Abstract:

Problem Statement:
The number of ageing people in the world is increasing. In the future societies need to create new opportunities for elderly people to live fulfilling lives. In addition nursing homes need to reorganize their system of management and implement new conceptions of high quality care and human interaction, where the co-operation between employees and patients creates a more fulfilling living and working environment. Employers need to create a work environment which more profoundly takes into consideration the needs of patients as well as the staff to be able to provide a quality care which satisfies the elderly.

Purpose of Study:
The purpose of the study is to investigate the improvement of the safety management system through its three main internal components (collaboration, commitment and learning from mistakes) with the final aim for the system being effective in nursing homes.

Method:
Our study includes two parts: experiment and interviews with care workers. In additional the Nordic Safety Climate Questionnaire was used to. The questions were categorized by four factors: commitment, learning, collaboration and influence of the management. The analyses were performed with IBM SPSS Statistics 24. The following statistical methods were used: correlation, MANOVA and Factor Analysis Principal Component.

Findings and Results:
Our results show positive correlations between the following factor scales: commitment and learning (p<0.01; r=0.600), learning and collaboration (p<0.01; r=0.668); and commitment and collaboration (p<0,01; r=0.752). Our results show that if employees learn from the experience not to repeat the same mistakes, they feel themselves securely in working their workplaces. The role of the management is to educate the employees to learn from the mistakes done earlier and not to repeat the same mistakes again. Our findings prove that in order to provide good care, the managers need to change the organizational culture from a punitive and blaming direction to that of justice and shared responsibility rather than working individually, in which errors are attributed to the deficiencies in the care system. The most important value of the current paper is impressed in the managers’ creation of the human resources considering work environment for the staff. The management is directed towards the evidence that there is an urgent shortage of qualified nursing staff in Estonia. The new elements for training proposed in the previous work of the authors are: simulation of advanced work methods, regular surveillance of the safety climate in the workplace, sharing good experience of other similar institutions visited by the managers.

Recommendations:
The results could be recommended to implement in a great number of Estonian nursing homes where the safety management is on the low level or non-exist. In the first stage, it is very important to educate the mangers of nursing homes in the safety and health area. Managers need to understand how urgent the care workers’ need for advanced knowledge really is; also the managers have to create a supportive internal environment for health care workers, where care workers can share their experience and speak about problems regarding their work. It is necessary to increase the rate of importance of the values of safety and health in everyday work in nursing homes.

Keywords:

Simulation training, safety climate, safety values, care workers training.