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Occupational Safety and Health Administration

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Business Case for Safety and Health

• Business Case for Safety and Health Home

Design for Safety

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• Workers' Rights

Workplace fatalities, injuries, and illnesses cost the country billions of dollars every year. In its 2021 Workplace Safety Index, Liberty Mutual estimated that employers paid more than $1 billion per week for direct workers' compensation costs for disabling, non-fatal workplace injuries in 2018. The National Safety Council estimated that work-related deaths and injuries cost the nation, employers, and individuals $171 billion in 2019. Employers that implement effective safety and health programs may expect to significantly reduce injuries and illnesses and reduce the costs associated with these injuries and illnesses, including workers' compensation payments, medical expenses, and lost productivity. In addition, employers often find that process and other changes made to improve workplace safety and health may result in significant improvements to their organization's productivity and profitability.

How can investing in workplace safety and health improve your organization's financial performance?

Source: David Levine, Michael Toffel, and Michael Johnson, "Randomized Government Safety Inspections Reduce Worker Injuries with No Detectable Job Loss." Science, Vol. 336, No. 6083, pp. 907-911 (May 18, 2012). See Abstract and Press Release .

Source: J. Paul Leigh, Economic Burden of Occupational Injury and Illness in the United States ." Milbank Quarterly, Vol. 89, Issue 4, p. 728 (Dec. 2011).

Source: 2021 Liberty Mutual Workplace Safety Index . Liberty Mutual Insurance Company, (2021).

Source: Workplace Safety Can Give Small Business Owners a Recruiting Edge, EMPLOYER Survey Finds (Sep. 2017).

Source: Goldman Sachs JBWere Finds Valuation Links in Workplace Safety and Health Data . Goldman Sachs JBWere Group, (October 2007). See Press Release .

Source: White Paper on Return on Safety Investment . American Society of Safety Engineers (ASSE), (June 2002).

Source: Chief Financial Officer Survey. Liberty Mutual Insurance Company, (2005).

Source: Anthony Forest Products . OSHA Small Business Success Stories, (February 2007).

Source: Voluntary Protection Programs (VPP) . OSHA.

Source: Foundry Ergonomics Partnership . OSHA Strategic Partnership Program Success Stories, (January 2005).

Source: Weston 4 Power Plant Construction . OSHA Strategic Partnership Program Success Stories, (February 2007).

The following resources provide background on the costs of workplace injuries and illnesses and how employers can estimate these costs at their workplaces.

The following resources provide background on the economic benefits of workplace safety and health and how safety managers and others may demonstrate the value of safety and health to management.

The following resources on the business case for safety and health are broken out by industry and safety and health topic.

The following resources address how accounting for employee safety in the design stage of a project may result in fewer injuries and illnesses and increased productivity.

The following is additional information on the business case for safety and health from OSHA, other federal and state agencies, other organizations, and other countries.

• Safe + Sound Campaign
• OSHA's Recommended Practices for Safety and Health Programs
• Sustainability in the Workplace

Now that you know that investing in workplace safety and health may improve your company's productivity and bottom line, here are some resources that may help you improve your organization's workplace safety and health and learn about OSHA's compliance assistance resources.

• OSHA's On-Site Consultation Program . Through this no-cost and confidential program, consultants from state agencies or universities work with small business employers to find and fix workplace hazards, give advice for complying with OSHA standards, and help establish and improve safety and health programs.
• Safety and Health Programs: 10 Ways to Get Your Program Started .
• Compliance Assistance QuickStarts . These step-by-step guides help employers identify major OSHA requirements and guidance materials that apply to their workplace.
• O SHA Publications , including:
• All about OSHA . Also available in Spanish and Vietnamese .
• Job Hazard Analysis .
• Small Business Safety and Health Handbook .

See also: Additional Resources .

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• 14 Jul 2022
• Research & Ideas

When the Rubber Meets the Road, Most Commuters Text and Email While Driving

Laws and grim warnings have done little to deter distracted driving. Commuters routinely use their time behind the wheel to catch up on emails, says research by Raffaella Sadun, Thomaz Teodorovicz, and colleagues. What will it take to make roads safer?

• 15 Mar 2022

This Workplace Certification Made Already Safe Companies Even Safer

New research by Michael Toffel and colleagues confirms what workplace safety advocates have long claimed: Adopting OHSAS 18001 reduces worker injuries and improves a brand's image. Open for comment; 0 Comments.

• 17 Aug 2021

Can Autonomous Vehicles Drive with Common Sense?

Driverless vehicles could improve global health as much as the introduction of penicillin. But consumers won't trust the cars until they behave more like humans, argues Julian De Freitas. Open for comment; 0 Comments.

• 17 Sep 2019
• Cold Call Podcast

How a New Leader Broke Through a Culture of Accuse, Blame, and Criticize

Children’s Hospital & Clinics COO Julie Morath sets out to change the culture by instituting a policy of blameless reporting, which encourages employees to report anything that goes wrong or seems substandard, without fear of reprisal. Professor Amy Edmondson discusses getting an organization into the “High Performance Zone.” Open for comment; 0 Comments.

• 11 Jun 2019
• Working Paper Summaries

Throwing the Baby Out with the Drinking Water: Unintended Consequences of Arsenic Mitigation Efforts in Bangladesh

In this study, households that were encouraged to switch water sources to avoid arsenic exposure experienced a significant rise in infant and child mortality, likely due to diarrheal disease from exposure to unsafe alternatives. Public health interventions should carefully consider access to alternatives when engaging in mass behavior change efforts.

• 31 Jan 2019

How Wegmans Became a Leader in Improving Food Safety

Ray Goldberg discusses how the CEO of the Wegmans grocery chain faced a food safety issue and then helped the industry become more proactive. Open for comment; 0 Comments.

• 09 May 2018

A Simple Way for Restaurant Inspectors to Improve Food Safety

Basic tweaks to the schedules of food safety inspectors could prevent millions of foodborne illnesses, according to new behavioral science research by Maria Ibáñez and Michael Toffel. Open for comment; 0 Comments.

• 12 Sep 2016

What Brands Can Do to Monitor Factory Conditions of Suppliers

For better or for worse, it’s fallen to multinational corporations to police the overseas factories of suppliers in their supply chains—and perhaps make them better. Michael W. Toffel examines how. Open for comment; 0 Comments.

• 17 Jun 2016

Companies Need to Start Marketing Security to Customers

The recent tragedies in Orlando underscore that businesses and their customers seem increasingly vulnerable to harm, so why don't companies do and say more about security? The ugly truth is safety doesn't sell, says John Quelch. Open for comment; 0 Comments.

• 05 Jan 2016

The Integrity of Private Third-party Compliance Monitoring

Michael Toffel and Jodi Short examine how conflict of interest and other risks lead to inaccurate monitoring of health, labor, and environmental standards.

• 21 May 2012

OSHA Inspections: Protecting Employees or Killing Jobs?

As the federal agency responsible for enforcing workplace safety, the Occupational Safety and Health Administration is often at the center of controversy. Associate Professor Michael W. Toffel and colleague David I. Levine report surprising findings about randomized government inspections. Key concepts include: In a natural field experiment, researchers found that companies subject to random OSHA inspections showed a 9.4 percent decrease in injury rates compared with uninspected firms. The researchers found no evidence of any cost to inspected companies complying with regulations. Rather, the decrease in injuries led to a 26 percent reduction in costs from medical expenses and lost wages—translating to an average of $350,000 per company. The findings strongly indicate that OSHA regulations actually save businesses money. Closed for comment; 0 Comments.

• 24 Jan 2011

Terror at the Taj

Under terrorist attack, employees of the Taj Mahal Palace and Tower bravely stayed at their posts to help guests. A look at the hotel's customer-centered culture and value system. Open for comment; 0 Comments.

OSHA's most interesting cases

What happened – and lessons learned.

Every OSHA investigation offers an opportunity for using what comes to light to help prevent similar incidents.

At the 2022 NSC Safety Congress & Expo in September, OSHA staffers highlighted three investigations – and the lessons learned – during the agency’s “Most Interesting Cases” Technical Session.

