• Safety climate was examined across organizational, team leader, and coworker levels in hospital settings. • Positive associations were found between safety climate and key safety-related indicators. • Time pressure showed a consistent negative relationship with safety climate. • Safety climate perceptions varied across professional groups and work schedules. • Findings provide practical guidance for targeted safety interventions and organizational improvement in hospitals. Safety climate is a crucial measure for organizations, predicting occupational accidents, monitoring safety performance, and identifying areas for improvement. However, its application in hospital settings remains limited. This study aimed to analyze safety climate levels and their relationship with other safety performance indicators in hospital settings using a multilevel perspective. The study was conducted in two hospital units located in Northern Portugal and involved 500 health professionals, including doctors, nurses, diagnosis and therapeutics technicians, operational assistants, and technical assistants. A questionnaire was applied to collect data of the variables under study. The questionnaire included a multilevel safety climate scale, which assesses the safety climate at the three different levels: management, team leader and coworkers. Additionally, it included scales to determine safety behaviours, motivation, time pressure and safety knowledge. Results revealed positive levels of safety climate across the three hierarchical subscales. Safety climate was positively associated with safety motivation, safety behaviors, and safety knowledge, and negatively associated with time pressure. Significant differences were observed across professional categories. Technical assistants were observed to reported lower levels for co-workers safety climate, safety knowledge, and safety participation, and higher time pressure. Additionally, work schedule was associated with safety climate perceptions and safety knowledge, with non-shift workers reporting higher safety climate at the management and team leader levels. This study enhances understanding of safety climate in hospital settings, highlighting the importance of addressing specific safety indicators, particularly among distinct professional groups.
Ferreira et al. (2026) studied this question.