[This article was originally published in Healthcare Quarterly, Volume 11, Number 2.]

Patient safety is a basic goal of all Canadian healthcare organizations. Yet we still have much to learn about the determinants of safety. One of the biggest knowledge gaps is how workplace factors influence safety outcomes. As the 2004 Canadian Adverse Events Study suggested, "The greatest gains in improving patient safety will come from modifying the work environment of healthcare professionals, creating better defenses for averting [adverse events] and mitigating their effects." (Baker et al. 2004: 1685). Echoing this point, the US Agency for Healthcare Research and Quality (AHRQ) concluded that working conditions affect patient outcomes, including safety (AHRQ 2003). However, little is known about the causal mechanisms by which work environment factors that influence employee behaviour also have implications for patient safety.  

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