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Updated: Jun 10, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Multilayered approach to patient safety culture
Teemu Reiman1, Elina Pietikäinen, Pia Oedewald
1VTT, PO Box 1000, FIN-02044 VTT, Finland. teemu.reiman@vtt.fi
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.
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