Organizational patient safety culture and workforce well-being among healthcare workers: associations with resilience and work–life balance in a hospital-wide cross-sectional study

Patient safety culture is widely recognized as a core determinant of healthcare quality, safety, and organizational performance (1). Increasing attention has also been directed toward healthcare workforce well-being, particularly positive psychological resources such as resilience (2) and work–life balance. These factors, alongside the mitigation of occupational stress (3), are essential in influencing safety-related behaviors and the sustainability of health service delivery. However, empirical evidence integrating multidimensional patient safety culture with positive workforce well-being outcomes at the organizational level remains limited (4). A hospital-wide cross-sectional survey was conducted among healthcare workers at a regional teaching hospital in Taiwan during 2024. Patient safety culture was assessed using a validated multidimensional safety culture instrument, while workforce well-being was measured in terms of resilience and work–life balance. Descriptive statistics, Pearson correlation analyses, and multiple linear regression models were applied to examine associations between safety culture dimensions and well-being outcomes, with subgroup analyses across demographic and professional characteristics. A total of 1,779 healthcare workers participated. Multiple linear regression revealed that while most safety culture dimensions positively influenced work-life balance, job satisfaction exhibited a significant negative association with resilience (β = -0.400, p < 0.001). Stress perception emerged as a strong predictor of higher resilience but poorer work-life balance. The study underscores the dialectical relationship between organizational culture and workforce well-being. The findings suggest that resilience may function as a compensatory resource for healthcare workers in demanding environments. Health services managers should integrate workforce well-being into safety frameworks, moving beyond satisfaction scores to address the structural conditions that shape both resilience and work-life balance.