s not about physical safety for staff. It’s about whether people believe their organization is truly committed to patient safety, and whether they feel safe speaking up when something’s not right. When that culture exists, patients can heal, and caregivers can thrive.

For those of us dedicated to advancing healthcare safety, the latest data offers both validation and renewed urgency.

Earlier this year, the American Hospital Association (AHA) and Press Ganey released a joint report, "Improvement in Safety Culture Linked to Better Patient and Staff Outcomes," which examined data from 13 million patients and 1.7 million healthcare workers in the U.S., surveying more than 25,000 units across 2,430 hospitals in 2024. The findings reveal what many of us have long believed: A strong culture of safety enhances workforce resilience and well-being. And workforce resilience and well-being directly impact patient outcomes and perceptions of care.

Encouragingly, the data shows improvements in patient experience, employee experience, and key outcomes like falls, infections, and hospital-acquired conditions. It’s showing a return to pre-pandemic levels in safety and quality—a milestone worth celebrating. Safety culture, in turn, has largely rebounded post-pandemic. But momentum is stalling. In other words, while care is getting safer, progress on safety culture is beginning to level off.

Now is not the time for a slowdown—it never is. In a field where lives are at stake every day, healthcare leaders must stay committed to continuous improvement.

What a strong safety culture looks like

A true culture of safety encompasses both physical and psychological safety—and, at times, the latter may be even more important. Yes, a strong safety culture means using the right protocols to protect patients. But it also means creating an environment in which everyone—no matter their rank—is empowered to speak up when something doesn’t seem right, acknowledge human error, and trust their concerns will be heard and acted upon. Mistakes should be met with fairness and compassion—not blame and punishment—and treated as learning opportunities.

Across all clinical settings, teamwork has emerged as the single largest driver of positive patient experiences. This underscores a fundamental truth: Technical excellence alone isn’t enough. When caregivers have strong interpersonal relationships, communicate well, and support one another, they help build environments where patients receive safer, more effective care, and employees feel engaged and valued, and can deliver their best work.

Overcoming the safety plateau: 4 action items for leaders

While it’s encouraging to see that critical safety metrics have largely returned to pre-pandemic levels, it is equally paramount that we continue moving forward rather than accepting a status quo. To progress beyond the current plateau in safety performance, healthcare leaders must take bold steps:

1. Embrace zero harm as your North Star: When it comes to safety, no goal is too ambitious. Zero harm should be the guiding principle that motivates organizations to think differently about safety and achieve previously unimaginable results.
2. Treat teamwork as a core safety strategy: Safety doesn’t happen in silos. High-functioning teams—where roles are clear, communication is strong, mutual respect is the norm, and social capital is hardwired into the organization’s culture and infrastructure—form the foundation of safety. And when employees believe their organizations prioritize and invest in safety, they’re more engaged and more likely to stay.
3. Foster psychological safety: Create environments where staff feel safe reporting errors. Open the lines of communication through judgement-free channels, like regular pulse checks, where they can report concerns, ideas, and uncertainties without fear of blame. Put support systems in place for staff affected by adverse events, so when mistakes happen, they get the care they need and a chance to recover.
4. Implement evidence-based measurement: Employ validated survey tools and regular assessment mechanisms to monitor safety culture and track improvements over time. Measuring both physical and psychological safety across the organization provides vital insights—and keeps us all accountable for real, positive change.

Doing the right thing drives the right results. This makes fostering a strong safety culture as much a strategic imperative as it is a moral one. Fewer costly errors. Greater trust. And a workforce that’s more engaged and likely to stay. Because care that’s compassionate, connected, and human must also be safe—in every sense of the word.