Workplace Relationships, Psychological Capital, Accreditation and Safety Culture: a new Framework of Analysis within Healthcare Organizations Elisabetta Trinchero 1 & Ben Farr-Wharton 2 & Yvonne Brunetto 3 Published online: 2 September 2017 Abstract This paper used Social Exchange Theory (SET), Positive Organization- al Behavior (POB) and Cooper ’ s(Safety Science, 36(2), 111–136, 2000) frame- works to operationalize a comprehensive model of safety culture, and tests whether one SET factor (supervisor-employee relationships) and one POB factor (psychological capital) predict accreditation and safety culture in a causal chain. Surveys from 1125 Italian doctors were analyzed using Structural Equation Modeling. Supervisor-employee relationships and psychological capital accounted for two-fifths of the accreditation culture, and, in turn, explained more than half of the safety culture. Hence, effective workplace relationships between manage- ment and doctors provide a trusting foundation to develop safe practices for better healthcare. Keywords Social exchange theory . Safety culture . Accreditation culture . Healthcare organization Public Organiz Rev (2019) 19:139–152 DOI 10.1007/s11115-017-0390-6 * Elisabetta Trinchero elisabetta.trinchero@unibocconi.it Ben Farr-Wharton Benjamin.Farr-Wharton@uts.edu.au Yvonne Brunetto yvonne.brunetto@scu.edu.au 1 SDA Bocconi School of Management, Bocconi University, Milan, Italy 2 University of Technology, Sydney, Australia 3 Southern Cross University, Coolangatta, Australia # Springer Science+Business Media, LLC 2017