A culture of innovation that promotes safety in hospitals

The aim of this article is to identify key factors contributing to a safety-enhancing innovation culture in hospitals. Based on a critical literature review, a unique approach to safety-enhancing innovation culture is proposed, integrating the perspectives of innovation culture and safety culture, particularly psychological and relational safety. Empirical research was conducted using an expert panel and MicMac structural analysis in three public hospitals with different reference levels: clinical, regional, and district. Nineteen factors of safety-enhancing innovation culture were analyzed, and their interactions and interdependencies were then determined. The analyses indicate that soft factors, such as trust, teamwork, organizational community, and learning, are primarily key in shaping a safety-enhancing innovation culture, rather than formal and structural solutions. The results indicate that innovation and safety are not competing categories but rather interdependent, provided that appropriate cultural conditions exist.