Nearly half of healthcare workers report low safety culture: Press Ganey

Nearly half of healthcare employees report a low perception of safety culture, according to Press Ganey’s “State of Healthcare Safety 2026” report.

The report draws on 2025 data from 1.3 million healthcare workers — including nurses, physicians, security professionals and managers from 225 health systems and 3,846 facilities — as well as nearly 23.5 million patients across 3,196 inpatient, ambulatory surgery and medical practice sites.

Here are six key takeaways:

1. Safety culture scores have improved following pandemic-era declines, with average survey scores rising year over year, including in “resources and teamwork,” “overall safety culture,” “prevention and reporting,” and “pride and reputation.” However, 46.6% of healthcare workers report low safety culture perceptions, with lower ratings among clinical staff.

2. Facilities reporting safety events at or above the expected rate perform better on teamwork measures. These organizations are more than eight times as likely to rank into the top quartile for employee-manager collaboration, learning from mistakes, teamwork within units and perception of care quality.

3. Social capital is key. Organizations with strong employee responses to questions about respect and teamwork are 50% to 80% more likely to excel on safety outcomes and three times more likely to reach top-quartile patient loyalty scores. High-performing units are also more than twice as likely to have patients report they were treated with courtesy and respect. 

4. Safety perceptions vary by shift. Staff report different perceptions of culture across day, night and weekend shifts within the same organization. Much of the improvement in safety culture scores was driven by day-shift employees, who reported the strongest gains in average safety scores year over year. Night-shift scores slightly improved and remained the lowest overall.

5. Leadership alignment matters. Units reporting strong alignment between front-line teams and senior leadership show stronger reporting cultures and higher safety outcomes performance. Among organizations in the top decile for employee engagement, three of the five largest performance differentiators relate to confidence, trust and respect in senior leadership.

6. Safety culture is tied to retention. Seven of the 10 strongest drivers of employee engagement are related to safety culture. Employees with unfavorable perceptions of safety culture are 1.74 times more likely to leave than those with neutral or positive views.

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