Safety culture surveys focus on respondents' perception of safety in specific contexts, and measurement of safety culture is recommended in order to identify problem areas and targets for improvement. However, this Dutch study, conducted in 33 emergency departments, found that positive safety culture perception may actually inhibit implementation of recommended safety practices. For example, hospitals where respondents felt that handoffs and signouts were carried out safely were less likely to have standardized protocols for supervision or case review. This finding raises the concern that, in some cases, important safety mechanisms may not be implemented due to a false sense of security regarding patient safety.