• Brian Elmore , an OSHA inspector based in Omaha, NE
• Marie Lord , assistant area director of the OSHA office in Marlton, NJ
• Peter Vo , safety engineer in OSHA’s Houston South area office

Here are the cases they presented.

• Shelving collapse in a cold storage warehouse
• Lockout/tagout-related amputation
• Crane collapse  

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Case studies showing how NZ businesses are finding innovative ways to involve workers in workplace health and safety, manage work-related health risks and keep healthy and safe at work.

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2020 Safeguard Awards finalists

WorkSafe is one of the major sponsors of the Safeguard New Zealand Health and Safety Awards. Hear from two of the finalists in our category for best initiative to address work-related health risk.

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Case Studies: Office Safety Success Stories

Ensuring a safe and secure workplace is of paramount importance for any organization. Office safety not only protects employees from accidents and injuries but also fosters a culture of well-being and productivity. In this article, we will explore two case studies that highlight successful office safety initiatives and how they have enhanced safety measures and cultivated a culture of workplace safety.

Case Study: Enhancing Office Safety Measures

In this case study, XYZ Corporation, a leading multinational company, took proactive measures to enhance office safety. They identified potential hazards through rigorous inspections and risk assessments. By conducting regular audits, they were able to identify areas that required improvement and promptly took necessary actions to address them. For instance, they installed safety signage, implemented ergonomic workstations, and organized training sessions on proper lifting techniques. Additionally, XYZ Corporation introduced a safety reporting system that encouraged employees to report any safety concerns or near misses, leading to prompt corrective actions.

Another key aspect of XYZ Corporation’s success in enhancing office safety measures was the implementation of a robust emergency response plan. They conducted thorough drills to ensure that all employees were familiar with evacuation procedures, assembly points, and emergency contacts. By involving employees in the planning process and assigning specific roles and responsibilities during emergencies, XYZ Corporation created a sense of ownership and preparedness amongst its workforce. This not only improved response times but also boosted employee confidence in handling critical situations.

Case Study: Achieving a Culture of Workplace Safety

In this case study, ABC Enterprises, a mid-sized company, focused on cultivating a culture of workplace safety by prioritizing employee engagement and empowerment. ABC Enterprises recognized that office safety is not just a set of rules and regulations, but a shared responsibility of every individual in the organization. To achieve this, they implemented a safety committee comprising representatives from different departments to regularly assess and review safety protocols.

Moreover, ABC Enterprises encouraged open communication channels, allowing employees to provide feedback, suggestions, and report potential hazards without fear of reprisals. They also organized regular safety training programs to educate employees about the importance of following safety protocols. By involving employees in decision-making processes and recognizing their contributions to office safety, ABC Enterprises successfully fostered a culture where employees felt safe, valued, and actively participated in maintaining a safe workplace.

The case studies of XYZ Corporation and ABC Enterprises demonstrate that enhancing office safety measures and achieving a culture of workplace safety require proactive and systematic approaches. By identifying potential hazards, implementing preventive measures, and engaging employees in safety initiatives, organizations can significantly reduce workplace accidents, injuries, and near misses. Moreover, a culture of workplace safety not only protects employees but also enhances productivity, morale, and overall well-being. Prioritizing office safety should be an integral part of every organization’s strategy to create a secure and thriving work environment.

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Case studies.

The Center’s research identifies and explores best practices, which in turn are the foundation for policies, programs, and practices that are implemented by organizations seeking to improve worker health, safety, and well-being. Our case studies provide concise summaries of organizational change implemented using a Total Worker Health ® integrated approach, and are based on the Center’s previous and current research projects.

The Workplace Organizational Health Study The Workplace Organizational Health Study sought to improve the health, safety, and well-being of front-line food service workers by identifying working conditions that could be modified to reduce pain and injuries and improve worker well-being. This case study, developed by the Center, summarizes the implementation of the 2+2 Feedback and Coaching tool, previously used with managers and modified for use with employees. Download the case study

Dartmouth-Hitchcock Medical Center To address rising employee health care expenses, Dartmouth-Hitchcock Medical Center (DHMC) launched an initiative to achieve its vision of the healthiest possible workforce, the foundation of which is an organizational culture that advances employee health, safety, and well-being. This case study, developed by the Center in collaboration with HealthPartners, summarizes the DHMC successful Total Worker Health approach and the resulting beneficial outcomes. Download the case study

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11.1 A Case Study

Story: andrea macphee-lay.

Andrea MacPhee-Lay was a massage therapist at the Fairmont Chateau Lake Louise hotel near Banff, Alberta. The hotel spa provided a range of massage treatments, including a hot-rock treatment where basalt rocks are heated in water to 49 degrees Celsius and strategically placed on the client’s back. Ideally, the rocks should be heated in a purpose-built, stone kettle. Fairmont had developed a practice of using two stainless steel roasters filled with hot water. [1] At a staff meeting on September 12, 2012, the Spa Director announced plans to replace the roasters with a household-grade electric Black and Decker grill.

MacPhee-Lay expressed concern about the proposed change, citing a variety of safety concerns, including the risk of the rocks exploding on the dry heat grill and the fact that dry stone heating was not an approved use of the household grill. After the meeting, MacPhee-Lay conducted internet research into using grills for heating basalt rocks. She later presented her findings to the Spa Director, the Lead Therapist, and a worker representative on the JHSC. Over the next few weeks, she repeatedly raised her concerns about the safety of this practice and also sought advice from Alberta Occupational Health and Safety officials.

On September 28, MacPhee-Lay was suspended and on October 1 terminated. No reasons for the termination were provided, although the employer asserted that there were performance issues that warranted termination.

MacPhee-Lay filed an OHS complaint over her dismissal, claiming she was disciplined for acting in compliance with the OHS Act, which requires her to report workplace hazards that pose an imminent danger. The investigating officer dismissed her complaint, finding insufficient evidence to link the dismissal to the dispute over the grill. MacPhee-Lay appealed the officer’s decision to the Alberta Occupational Health and Safety Council, who upheld the decision.

The decision to uphold the officer’s ruling was based mostly on technical grounds. Alberta’s OHS Act requires a worker to report and refuse unsafe work if the work poses an imminent danger. The Act also protects workers who exercise this right from retaliation. The panel reasoned that the grill, which was not yet in use, did not pose an imminent danger at the time of the refusal. For this reason, MacPhee-Lay’s actions were not strictly “in compliance” with the Act and she could not claim protection under the Act. Interestingly, Fairmont eventually decided not to use the grill for hot-rock treatment.

While the facts are complex, this case illustrates how health and safety issues develop differently in practice than they do in textbook examples. In theory, MacPhee-Lay acted appropriately. She expressed concerns about a hazard and conducted research to support them. Yet her employer seems to have fired her for trying to ensure her workplace was safe. In considering this case, we need to recognize that the circumstances of her complaint cannot be disentangled from the dynamics of her employment relationship, which had begun to deteriorate prior to the complaint. We should also be cognizant that she was challenging her employer’s ability to implement a new work process, behaviour that employers often suppress by disciplining one worker as an example to the rest.

The case also points out weaknesses in OHS laws and government enforcement activity. MacPhee-Lay’s case was not decided on the merits of her safety concern. Neither the OHS officer nor the panel disputed her claims about the grill’s safety hazards. Instead, her complaint was dismissed based upon a narrow reading of the Act that produced a procedural loophole the appeal panel used to excuse the employer’s conduct. Research suggests that arbitration and labour boards often defer to employers in matters of disciplining workers who refuse unsafe work. [2]

This chapter examines OHS in practice to reveal the ways in which working toward safety in real workplaces is more complex than we might anticipate. It extends our analysis of how power shapes workplace health and safety. It looks at how the internal responsibility system does not work exactly as intended. And it also considers the nature of government OHS enforcement in the 21st century and how it can impede workplace safety. The chapter concludes by offering some practical tips for workers, OHS activists, and safety practitioners about how to improve safety in Canadian workplaces.

