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Leadership July 2026

Aligning Executive Compensation with Safety Culture

Beterra's position paper on incentive design using safety culture improvement - a three-lever model of Engagement, Activity, and Performance, with phased Crawl → Walk → Run weightings and guardrail guidance.

About this white paper

Health systems want executive compensation tied to safety culture, and they should - what leaders are paid to improve is what organizations prioritize. But paying on a single culture score invites the failure modes high-reliability engineering warns about: it rewards oversimplification, treats rising event reporting as a problem rather than the signature of a maturing reporting culture, and erodes the candor the instrument depends on. This position paper sets out a three-lever model of Engagement, Activity, and Performance, with phased Crawl → Walk → Run weightings and guardrail guidance.

Aligning Executive Compensation with Safety Culture

What you'll learn

  • Evidence-based frameworks you can apply immediately
  • Practical measurement and benchmarking approaches
  • How leading health systems are getting results
  • Actionable next steps for your organization

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Aligning Executive Compensation with Safety Culture

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