Creating a culture of safety and respect

Creating a culture of safety and respect

A controlled, mixed-methods study of the effectiveness of a behavioural accountability intervention to reduce unprofessional behaviours

This project is funded by a National Health and Medical Research Council Partnership Project - GNT1134459 and St Vincent’s Health Australia.

Project members


Professor Johanna Westbrook
Professor and Director

Dr Neroli Sunderland
Research Fellow

A/Prof Ling Li
Associate Professor


Dr Ryan McMullan 
Postdoctoral Research Fellow

Professor Jeffrey Braithwaite
Professor and Director

Professor Frances Rapport


Associate Professor Rebecca Mitchell
Associate Professor

Dr Robyn Clay-Williams
Senior Research Fellow

Professor Clifford Hughes AO
Professor of Patient Safety and Clinical Quality


Dr Kate Churruca
Postdoctoral Research Fellow

Mr Peter Hibbert
Honorary Associate Professor

Associate Professor Melissa Baysari
Honorary Associate Professor

External Chief Investigators:

Professor Ric Day – UNSW, St Vincent’s Hospital Sydney

Professor Sandy Middleton – Nursing Research Institute

Professor David Scott – St Vincent’s Hospital Melbourne

Dr Natalie Taylor – NSW Cancer Council

St Vincent’s Health Australia partner investigators

Project contact

Dr Neroli Sunderland  
T: +61 2 9850 2421

Project main description

Unprofessional behaviour in healthcare is widespread, and significantly undermines the effective functioning of teams, staff wellbeing, patient experience and safety, and organisational productivity. Unprofessional behaviours are associated with higher staff turnover, incidence of patient dissatisfaction, medicolegal risk and significant financial costs. There is a pressing need for evidence-based interventions to reduce the prevalence of negative behaviour, minimise its impact on staff and patients, and normalise a culture of safety and respect.

This project will assess the effectiveness of an innovative structured staff behaviour and escalating accountability intervention, the Ethos program, to be rolled out across St Vincent’s Health Australia hospitals. The study will assess the ability of the Ethos program to reduce unprofessional behaviours, improve the experience of staff, and improve the safety, experience and outcomes of patients. It will also identify enablers and barriers to Ethos program effectiveness and enhance spread and sustainability. The project is a controlled, before and after study using qualitative and quantitative methods – including surveys, interviews, direct observation, HR and patient outcome data linkage.

Collaborative partners

St Vincent’s Health Australia

Project status


Centres related to this project

Centre for Health Systems and Safety Research

Centre for Healthcare Resilience and Implementation Science

Content owner: Australian Institute of Health Innovation Last updated: 07 May 2020 3:00pm

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