Explore the vast range of titles available.

Starting from an extensive database, pooling 9 years of data from the top three insurance brokers in Italy, and containing 38125 reported claims due to alleged cases of medical malpractice, we use an inhomogeneous Poisson process to model the number of medical malpractice claims in Italy. The intensity of the process is allowed to vary over time, and it depends on a set of covariates, like the size of the hospital, the medical department and the complexity of the medical operations performed. We choose the combination medical department by hospital as the unit of analysis. Together with the number of claims, we also model the associated amounts paid by insurance companies, using a two-stage regression model. In particular, we use logistic regression for the probability that a claim is closed with a zero payment, whereas, conditionally on the fact that an amount is strictly positive, we make use of lognormal regression to model it as a function of several covariates. The model produces estimates and forecasts that are relevant to both insurance companies and hospitals, for quality assurance, service improvement and cost reduction.

Purpose Using social exchange theory (SET) and Cooper’s (2000) model, the purpose of this paper is to operationalise a comprehensive model of safety culture and tests whether SET factors (supervisor-employee relationships and engagement) predict safety culture in a causal chain. Design/methodology/approach The model was tested using surveys from 648 healthcare staff in an Italian acute care hospital and analysed using structural equation modelling. Findings Safety behaviours of clinical staff can be explained by the quality of the supervisor-employee relationship, their engagement, their feelings about safety and the quality of organisational support. Practical implications The model provides a roadmap for strategically embedding effective safe behaviours. Management needs to improve healthcare staff’s workplace relationships to enhance engagement and to shape beliefs about safety practices. Originality/value The contribution of this paper is that it has empirically developed and tested a comprehensive model of safety culture that identifies a causal chain for healthcare managers to follow so as to embed an effective safety culture.

This paper used Social Exchange Theory (SET), Positive Organizational Behavior (POB) and Cooper’s (Safety Science, 36(2), 111–136, 2000) frameworks to operationalize a comprehensive model of safety culture, and tests whether one SET factor (supervisor-employee relationships) and one POB factor (psychological capital) predict accreditation and safety culture in a causal chain. Surveys from 1125 Italian doctors were analyzed using Structural Equation Modeling. Supervisor-employee relationships and psychological capital accounted for two-fifths of the accreditation culture, and, in turn, explained more than half of the safety culture. Hence, effective workplace relationships between management and doctors provide a trusting foundation to develop safe practices for better healthcare.