Patient safety is a dimension of health care quality and a part of organisational safety culture. A deficit in safety culture represents an increased risk for ‘system’ errors. Errors in the health care sector are frequent and seriously harm a significant amount of patients. These errors must be seen as the end-product of accumulation of latent and active failures within the system and not systematically as the result of an individual mistake. The management of system failure to increase patient safety requires a cultural change. A long-lasting ‘blame and shame policy’ is seriously hampering this cultural change as under-registering of near misses and adverse events are the norm!

Organisational safety culture is multi-faceted and multidimensional. The main characteristics of the safety culture will be highlighted, as well as the methods to assess and detect a weakening safety culture. The health care sector faces an enormous challenge and the journey to better and safer care is a never ending road full of stumbling blocks hindering progression, especially in an environment where reduced financial potential will soon become the norm.

(BELG J MED ONCOL 2014;8(3):66–71)