• Alberta Occupational Health and Safety Council. (2014). Order: Andrea L. MacPhee-Lay and FHR Lake Louise Operations Corporation. Edmonton: Government of Alberta. ↵
• Harcourt, M., & Harcourt, S. (2000). When can an employee refuse unsafe work and expect to be protected from discipline? Evidence from Canada. ILR Review, 53(4), 684–703. ↵

Canadian Health and Safety Workplace Fundamentals Copyright © 2022 by Connie Palmer is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Safety at Workplace: A Case Study

To classify these incidents, there are primarily three types of hazards, workplace fatal, non-fatal and physical injuries, and occupational diseases.

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• 12 Jun 2016

Alarming rise in cases of workplace casualties

India ranks second when it comes to workplace accidents and illnesses. In fact, the International Labour Organization (ILO) reports that globally, every 15 seconds, 153 workers meet with an accident at the workplace.. It would be good idea to opt for a health insurance   policy to cope with any accidents at the workplace.

Apart from that, on an average everyday around 6300 people, worldwide, die from occupational accidents or work-related diseases.

From these staggering statistics, one can identify that human loss has been immense due to unsafe work environments.

To classify these incidents, there are primarily three types of hazards, workplace fatal, non-fatal and physical injuries, and occupational diseases. Out of which workplace accidents take the top spot.

The Tragic Incident of Dombivali Factory Blast

In May 2016, the chemical factory owned by Probace enterprises exploded at Dombivali East in Mumbai MIDC area. The incident caused the death of 12 people and injured around 201. The impact of the explosion affected the people at the nearby residents and shops.

The mysterious blast resulted in the shattering of glasses and rooftops in a two-kilometre radius from the factory. Resulting in many reported cases of trauma victims, the incident noted prominent injuries due to the cuts from the shattered glass pieces.

With the cause for the accident still being investigated, the loss of people remains uncompensated. The injuries and deaths left people with deep scars both physically and financially.

Framework for Safety in Indian Workplace

In the past 50 years, India has witnessed an immense growth in the manufacturing, industrial and technological fields. With the upscale in business, the number of dangerous incidents in workplace is bound to increase unless stricter, more refined laws and implementations are followed.

Although the Indian Constitution contains a system for occupational health and safety, it only applies to certain restricted industries. It still keeps a huge part of the workforce outside the scope. According to international studies, many workers employed in smaller factories and industries in India are not provided with any legal and healthcare protection in the instance of an accident on the job. So, in this case a personal accident insurance   would be a good friend, which keeps you covered against any unforeseen circumstances.

Ways to Prevent and Protect Against Workplace Hazards

The rising workplace accidents can be mitigated by consciously taking measures. Some of the safety pre-requisites are as follows:

• Employee responsibility of being alert and aware of volatile surroundings
• Proper safety equipment for operating tools and heavy instruments
• Reduction in stress and distraction in workplace through appropriate and timely breaks
• Proper and regular maintenance checks on heavy machinery
• Organizing safety classes in workplace
• Precautionary measures through healthcare aid and insurance policies for workers
• Ease of accessibility to emergency exits and paths in case immediate evacuation is required
• Coverage for risks in special environments involving chemical and other combustible processes
• Accountability through reports sent to higher authorities even of the smallest inconsistency concerning safety

While accidents by definition cannot be avoided, proper precaution can save lives and savings of the people. Safeguarding the interests of the employees, employers can protect their workforce with the appropriate personal accident insurance and diseases at the work place.

ICICI Lombard also provides health insurance plans like Complete Health Insurance  , Health Booster  , Arogya Sanjeevani Policy , Corona Kavach Policy   which offers people with the much needed financial backup during any medical emergencies.

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Failure of Francis Scott Key Bridge provides future engineers a chance to learn how to better protect the public

Professor of Civil and Environmental Engineering, University of Delaware

Disclosure statement

Michael J. Chajes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

University of Delaware provides funding as a member of The Conversation US.

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The cargo ship collision that destroyed the Francis Scott Key Bridge in Baltimore on March 26, 2024, is raising questions about just how much engineers can do to prevent such catastrophes from occurring in the future. Here, Michael J. Chajes , a professor of civil and environmental engineering at the University of Delaware, discusses how bridge design codes have changed over the years and the challenges of building new structures, and retrofitting existing ones, so they can survive extreme events

How hard is it to design a bridge to withstand the force that took down the Francis Scott Key Bridge?

Once engineers understand the forces that a structure will be subjected to, they can design a structure to withstand them. That said, we know that each force has a range of magnitudes that can occur. For example, not all trucks on the roadways weigh the same amount, not all earthquakes are of the same magnitude, and not all ships have the same weight. We incorporate this variability in forces into the design.

Even if built to a given set of plans, the final strength of the structure can vary. The materials used have variations in strength. For example, concrete delivered on two successive days will have a sightly different final strength. This variability in the strength of the final structure is also taken into account in the design process to ensure the bridge or building is safe. There’s no way we could build two bridges from the same set of plans and they end up with the exact same strength.

Based on the weight and speed of the ship that hit the Francis Scott Key Bridge, today’s U.S. bridge design code would call for the bridge to be designed to resist a lateral force of 11,500 tons. This means the bridge has the ability to withstand a lateral hit of that magnitude. That is equivalent to the weight of about 50 loaded Boeing 777s or the weight of the Eiffel Tower. While this is a very large lateral force, structures can be designed to resist such forces. Tall buildings are routinely designed to resist lateral loads of this magnitude that result from wind or earthquakes. However, it is a matter of how much one wants to spend on the structure, and many design goals and constraints need to be balanced against each other.

What do engineers do to ensure safety in extreme events?

Our knowledge of how extreme events affect structures is constantly evolving. One area where this is very apparent is earthquake engineering . After each earthquake, structural engineers learn what has worked and what has not worked, and then the building and bridge design codes evolve. Infrastructure owners also try to retrofit existing structures that were designed to earlier codes.

Ship collisions and their impact on bridges are a similar area of evolving understanding and improved design codes. There have been over 35 major bridge collapses globally that were caused by ship collisions from 1960 to 2015 . Engineers evaluate the failures, and they update the engineering codes so that they better account for the effects of ship collisions.

How has bridge design evolved since the Baltimore bridge was built?

The Francis Scott Key Bridge was designed in the early 1970s. Construction started in 1972, and it opened to traffic in 1977. This preceded the 1980 collapse of the Sunshine Skyway in Florida, which was caused by a ship collision, similar to what happened in Baltimore. That bridge collapse led to the initiation of research projects that culminated in the development of a U.S. guide specification in 1991 that was updated in 2009.

Based on that guide specification, bridge design codes were changed to include forces due to ship collisions. The design of the Francis Scott Key Bridge would not have been required to consider the effect of ship collisions. The current U.S. bridge design code says that:

“where vessel collision is anticipated, structures should be:

• Designed to resist vessel collision forces and/or

• Adequately protected by fenders, dolphins, berms, islands, or other sacrifice-able devices.”

Other changes since the 1970s are that cargo ships have increased in size and weight . The ship that brought down the Sunshine Skyway in 1980 weighed 35,000 tons, while the ship that collided with the Francis Scott Key Bridge weighed 95,000 tons.

With the increasing weight of cargo ships, the most cost-effective design strategy to prevent collapse of bridges due to vessel collision may well be to protect the bridge piers from the impact. This is done by building a bridge collision protective system, which is often a concrete or rock structure that surrounds the pier and stops the ship from getting to the pier, as is done to protect many of our national monuments.

A pier protection system was installed when the Sunshine Skyway bridge was rebuilt, and it has been used on numerous other bridges . The same approach is currently being applied by the Delaware River and Bay Authority at a cost of US$93 million to protect the piers of the Delaware Memorial Bridge .

But what about existing bridges like the Francis Scott Key Bridge? Bridge owners have a tremendous challenge finding the financial resources needed to retrofit their bridges to satisfy the latest design codes and to account for the increased impact loads expected due to the heavier and heavier ships. Both things happened here. That is, design codes changed and improved, and loads got much larger. Engineers and infrastructure owners try their best to prioritize where their limited funds can be used to increase structural safety and minimize the chance of structural failure.

