The context and influences of safety: an exploration of social networks, actions, and behaviour

Jo Wailling, Janet C. Long, Iwona Stolarek

Research output: Contribution to journalArticlepeer-review


Background: Safety systems are socio-cultural in nature, characterized by people, their relationships to one another and to the whole. This study aimed to (i) map the social networks of New Zealand's quality improvement and safety leaders, (ii) illuminate influential characteristics and behaviours of key network players and (iii) make recommendations regarding how networks might be optimized.

Methods: Instrumental case study was done using mixed methods. Purposeful sampling was applied to collect survey data from delegates at two national safety and quality forums (n = 85). Social network questions asked respondents who influenced their safety work. Key network players were identified and invited to participate in a semi-structured interview (n = 7).

Results: Key players described safety systems in humanistic terms. Safety influence was determined to be a responsive relational process. Adaptive leaders broker relationships between multiple perspectives and contexts, which is essential for safe healthcare.

Conclusion: Influential safety approaches appreciate the human contribution to safety. Designing the health system to adapt and respond to the needs of people, teams and communities, rather than the unilateral needs of the system, is essential. Adaptive leadership will assist in achieving these aims and will likely be embraced by New Zealand health professionals.

Original languageEnglish
Article numbermzaa157
Number of pages7
JournalInternational Journal for Quality in Health Care
Issue number1
Early online date26 Nov 2020
Publication statusPublished - 2021


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