This paper analyses various approaches tothe concept of a ‘safety culture’ in terms of theirepistemological assumptions regarding the nature oflearning. As a result of this analysis, the studyproposes a relational-interpretive framework for thepromotion of safety in health care, which is based onrelational theories and the philosophy of conceptualpragmatism as this can be used to integrate thevarious strands of current safety research. In particular, the approach based on a relational-interpretiveperspective can bridge the apparent dualist gap thatexists between the rational objectivist perspective andthe relativist perspective on the role of learning indeveloping a safety culture. According to the relational-interpretive perspective of safety managementthat is proposed here, organizational members need togive continuous attention to the accepted organizational norms and values, which shape the safetyculture. A case study from a health care safety projectin Sweden is utilized to illustrate the ideas advancedin this paper.