What can universities do?

The No. 1 job of structural engineers is to protect the public and minimize the risk of structural failures that pose a threat to human life. To do that, engineers must be able to calculate the forces that our structures may be subjected to. This includes cases where a large ship accidentally collides with a bridge, or a large earthquake or hurricane strikes.

In these extreme cases, the structure will almost assuredly sustain damage, but, if at all possible, it should be resilient enough to not collapse. The design codes are continually updated to account for new knowledge, new materials and new design techniques. The reliability of our structures is improving all the time.

Retrofitting structures built to prior codes is an ongoing process, and one that this disaster moves to the forefront. The U.S. has a lot of infrastructure that was designed to old codes, and we have larger trucks crossing our bridges, and larger ships passing beneath them.

Engineers can never reduce the probability of failure to zero, but they can reduce it to the point where failures happen very infrequently and only in cases where numerous unforeseen circumstances combine to make a structure vulnerable to collapse.

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How to Build a Psychologically Safe Workplace

• 28 Mar 2024

You’ve hired an excellent team, set lofty but realistic goals , and implemented efficient processes —so why aren’t your employees reaching their full potential?

It could be that they’re afraid to make mistakes or contribute new ideas.

“Overcoming challenges requires a strong sense of psychological safety and disciplined learning practices,” says Harvard Business School Professor Amy Edmondson in the online course Dynamic Teaming, one of seven courses in the Credential of Leadership, Impact, and Management in Business (CLIMB) . “This is where you come in. As a leader, it’s your job to unlock the potential of your team and create the best possible chance for breakthrough performance.”

Here’s a primer on psychological safety, why it’s important in the workplace, and how to build it in your organization.

Access your free e-book today.

What Is Psychological Safety?

Psychological safety is a phenomenon that allows and sparks interpersonal risk-taking within teams. It encourages group members to offer opinions, suggest ideas, ask questions, raise concerns, speak up, and admit mistakes without fearing negative consequences.

According to Dynamic Teaming, psychological safety has four dimensions:

• Willingness to help: Employees believe asking for help is appropriate and their colleagues are willing to provide it.
• Inclusion and diversity: Employees feel included and that their diverse experiences and expertise matter.
• Attitude to risk and failure: Employees view mistakes and failures as acceptable in favor of learning.
• Open conversation: Employees perceive conversations as open, candid, and safe to contribute to.

For a workplace to be psychologically safe, it must meet all four dimensions.

Why Is Psychological Safety Important at Work?

By definition, psychological safety makes employees feel safe speaking up, taking risks, and making mistakes at work—all of which can increase their satisfaction, innovation, and performance.

Yet, psychological safety’s importance extends further. In Dynamic Teaming, Edmondson explains that it’s critical to managing dynamic teams.

Dynamic teams have fluid membership and may gather in the moment across industries, functions, time zones, and languages without proper preparation to navigate ever-shifting circumstances and tasks.

As the world becomes more volatile, uncertain, complex, and ambiguous (VUCA), dynamic teaming is crucial to responding to new challenges.

“To move from traditional management to managing in a VUCA world requires adopting a new mindset,” Edmondson says in the course. “Today’s world requires cross-functional and dynamic teaming. It’s your job—the leader’s job—to move your team and organization toward that mindset.”

One key attribute of dynamic teams is their ability to experiment, leverage diverse backgrounds and expertise, and work creatively to find innovative solutions .

In the course, Edmondson explains that while diversity and an inclusive leadership style are key to dynamic teams’ success, psychological safety is the underlying factor. Without it, diverse teams can underperform compared to their homogenous counterparts.

To help unlock your team’s potential, here are five ways to create a culture of psychological safety.

5 Ways to Create Psychological Safety in the Workplace

1. talk about it.

While it may seem simple, the first step to creating psychological safety is talking about it. The term has become a buzzword and can trigger defensive reactions that imply talking about improving it labels your current culture as “unsafe.”

By openly prioritizing psychological safety as a leader, you can define and dispel misconceptions about it.

For instance, in the Harvard Business Review , Edmondson cautions against the myth that in a psychologically safe workplace, everyone is always “nice” and “comfortable.”

“Too many people think that it’s about feeling comfortable all the time,” Edmondson says, “and that you can’t say anything that makes someone else uncomfortable or you’re violating psychological safety. Anything hard to achieve requires being uncomfortable along the way.”

Being transparent about goals and your new workplace culture’s impact requires buy-in from your team and can set the stage for a successful transition.

2. Use the Psychological Safety Scale

Before making changes, assess your organization’s psychological safety performance.

One tool you can use is the psychological safety scale. Created by Edmondson, it’s a series of statements that employees indicate to what extent they agree.

For instance, for the statement, “I am comfortable asking other members of my team for help,” the employee checks off their answer on a scale of “strongly disagree” to “strongly agree.”

Once all employees have filled out the scale, average the score for each question to identify which areas the team is strongest in and which need improvement.

The scale is useful not only for assessing what to work on but also for gaining visibility into the improvement process and measuring progress toward goals quantitatively.

3. Request Input

A critical part of fostering psychological safety is requesting employee input. Until it becomes an ingrained part of your team’s culture, they may hesitate to provide feedback unless explicitly asked.

When soliciting their opinions, explain why doing so matters. Make it clear that a team in which they share their thoughts—on everything from strategic decisions to brainstorming new ideas—provides a diversity of perspectives, opportunities for discussion, and chances to innovate and break from the status quo.

Once your team provides thoughts, respond productively. Even if you don’t agree or like someone’s idea, ensure they know you appreciate that they shared it. Refrain from shutting down ideas right away; instead, use them as starting points for group discussion and new ideas.

4. Admit Your Mistakes

If you want your employees to feel safe making mistakes, you must be transparent about yours and frame missteps as learning opportunities.

According to a Deloitte study , leaders in high-performing organizations are 28 times more likely to model learning from mistakes than their low-performing counterparts.

Doing so can encourage your employees to be forthcoming with their missteps, secure in knowing they won’t receive punishment but rather a debrief about what went wrong and what to do differently next time.

5. Continually Reassess

Finally, remember that psychological safety requires consistent work.

Dynamic Teaming likens an organization’s psychological safety to muscular strength in the body—just as you must work to maintain strength over time, you need to put in effort to keep your organization psychologically safe.

If you use the psychological safety scale, revisit it periodically to track whether your efforts are yielding the culture you want. You can also regularly solicit feedback from employees in a one-on-one setting about how they feel about the team culture and adjust accordingly.

Unleash Your Team’s Potential

Creating a psychologically safe workplace takes time, effort, and vulnerability—making some leaders shy away from it.

If you’re courageous enough, you can unleash your team’s full potential by cultivating a culture that values open communication, sharing ideas, supportive discussions, and growing from mistakes.

Are you interested in building psychological safety at your organization? Explore our yearlong Credential of Leadership, Impact, and Management in Business (CLIMB) program, which comprises seven courses for leading in the modern business world. Download our CLIMB brochure to learn more about the curriculum, admissions requirements, and benefits.

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Ensuring Patient and Workforce Safety Culture in Healthcare

Introduction.

In 2020, the Institute for Healthcare Improvement (IHI) and the Agency for Healthcare Research and Quality (AHRQ) unveiled the National Action Plan to Advance Patient Safety. 1 Within this framework, four pillars were identified as critical to fostering a safer health care environment: Culture, Leadership and Governance; Patient and Family Engagement; Learning Systems; and Workforce Safety. This 2023 Year in Review Perspective highlights some of the research posted on PSNet in 2023 related to two of these elements: patient safety culture and workforce safety culture.

At a high level, organizational culture is the aggregated attitudes, norms, and perceptions of a team of workers. Although organizational policies certainly influence aspects of culture, the daily interactions that staff members have with each other and with managers are the lifeblood of an organization's culture. In healthcare organizations, patient and workforce safety culture are founded on how well teams work together, how supportive leadership and managers are of patient and workforce safety, how staff report events and near misses, and how teams and leaders respond to events. 2

A positive patient and workforce safety culture has been shown to significantly improve a number of patient outcomes, including lower rates of surgical site infections , falls, and medication errors . In addition to specific health outcomes, patients report having better experiences with their care when the culture of patient safety is strong.

