Nearly half of the nation’s healthcare employees have low perceptions of safety culture at their organization, and that opinion varies substantially between workers on different shift schedules, according to a new report from Press Ganey.
The group’s findings, part of a broader analysis extending to topics of workplace violence and preventable patient harm, emphasize the “pitfalls of three hospitals under one roof.”
Across all areas of safety culture, day shift staff describe an experience “that is consistently the strongest” among their peers, according to the group’s “State of Healthcare Safety 2026” analysis. Weekend shift staff are roughly aligned with day shift workers when grading their perception of “resources and teamwork” but fell behind somewhat on reporting measures tied to “prevention and reporting” and “pride and reputation.”
Night shift workers, meanwhile, “report systematically lower perceptions of safety culture across every measured dimension compared to their day-shift peers,” including their overall safety. Specifically, night-shift employees are 17% less likely to believe their organization cares about their safety and 11% less likely to believe their leadership collaborates to ensure conditions are safe.
“These findings suggest that off-hours staff may feel less supported, less connected and less confident in the organization’s reliability—conditions that can exacerbate burnout and quietly shape how care is delivered,” Press Ganey wrote.
Despite the disparity between shifts, perceptions of safety culture have generally increased in recent years, and, for some measures, have returned to pre-pandemic levels or higher, according to the report. Press Ganey also highlighted the correlation between healthcare employees’ high perceptions of their organization’s overall safety culture and employee engagement (while noting that disengaged employees are 2.6x more likely to leave than their highly engaged co-workers).
Further, the report noted better performances in areas like employee-manager collaboration and perception of care quality among facilities that frequently report safety events and highlighted a “virtuous cycle” in which organizations’ strong learning systems (cause analysis and action plans) and reporting cultures can mutually reinforce each other.
“Safe care starts with strong cultures,” Tejal Gandhi, M.D., chief safety and transformation officer at Press Ganey, said in a release. “When leadership actively demonstrates safety as a core value, and when teamwork, learning, and improvement are reinforced across the organization, reliability strengthens and variation narrows.”
Press Ganey’s safety culture analysis is based on 2025 data collected from 1.3 million healthcare employees at 225 health systems and 3,846 facilities as well as 23.5 million patients.
Among those patients, perceptions of safety trends have also improved over recent years across settings, with inpatient centers notching the largest recent lift. Younger patients have persistently reported the lowest baseline perception of safety and year-to-year increase.
As far as safety outcomes like fall rates, hospital-acquired pressure injuries and preventable infections, the report outlined improvements since mid-pandemic peaks. However, reported assaults on nurses remain elevated, and have inched higher, since pre- and early pandemic.