To our knowledge, this is the 1st study to test the
relationships between hospital management support
for patient safety, trust in hospital management, and
overall perception of patient safety while considering
aspects of safety communication as mediating variables.
The results of the path analysis confirmed that
higher hospitalmanagement support for patient safety
was related to overall higher perceptions of safety
with aspects of safety communication, that is, nonpunitive
response to error, communication openness,
organizational learning and feedback, and communication
of errors, functioning as important factors
playing a partial mediating role. Analysis indicated a
moderate direct association between ‘‘management
support for patient safety’’ and ‘‘trust in management.’’
In Switzerland, aswell as inmany other countries,
chief nursing officers (CNOs) are part of the hospital
management board. According to the European
Nurse Directors Association, personal integrity, courtesy,
honesty, trust, and mutual respect should be key
characteristics of CNOs.28 In particular, trust links
and forms the basis of productive collaboration between
management and frontline staff.