Although most organizations and healthcare workers (HCWs) agree on the importance of safety culture, research this year focused heavily on the psychological factors surrounding culture, such as psychological safety, how to support HCWs after an adverse event, and burnout. There was also a smaller focus on safety culture in nonacute care settings. Methodologically, the year's research predominantly centers on surveys capturing health care workers' perceptions of culture, with less emphasis on interventions to improve safety culture. Researchers reviewed all relevant articles on PSNet in 2023 and consulted with Dr. John Murray, PhD, RN and Dr. Joann Sorra, PhD, subject matter experts in safety culture.

Psychological Safety and Employee Voice

The most prominent focus within the area of safety culture in 2023, based on the number of articles published on PSNet, was on the concepts of psychological safety and employee voice. These concepts are both related to how respected and comfortable employees feel speaking up and expressing their ideas, opinions, and concerns without fear of retribution. In a patient safety–specific context, this might entail a HCW raising a concern about a patient’s safety (such as an HCW missing a contraindication when prescribing a medication or not washing their hands prior to a procedure) to their peers or leaders. The concern may be raised preemptively before an incident occurs, or after, and it may involve either the actions of the individual who is raising the issue or the actions of their teammates. If an organization or a team has a culture of blame and retribution, then HCWs may stay silent about concerns or safety events. Psychologically safe cultures focus more on learning and how system failures lead to safety events rather than on individual actions. However, a culture focused on system failures does not preclude individual accountability where appropriate. The concept of just culture seeks to balance this systems-based approach to safety events with appropriate individual accountability if the events are negligent or repeated regularly.

Various tools have been developed to measure psychological safety and employee voice, primarily through Likert scale–based surveys to rate items such as “If you make a mistake on this team, it is often held against you,” “It is difficult to ask other members of this team for help,” and “Working with members of this team, my unique skills and talents are valued and utilized.” 3 However, objectively assessing these psychological concepts remains challenging. This reliance on self-reported data was listed as an evidence gap by a systematic review this year.

After reviewing the research on psychological safety and employee voice from the past year, we categorized the influencing factors into individual, team, and leadership factors. Although these factors are not mutually exclusive, this is a useful model for understanding what motivates an HCW to feel safe enough to speak up.

Individual Factors

At the most basic level, an individual’s personality traits could make it more likely for them to speak up, regardless of the environment. For example, someone who is extroverted may be more likely to speak up than someone who is introverted. Research linking specific personality traits to psychological safety and employee voice is currently limited but starting to be explored. A systematic review this past year found that prosocial motivations, dominant traits, level of competence, and level of self-efficacy affected speaking-up behavior. Another qualitative study found significant but weak correlations between participants’ emotional stability and level of abstract thinking and their feelings of psychological safety.

Despite the lack of evidence linking personality traits to psychological safety and employee voice, some studies in 2023 focused on improving individual psychological safety and speaking-up behavior. One pre-post study found that a four-hour communication training did not increase psychological safety or communication, but it should be noted that there was no control group in that study and the sample size was relatively low (N = 137). However, a meta-analysis found that assertive communication training for nurses improved speaking-up behavior related to safety events. This difference may speak to the variance in quality of each training, but the meta-analysis results suggest that a well-designed training could improve employee voice and psychological safety.

Team Factors

The team that an HCW interacts with every day can impact their psychological safety and willingness to speak up. For example, seeing others on the team speak up and receive a negative reaction, a peer discouraging them from speaking up to the manager, or experiencing retribution after a mistake could all potentially negatively affect HCWs’ psychological safety and suppress employee voice going forward. One large survey study in 2023 found the main factors that affected employee voice were the person’s social capital within the team, such as rank or seniority; their exposure to unprofessional behaviors; and demographic features such as age and gender (with older and male respondents more likely to speak up). The authors concluded that healthcare organizations should combine interventions to improve culture with efforts to reduce hierarchical structures, reduce inequalities, and increase protection for staff who speak up.

Several studies in 2023 found that when psychological safety is high, event reporting rates and teamwork improve. One survey of 526 nurses found that those who report high psychological safety are more likely to share important information about patient safety, actively engage in teamwork behaviors, and report safety events and near misses. 4 Similarly, another study with nurses found a correlation between high psychological safety and willingness to report safety events. A study using vignettes demonstrated that when an HCW has high personal psychological safety, they perceive colleagues who speak up as more helpful to the team. This finding suggests that high psychological safety can not only impact individual behavior but also improve teamwork and cohesiveness through increased positive affect. This observation is echoed by another study on psychological safety that found the more a team agrees on the level of psychological safety, the better their overall performance. 5

Some intervention studies this past year on improving team safety culture, centered on the use of in situ simulation. This type of simulation takes place in the same clinical environment with the same equipment and with the same team members as a real clinical situation. One systematic review found that in situ simulation training increased ICU staff perceptions of safety culture and teamwork climate post training. This is reinforced by a qualitative study on anesthesia personnel , where participants reported that the realism of the in situ training helped clarify team roles and improve clarity in communication.

Leadership and Organizational Factors

Finally, the last set of factors shown to affect psychological safety and employee voice come from leadership and the organization as a whole. The importance of this aspect was delineated in the National Action Plan to Advance Patient Safety, which called for governing boards to understand importance of safety, get involved in safety, and promote a culture of safety. 1 Studies on this topic on PSNet in 2023 covered many levels of leadership, from unit managers to executives.

A few studies this past year showed that when employees rate their leaders highly, employees’ perceptions of safety culture and psychological safety improve, such as a study of infection preventionists during the COVID-19 pandemic. Another large survey study found that rating leadership highly on items like “provides useful feedback about my performance” and “is available at predictable times” correlates with a higher perception of safety climate and teamwork climate.

Other studies focused on what attributes and techniques leaders can have or use to improve their role in psychological safety and safety culture. A systematic review of employee’s perceived ability to speak up found that leadership attributes (such as higher levels of inclusion, mediation, humility, and lower levels of narcissism), higher supervisor job security, and less top-down decision making were associated with more speaking up behaviors among employees. Another integrative review on Just Culture showed that leaders can demonstrate full commitment to Just Culture by being “visible, accessible, approachable and committed to providing the support and resources needed.” One smaller survey study concluded that leaders should understand employees’ unique skills and needs, express confidence in their abilities, and encourage them to share their ideas (safety related or otherwise) to create an inclusive and trusting work environment that facilitates psychological safety and ultimately reduces safety events. A qualitative study echoed that leaders should get to know the personalities of their employees.

Leaders can encourage psychological safety and employee voice in their responses to staff who bring up safety concerns. One qualitative study reported that nurses who tried to speak up about concerns during the COVID-19 pandemic often felt unheard, were treated with hostility, or experienced a lack of meaningful change. One reason for this may be that leaders and workers have different perceptions of how strong the safety culture is, as illustrated in one study of radiologist managers and staff. In an effort to address this, a qualitative study using simulation videos reported on various barriers to and enablers of receiving a safety message. These studies suggest it is important to train leaders on how to best receive a safety concern in addition to training staff members to speak up more often.

Few intervention studies posted on PSNet in 2023 related to leadership and psychological safety. One study demonstrated that when leaders capture and highlight proactive safety behaviors of staff daily, it can improve behaviors related to patient safety. This finding implies that a leader’s role in building a culture of safety is not only responding to events but also regularly highlighting their employees’ successes.

Supporting HCWs Who Are Involved in Adverse Events

In addition to fostering an environment of psychological safety, a strong safety culture creates an environment where HCWs feel support from their colleagues and leaders following an adverse safety event that may have caused preventable harm. Strong support of HCWs may decrease negative psychological symptoms, increase the safety awareness of that staff member and others they share the event with, and decrease staff turnover. Research posted on PSNet in 2023 examined how adverse events affect HCWs psychologically and how they hoped to be supported.

