Associations of psychological safety and perceptions of organizational environment among healthcare workers: a cross-sectional study in a university hospital
- 1The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194 Japan
Abstract
Background: Psychological safety is increasingly recognized as an important organizational factor in healthcare, yet its relationship with staff satisfaction at the institutional level remains unclear. This study examined the association between psychological safety and staff satisfaction using perceptions of their organizational environment framework.
Methods: We conducted a single-center cross-sectional survey of healthcare workers at a university hospital in November 2023. Staff satisfaction and psychological safety were assessed using a web-based anonymous questionnaire. The overall evaluation score was used as a global indicator of perceptions of their organizational environment. Importance–satisfaction analysis identified priority domains, and multivariable linear regression evaluated associations between psychological safety and outcomes.
Results: Among 685 participants, retention intention and perceived quality of care were identified as priority improvement domains. All psychological safety items correlated positively with overall evaluation (p < 0.05). In multivariable analyses, “skills and talents valued and utilized” (β = 0.381, p < 0.001) and “able to bring up problems” (β = 0.188, p < 0.001) showed the strongest associations with organizational evaluation. Similar relationships were observed for priority domains. Employees in their 30s demonstrated lower scores than older groups.
Conclusions: Psychological safety, particularly the speak-up climate and recognition of professional expertise, was strongly associated with healthcare workers’ overall perceptions of their organizational environment.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15330-3.
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BibTeX
@article{koike2026associations,
title = {{Associations of psychological safety and perceptions of organizational environment among healthcare workers: a cross-sectional study in a university hospital}},
author = {Tsutomu Koike and Teruhiko Imamura and Kota Kakeshita and Koichiro Kinugawa},
journal = {BMC Health Services Research},
year = {2026},
month = aug,
doi = {10.1186/s12913-026-15330-3},
url = {https://doi.org/10.1186/s12913-026-15330-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Associations of psychological safety and perceptions of organizational environment among healthcare workers: a cross-sectional study in a university hospital
AU - Tsutomu Koike
AU - Teruhiko Imamura
AU - Kota Kakeshita
AU - Koichiro Kinugawa
PY - 2026
DA - 2026/08/07
JO - BMC Health Services Research
DO - 10.1186/s12913-026-15330-3
UR - https://doi.org/10.1186/s12913-026-15330-3
AB - Background: Psychological safety is increasingly recognized as an important organizational factor in healthcare, yet its relationship with staff satisfaction at the institutional level remains unclear. This study examined the association between psychological safety and staff satisfaction using perceptions of their organizational environment framework. Methods: We conducted a single-center cross-sectional survey of healthcare workers at a university hospital in November 2023. Staff satisfaction and psychological safety were assessed using a web-based anonymous questionnaire. The overall evaluation score was used as a global indicator of perceptions of their organizational environment. Importance–satisfaction analysis identified priority domains, and multivariable linear regression evaluated associations between psychological safety and outcomes. Results: Among 685 participants, retention intention and perceived quality of care were identified as priority improvement domains. All psychological safety items correlated positively with overall evaluation (p < 0.05). In multivariable analyses, “skills and talents valued and utilized” (β = 0.381, p < 0.001) and “able to bring up problems” (β = 0.188, p < 0.001) showed the strongest associations with organizational evaluation. Similar relationships were observed for priority domains. Employees in their 30s demonstrated lower scores than older groups. Conclusions: Psychological safety, particularly the speak-up climate and recognition of professional expertise, was strongly associated with healthcare workers’ overall perceptions of their organizational environment. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15330-3.
SN - 1472-6963
ER -