RT Journal Article SR Electronic T1 Multilayered approach to patient safety culture JF Quality and Safety in Health Care JO Qual Saf Health Care FD BMJ Publishing Group Ltd SP e20 OP e20 DO 10.1136/qshc.2008.029793 VO 19 IS 5 A1 Teemu Reiman A1 Elina Pietikäinen A1 Pia Oedewald YR 2010 UL http://qualitysafety.bmj.com/content/19/5/e20.abstract AB Background The concept of patient safety culture (PSC) has increasingly been used in the development of patient safety. However, no theoretical framework on the nature of the underlying phenomenon has been created. Multiple characterisations of the key dimensions of PSC exist, but they yield little theory on patient safety culture or its relation to patient safety. The authors propose a dynamic and multilayered construct of patient safety culture and illustrate the critical dimensions at each layer.Conclusions PSC can be defined as the willingness and ability of an organisation to understand safety as well as the willingness and ability to act on safety. Patient safety requires controlling and steering the organisation, and being mindful of the social processes and psychological phenomena.