On the most recent AHRQ Hospital Survey on Patient Safety Culture (SOPS) report , 64% of respondents said a lack of support exists for staff involved in patient safety events. This finding is significant because of the serious effects an adverse event can have on HCWs. One scoping review on nurses who were involved in adverse events indicated that nurses most commonly reported feeling a loss of confidence, anxiety, shame, guilt, exhaustion, depression, and fear of lost trust from colleagues and managers after adverse events. Some coped with these symptoms by becoming hypervigilant, sharing their experience with others, and taking leave. All studies included in the review identified a lack of emotional support after a safety event. Many nurses yearned for empathy from their peers, opportunities to debrief about the incident, and follow-up check-ins on their mental health. These findings were echoed in studies with other professions in 2023, such as surgeons , respiratory therapists , and pediatric ICU staff . The latter study quantified that 42% of pediatric ICU staff who had experienced an adverse event felt psychological distress, 22% reported absenteeism, and 23% considered leaving the ICU. The most commonly sought form of support was a respected peer with whom to discuss the details of what happened (86%), followed by taking time off of the unit (73%). In response to these findings, the authors suggested creating and maintaining a supportive, empathetic, and nonpunitive workplace culture, establishing a peer support program with debriefs and regular check-ins, and using near misses and adverse events to improve safety awareness and skills among all staff.

Stress and Burnout Among HCWs

The final psychological factor of safety culture explored in research posted on PSNet in 2023 was HCW stress and burnout. The healthcare profession is inherently demanding, and HCWs may be prone to burnout due to issues including a heavy workload, responsibility for the wellbeing of others, irregular hours, experiences of workplace violence, and high administrative burden. This feeling of burnout can be worsened if organizations don’t provide adequate staffing, resources, and a positive workplace culture. A large hospital survey study in 2023 found that employees’ ratings of safety culture are negatively correlated with stress and burnout. A systematic review of research among nurses also found a negative relationship between safety culture and job-related stress. Although it is important to note that the theoretical relationship between these two concepts is unclear and may not be unidirectional, a poor workplace safety culture can worsen stress, and stress and burnout can also worsen safety culture.

Burnout was shown to affect a significant proportion of clinicians in 2023. Two recent large survey studies, one on the AHRQ Workplace Safety Supplemental Item Set for Hospitals and one in military hospitals , reported the rate of HCW burnout at 34% and 35%, respectively. This high HCW burnout rate has a compounding effect: It negatively affects individual HCWs and it also potentially leads to more adverse events. The majority of studies in one systematic review on physicians found a link between burnout and clinically significant safety events. In addition to burnout increasing the risk of adverse events, the number of adverse events in a unit can cause burnout , leading to a downward cycle in HCWs’ mental health and patient safety.

Several studies this year discussed factors that were associated with decreased stress and burnout. Strong teamwork, adequate staffing, and high-quality leadership were the most common themes. One study on military hospitals found that higher ratings of within- and across-unit teamwork significantly reduced the odds of burnout across all clinical areas studied. Another study in large academic medical centers found the same correlation. In addition, that study found a significant correlation between staffing levels and reported burnout. High ratings of leadership were also shown to be negatively correlated to burnout, such as in a study among infection preventionists. A systematic review found that high scores of nurse leaders on leadership metrics (such as coaching, informing, and interacting) was correlated with higher job satisfaction and improved performance among employees. 6 Finally, another study found the strongest correlation between leadership and reduced burnout came from leaders providing regular useful feedback on performance. The authors posit that this regular feedback may be increasing psychological safety in employees, which, as previously noted, correlates with improved safety culture.

Safety Culture in Nonacute Settings

Historically, the majority of safety culture research has focused on hospital safety culture. However, some research in non-acute settings (­specifically, nursing homes) was posted on PSNet in 2023. Very little research in 2023 focused on safety culture in other non-acute settings, such as primary care or medical offices.

Research into patient safety in nursing homes and long-term care settings has increased in the last decade. Research in 2023 built on this by focusing on safety culture in nursing homes. The most recent AHRQ SOPS Nursing Home Survey found that 54% of nursing home employees rated resident safety as very good or excellent, compared to 67% of employees in hospitals . While respondents rated nursing home culture highly on some measures, such as communication about incidents, only 39% of respondents agreed there were enough staff to handle the workload, meet residents’ needs during shift changes, and keep residents safe. In addition, only 54% of respondents agreed that nonpunitive responses to mistakes were used. Interestingly, a different survey study focusing exclusively on licensed practical nurses (LPNs) compared their results with the AHRQ SOPS Nursing Home Survey (LPNs comprised only 18% of SOPS Nursing Home Survey respondents) and found that LPNs rated all measures of safety culture lower than the average reported in the SOPS Database. Similar to the overall SOPS Nursing Home Survey results, the lowest rated dimensions were adequate staffing (29%) and non-punitive responses to mistakes (31%). This survey also found that LPNs working in nursing homes were less satisfied with their jobs than LPNs working in other settings, and that their job satisfaction was significantly but weakly correlated with their ratings of safety culture. This low job satisfaction may lead to burnout, turnover, and increased staffing issues. According to AHRQ’s pilot study on the Workplace Safety Supplemental Item Set for Nursing Homes, 33% of nursing home staff experienced burnout, similar to the rate in hospitals. 7 Two other studies on nursing home culture in 2023 were qualitative in nature. One study asked employees how they would improve safety culture. The most prominent themes included better staff orientation, with a focus on safety; better ongoing training; improvement of infrastructure (such as reducing stairs and increasing grip handles); and procuring more security staff. Another study among nursing home leaders asked what differentiates high-performing nursing homes from lower-performing ones. The main themes that emerged were communication about resident safety, particularly the important role of physician and manager accessibility, and leadership support for and responsiveness to resident safety issues raised by frontline staff. Although the amount of research on nursing home culture was low in 2023, the increased focus on this setting in recent years provides a solid foundation for future work to illuminate the challenges to and facilitators of building a culture of safety in this setting.

Conclusion and Future Directions

Research in 2023 on PSNet has predominantly focused on understanding the psychological aspects of safety culture. Studies delved into the factors influencing HCWs’ perceptions of patient and workplace safety, including their willingness to speak up, as well as the support they received after being involved in adverse events, and the pervasive influence of burnout on safety culture. A key recommendation emerging from this research is for more proactive training aimed at empowering all staff members, irrespective of their seniority or role, to freely express their concerns and report safety events. 8 , 9 The research also emphasizes the need for leaders and organizations to respond supportively and actively, fostering a culture of psychological safety. In addition, the research underscores the importance of providing support structures, including peer and organizational support, for HCWs involved in adverse events to help rebuild their confidence. To address burnout, the research suggests strategies such as regular feedback from leaders, teamwork initiatives, and thoughtful consideration of working hours and staffing levels.

The field would benefit from more research in several areas in upcoming years. Future research areas include more studies on nonacute settings, and additional research exploring the links between safety culture, patient outcomes, and patient experience. Finally, more research on design, implementation, and evaluation of interventions to enhance safety culture would be beneficial as organizations strive to embed this foundational aspect of providing safe care.

1. Institute for Healthcare Improvement. National Steering Committee for Patient Safety. Declaration to advance patient safety. Boston: Institute for Healthcare Improvement; 2022. https://www.ihi.org/initiatives/national-steering-committee-patient-safety/declaration-advance-patient-safety

2. Agency for Healthcare Research and Quality. About SOPS. Accessed February 5, 2024. https://www.ahrq.gov/sops/about/index.html

3. Edmondson A. Psychological safety and learning behavior in work teams. Admin Sci Quart . 1999;44(2):350-383.

4. Lee SE, Dahinten VS, Lee JH. Testing the association between the enabling and enacting factors of patient safety culture and patient safety: structural equation modelling. BMC Nurs . 2023;22(1):32.

