Organizational patient safety culture and workforce well-being among healthcare workers: associations with resilience and work-life balance in a hospital-wide cross-sectional study.

BACKGROUND

Patient safety culture is widely recognized as a core determinant of healthcare quality, safety, and organizational performance (1). Increasing attention has also been directed toward healthcare workforce well-being, particularly positive psychological resources such as resilience (2) and work-life balance. These factors, alongside the mitigation of occupational stress (3), are essential in influencing safety-related behaviors and the sustainability of health service delivery. However, empirical evidence integrating multidimensional patient safety culture with positive workforce well-being outcomes at the organizational level remains limited (4).

METHODS

A hospital-wide cross-sectional survey was conducted among healthcare workers at a regional teaching hospital in Taiwan during 2024. Patient safety culture was assessed using a validated multidimensional safety culture instrument, while workforce well-being was measured in terms of resilience and work-life balance. Descriptive statistics, Pearson correlation analyses, and multiple linear regression models were applied to examine associations between safety culture dimensions and well-being outcomes, with subgroup analyses across demographic and professional characteristics.

RESULTS

A total of 1,779 healthcare workers participated. Multiple linear regression revealed that while most safety culture dimensions positively influenced work-life balance, job satisfaction exhibited a significant negative association with resilience (β = -0.400, p < 0.001). Stress perception emerged as a strong predictor of higher resilience but poorer work-life balance.

CONCLUSIONS

The study underscores the dialectical relationship between organizational culture and workforce well-being. The findings suggest that resilience may function as a compensatory resource for healthcare workers in demanding environments. Health services managers should integrate workforce well-being into safety frameworks, moving beyond satisfaction scores to address the structural conditions that shape both resilience and work-life balance.