In this project, the investigators will investigate three important factors to optimize working conditions and patient safety: Joy in Work, Resilience Capacity, and Patient safety culture using both questionnaires and focus group interviews.

Already in 2021, the Norwegian Patient Safety Conference 'In Safe Hands 24-7' focused on adaptability: "How can health care professionals learn from what goes well?" Working to be excellent, identifying areas for improvement, and succeeding in a continuous improvement process. A solid patient safety culture requires competent and adaptable health care professionals, leaders, and health care systems. Joy in work is the experiential factor that revolves around opportunities for personal development, influencing one's own work, having individual contributions valued, and feeling like a meaningful part of the community.

This project spans three years-before (2024), during (2025), and after (2026) the physical co-location of Department of Cardiothoracic Surgery at Oslo university hospital. Four-hundred (n=400) health care professionals are working at Department of Cardiothoracic surgery, Oslo University Hospital, Norway and are eligible to be included in the study.

Health care professionals view of Joy in Work, Resilience Capacity, and Patient safety culture will be described using three international questionnaires. It is within the scope of the study to perform sub-analysis due to sub-categories of the questionnaires. Analysis across the questionnaires will be performed.

Furthermore, the three terms Joy in Work, Resilience Capacity, and Patient safety culture will be explored by approximately 10 % of the four-hundred (n=40) health care professionals in 5-6 focus group interviews, in 2024, 2025 and 2026..

Inclusion Criteria:

• Health care professionals working at Department of Cardiothoracic Surgery

Exclusion Criteria:

• Not able to understand the Norwegian questionnaires

All kind of gender-

All health care professionals working at Department of Cardiothoracic Surgery November/December 2024, 2025 and 2026. 400 employees x 3 years, a total of 1200 possible respondents.

This is a descriptive and exploratory study (i.e., no priority given to a specific hypothesis). No relevant studies available to estimate the number of participants needed in this study. To detect medium effect sizes (Cohen's d=0.5) between groups, need to include a total of 172 participants, considering a type I error rate of 5% and a power of 90%. Two-sided t-test were used as the basis for this calculation. In addition, we aim to investigate factors associated with job satisfaction, resilience capacity, or patient safety culture. A sample of 147 participants would be sufficient to detect a small to medium effect size (f2=0.08) with 90 % power and a type I error of 5% in a multiple linear regression model with ten predictor variables. Sufficient power for analyzing subscales/subgroups, aim include 400.

Not included in the informed consent to the respondents