5. Fyhn B, Bang H, Sverdrup TE, et al. Safe Among the Unsafe: Psychological Safety Climate Strength Matters for Team Performance . Small Group Research, 2023; 54(4), 439-473. https://doi.org/10.1177/10464964221121273

6. Alsadaan N, Salameh B, Reshia FAAE, et al. Impact of nurse leaders behaviors on nursing staff performance: a systematic review of literature. Inquiry . 2023;60:469580231178528. doi:10.1177/00469580231178528

7. Agency for Healthcare Research and Quality. Workplace Safety Supplemental Item Set for Nursing Home SOPS. Rockville, MD: Agency for Healthcare Research and Quality; 2023. Accessed February 5, 2024. https://www.ahrq.gov/sops/surveys/nursing-home/supplemental-items/workplace-safety.html

8. Chen H-W, Wu J-C, Kang Y-N, et al. Assertive communication training for nurses to speak up in cases of medical errors: a systematic review and meta-analysis. Nurse Educ Today . 2023;126:105831. doi:10.1016/j.nedt.2023.105831.

9. Pavithra A, Mannion R, Sunderland N, et al. Speaking up as an extension of socio-cultural dynamics inhospital settings: a study of staff experiences of speaking upacross seven hospitals. J Health Organ Manag . 2022;36(9):245-271.

This project was funded under contract number 75Q80119C00004 from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The authors are solely responsible for this report’s contents, findings, and conclusions, which do not necessarily represent the views of AHRQ. Readers should not interpret any statement in this report as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the authors has any affiliation or financial involvement that conflicts with the material presented in this report. View AHRQ Disclaimers

Perspective

Perspectives on Safety

Annual Perspective

Surveys on Patient Safety Culture (SOPS) Ambulatory Surgery Center Survey: User Database Report. January 14, 2024

Surveys on Patient Safety Culture (SOPS) Medical Office Survey: 2024 User Database Report. February 28, 2024

Patient safety and adverse maternal health outcomes: the missing social inequalities 'lens.' October 5, 2005

Agent of change. August 1, 2018

WebM&M Cases

Amid lack of accountability for bias in maternity care, a California family seeks justice. August 16, 2023

Simulation and the diagnostic process: a pilot study of trauma and rapid response teams. December 20, 2017

Management of drug shortages in the perioperative setting. February 6, 2013

On Patient Safety. January 13, 2024

Nursing Home Survey on Patient Safety Culture. August 31, 2022

Patient Safety Primers

Discharge Planning and Transitions of Care

Hospital Survey on Patient Safety Culture: 2010 User Comparative Database Report. May 19, 2010

Hospital Survey on Patient Safety Culture: 2011 User Comparative Database Report. April 6, 2011

Medical Office Survey on Patient Safety Culture: 2016 User Comparative Database Report. June 8, 2016

Nursing Home Survey on Patient Safety Culture: 2011 User Comparative Database Report. September 14, 2011

Hospital Survey on Patient Safety Culture: 2009 Comparative Database Report. June 10, 2009

Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report. April 16, 2008

Medicines-related harm in the elderly post-hospital discharge. March 27, 2019

AHRQ Nursing Home Survey on Patient Safety Culture: 2016 User Comparative Database Report. November 23, 2016

Hospital Survey on Patient Safety Culture: 2016 User Comparative Database Report. May 11, 2016

AHRQ Nursing Home Survey on Patient Safety Culture: 2014 User Comparative Database Report. November 19, 2014

Hospital Survey on Patient Safety Culture: 2014 User Comparative Database Report. April 23, 2014

2012 User Comparative Database Report: Medical Office Survey on Patient Safety Culture. June 27, 2012

Nurse leader attitudes and beliefs regarding medical errors. March 6, 2024

Right Kind of Wrong: Why Learning to Fail can Teach us to Thrive. October 18, 2023

Adverse Health Events in Minnesota: Annual Reports. September 30, 2023

In search of an international multidimensional action plan for second victim support: a narrative review. September 13, 2023

Patient, carer and family experiences of seeking redress and reconciliation following a life-changing event: systematic review of qualitative evidence. August 2, 2023

Patient Safety Innovations

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Emotional responses and support needs of healthcare professionals after adverse or traumatic experiences in healthcare-evidence from seminars on peer support. June 28, 2023

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

The i-readi quality and safety framework: strong communications channels and effective practices to rapidly update and implement clinical protocols during a time of crisis.

Support for healthcare workers and patients after medical error through mutual healing: another step towards patient safety. January 18, 2023

Posttraumatic growth and second victim distress resulting from medical mishaps among physicians and nurses. January 11, 2023

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U.s. department of energy - energy efficiency and renewable energy, alternative fuels data center.

• Printable Version
• Electricity Basics
• Benefits & Considerations
• State & Local Infrastructure Planning
• Procurement & Installation
• Operation & Maintenance
• Charging at Home
• Charging for Multifamily Housing
• Charging in Public
• Workplace Charging
• Charging Infrastructure Trends
• Laws & Incentives

Workplace Charging for Electric Vehicles

With proper workplace charging implementation, employers can help increase the convenience and affordability of driving electric for their employees. Workplace charging can demonstrate a commitment to adopting advanced vehicle technologies.

Employers and workers can find resources on planning, organizing, and executing successful and educational workplace charging events in the Clean Cities Workplace Charging Toolkit .

Evaluating and Planning for Workplace Charging

Determining if a workplace charging program is right for an organization often begins by gauging employee interest through a survey . The following resources can help employers understand how workplace charging may support their sustainability portfolio:

• Electricity Sources and Emissions – Explore how grid mix impacts the emission reduction benefits of EV-commuting employees.
• Emission Reduction Benefits of Workplace Charging – Learn how workplace charging compares to other sustainable commuting options in reducing greenhouse gas (GHG) emissions from employees' commutes, also known as Scope 3 emissions.
• Charging Station Credit for Green Building Certification – Evaluate how installing workplace charging can support certification by green building certification programs, including Leadership in Energy & Environmental Design (LEED) , Green Globes , ENERGY STAR® for Buildings and Plants , and Sustainability Tracking, Assessment & Rating Systems (STARS) .
• FEMP Workplace Charging Program Guide .

Employers should consult their utility, an electrical contractor , charging equipment provider, and other stakeholders early in the process to identify and discuss potential challenges. For example, offering charging at workplaces located in leased facilities requires negotiations with the building owners .

Installing Workplace Charging

Charging equipment delivers electrical energy from an electricity source, such as the grid or solar panels , to an EV. Level 1, Level 2, and direct-current (DC) fast charging each offer benefits and require different considerations for workplace charging:

• Level 1 stations are less expensive than Level 2 stations, but they charge vehicles at a slower rate and generally may only be used by one vehicle during the standard workday. See Level 1 Electric Vehicle Charging Stations at the Workplace for more information.
• Level 2 stations are the most commonly used at workplaces, and each Level 2 connector is capable of charging more than one vehicle per day. It is often necessary for organizations to establish policies that encourage employees to share the stations and move their charged vehicles after a certain amount of time. Some Level 2 stations enable easier sharing with multiple connectors that allow vehicles to charge in succession without owners having to disconnect or move vehicles.
• DC fast charging may be used as part of a strategy to alleviate charging congestion or to allow employees to charge in a very short amount of time. Often, DC fast charging stations are the most expensive to install. Learn more in a Drive Electric Minnesota case study

Employers seeking to procure charging infrastructure and offer workplace charging must also consider costs associated with equipment, installation, maintenance , and electricity. Costs Associated with Non-Residential Electric Vehicle Supply Equipment and the International Council on Clean Transportation’s review of charging infrastructure costs provide information on the costs associated with purchasing, installing, and owning the equipment. Federal, state, and utility incentives can provide discounts that lower workplace charging costs.

By evaluating goals and needs, employers can select the best workplace solution. Find available charging equipment options using Plug In America's Get Equipped resource or GoElectricDrive’s website and consult DOE's workplace charging Request for Proposal Guidance .

Managing Workplace Charging

Organizations offering workplace charging for EVs can benefit from setting clear guidelines in the areas of administration , registration and liability , sharing , and pricing to help ensure a safe and successful workplace charging experience. For organizations offering charging at Level 1 charging receptacles, or wall outlets, consider important Level 1 safety and management policies .

