Tackling operating theatre waiting lists may focus healthcare organisations’ attention on increased productivity while downplaying safety concerns.

To explore safety culture in a perioperative department from operating theatre practitioners’ perspective.

Cross-sectional pen-and-paper survey among nurses in an operating theatre department in Malta using the Safety, Communication, Operational Reliability and Engagement questionnaire.

The response rate was 71.2% (n = 146). Engagement domains and Organisational Safety Culture domains were perceived to be at an average level, apart from Unit Leadership which was perceived to be low. Burnout domains were perceived to be high or very high. Correlation analysis showed that leaders’ recognition of staff feedback and input is associated with improved safety culture perceptions.

An organisational win-win situation is achievable, whereby safety culture perceptions are improved, not necessarily by decreasing job demands such as tackling waiting lists, but by recognising operating theatre staff’s input and involving them in work-related decisions.