Administration

The first step toward successful workplace charging administration is to designate a responsible individual or group for ongoing operation and maintenance issues of the charging stations and any related costs. In larger organizations, workplace charging operations are typically handled by a sustainability or facilities manager; however, in smaller organizations where these positions may not exist, it may be unclear who is directly responsible. By ensuring that all appropriate departments and individuals know who is responsible for the administration and enforcement of the program, employers will be able to address challenges swiftly and efficiently.

See the Other Considerations section of the Charging Infrastructure Procurement and Installation page for more information on charging administration. Additional areas to consider when developing workplace charging administration policies include:

• Charging Access – Some employers may decide to limit charging station use to employees while others also allow visitor use during certain hours of the day (see the U.S. Department of Energy's (DOE) sample workplace charging policy for additional considerations). Employers can increase charging station use by charging fleet vehicles at night or by allowing public charging after business hours.
• Enforcement & Security – Management should identify who is responsible for enforcing workplace charging policies. Options may include parking garage attendants, security personnel, or employee self-monitoring. When considering enforcement and security options, employers may also want to consider how to prevent against vandalism and theft of charging stations after regular business hours when the identified enforcement personnel may not be available.

Registration and Liability

Many organizations require that EV-driving employees register their vehicle, and some require them to sign a standard waiver. Examples include:

• Registration – Many employees are required to register their EV with their employer through an internal registration or ticketing. This registration allows the employer to accurately count the number and type of vehicles that are actively using the worksite's charging stations. A registration form may include language that requires vehicle owners to agree not to hold the employer responsible for any damage to the vehicle that occurs while it is parked at the charging station. Depending on the charging station or charging service provider, the employer may also need to set up an account with the charging network and obtain access cards or key fobs for employees.
• Waiver – Some employers also require their EV-driving employees to sign a standard waiver of liability or a user agreement. These documents stipulate, among other things, that the employee accepts responsibility for any risks associated with use of the workplace charging stations. Some employers may require all employees using their parking facilities to sign a parking liability form. In this case, it is easy to add language specific to charging rather than creating a separate form. Employers are strongly encouraged to consult with their legal counsel regarding potential liability related to workplace charging stations.

Station Sharing

Employers should consider developing a policy that specifies what employees should do when there are more EVs that need to charge than there are charging stations available. When creating charging station sharing policies, management should consider how far employees are commuting and the types of EVs they are driving. The vehicles' battery pack size and state of charge (almost empty to nearly full) will influence the time required to recharge. For example, employers could give preference to drivers of all-electric vehicles who need workplace charging to complete their daily commute.

It is important to ensure EV drivers are aware of who is enforcing the policy, as well as the consequences for not following the stated charging policy. There are many strategies for managing charging station sharing, including:

• Assignment – For organizations with more charging stations than EV drivers, assign a single employee to a charging station. For organizations with fewer stations than EV drivers, assign two "charging buddies" to each station. These "charging buddies" coordinate their charging on a daily basis. Alternatively, assign two employees to each charging spot but give one charging access in the morning and the other access in the afternoon.
• Reservation System – Use an internal shared calendar or other reservation tool. This system allows employees to book their charging access in a similar way that employees book conference room reservations.
• Time Limit – Use a well-enforced time-limit policy to ensure that workplace charging stations are shared among employees. A time-limit policy can be enforced in a number of ways. For example, employers can program the charging station software to provide free charging for up to four hours, after which it charges the user a $10 per hour fee. Other employers may have a similar four-hour maximum charging time. While most do not enforce a fee, they encourage drivers to voluntarily move their vehicle. If drivers do not adhere to this policy on three separate occasions, they may have their charging privilege suspended.
• Employee Self-Managed – Provide a good communication platform such as a dedicated intranet forum or email listserv for EV drivers. These communication platforms allow employees to let each other know if they are in need of charging or that they have completed charging and a charging spot is free. Employees in a self-managed charging system charge their vehicles on a first-come, first-served basis and often agree to the rule that only EVs that are actively charging can use a parking spot associated with a station. Even in a self-managed workplace charging program, it is very important that participants have a designated management point of contact to coordinate with if users are experiencing issues with equipment or co-workers' behavior.

Employers that provide workplace charging must decide if and how employees will pay for charging station use. Many existing workplace charging programs are free for employees. However, fees can help offset capital and operational costs associated with workplace charging. It may also increase the perception of fairness, as not all employees can use EV charging. See the Fees section of the Charging Infrastructure Operation and Maintenance page for more information.

If an employer institutes a payment system, it is important to develop a fee structure that is not a major barrier to use. In fact, a fee structure may help relieve charging station congestion. Charging employees at a rate slightly above local residential electricity rates is recommended as it allows people who cannot charge at home to benefit from the economic advantage of driving electric while discouraging those employees who do not truly need to charge at work from occupying the stations.

It is important that employers choose which scenario is right for them and clearly state the policy in relevant employee educational material. It's important to have a consistent policy in the case of EV charging price because employees factor these anticipated costs (or lack thereof) into their decision to purchase EVs. Employers should check with their accountant or chief financial officer to determine any tax implications of providing free charging to employees.

Level 1 Safety and Management Policies

Organizations offering EV charging at Level 1 charging receptacles, or wall outlets, can ensure a safe and successful workplace charging experience by considering the following safety and management policies:

• Level 1 charging receptacles should meet the National Electrical Code for safe charging of EVs and should comply with local building codes. Employers should confirm that the Level 1 charging receptacle is a commercial grade National Electrical Manufacturers Association (NEMA) outlet connected to a dedicated circuit breaker. Ground-fault circuit interrupter outlets, which protect against electrical shock, are required for outdoor use. Additionally, it is a good practice to ask an electrician to inspect the Level 1 charging receptacle and ensure it is in good condition before using it for charging. See the Other Considerations section of the Charging Infrastructure Procurement and Installation page for more information on compliance, permitting, and inspection.
• Employers should consult best practices for installing Level 1 charging receptacles in compliance with the Americans with Disabilities Act (ADA). In California, new accessibility regulations for EVSE are defined in the 2016 California Green Building Standards Code (“CALGreen Code”), section 821 which defines technical requirements for three types of accessible EV spaces: van, standard, and ambulatory.
• Employers are encouraged to consider cordset weight and typical length of the cord when determining the Level 1 outlet height. Putting strain on the Level 1 charging receptacle or the cordset by having the cordset hang in the air should be avoided.
• By annually checking their Level 1 charging receptacles, employers can ensure that the devices are working and capable of safe operation.

Engaging Employees

Once charging is available at work, employers may want to engage employees on how they can take advantage of this. DOE's Plug-In Electric Vehicle Outreach Resources for Your Employees offers tips for educating employees about why and how they can take advantage of workplace charging. Ride-and-drive events may also be an effective way to introduce employees to EVs and workplace charging.

Below are some examples of how organizations have made workplace charging available to their employees:

• Local Businesses – Learn how three small companies—Hollywood Woodwork, MOM's Organic Market, and Posty Cards—have successfully installed charging stations for their employees.
• University Campuses – Learn how higher education institutions are promoting PEV adoption by faculty, staff, and students.
• Healthcare Facilities – Learn how hospitals and other healthcare organizations are improving local air quality by promoting employee EV adoption.
• Utilities Power Change – Learn how New Jersey's Public Service Electric and Gas Company and Southern Company's unit Georgia Power are launching workplace charging programs for their commercial customers.

Maps & Data

More Electricity Data | All Maps & Data

Case Studies

• Workplace Charging Success: MetLife
• Workplace Charging Success: lynda.com
• Local Businesses Get Creative to Offer Workplace Charging

More Electricity Case Studies | All Case Studies

Publications

• Sample Employee Survey for Workplace Charging Planning
• Workplace Charging: Charging Up University Campuses
• PEV Outreach Resources for Your Employees

More Electricity Publications | All Publications

• EVI-X Toolbox
• Charging Hub Economic & Costing Tool
• Electric Vehicle Charging Station Locations