martes, 12 de abril de 2011

Organisational culture: variation across hospitals... [Qual Saf Health Care. 2010] - PubMed result


Qual Saf Health Care. 2010 Dec;19(6):592-6.

Organisational culture: variation across hospitals and connection to patient safety climate.

Speroff T, Nwosu S, Greevy R, Weinger MB, Talbot TR, Wall RJ, Deshpande JK, France DJ, Ely EW, Burgess H, Englebright J, Williams MV, Dittus RS.

Department of Medicine, Center for Health Services Research, Veterans Affairs Tennessee Valley Healthcare System, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA
. ted.speroff@vanderbilt.edu

Abstract

CONTEXT: Bureaucratic organisational culture is less favourable to quality improvement, whereas organisations with group (teamwork) culture are better aligned for quality improvement.

OBJECTIVE: To determine if an organisational group culture shows better alignment with patient safety climate.

DESIGN: Cross-sectional administration of questionnaires. Setting 40 Hospital Corporation of America hospitals.

PARTICIPANTS: 1406 nurses, ancillary staff, allied staff and physicians.

MAIN OUTCOME MEASURES: Competing Values Measure of Organisational Culture, Safety Attitudes Questionnaire (SAQ), Safety Climate Survey (SCSc) and Information and Analysis (IA).

RESULTS: The Cronbach alpha was 0.81 for the group culture scale and 0.72 for the hierarchical culture scale. Group culture was positively correlated with SAQ and its subscales (from correlation coefficient r = 0.44 to 0.55, except situational recognition), ScSc (r = 0.47) and IA (r = 0.33). Hierarchical culture was negatively correlated with the SAQ scales, SCSc and IA. Among the 40 hospitals, 37.5% had a hierarchical dominant culture, 37.5% a dominant group culture and 25% a balanced culture. Group culture hospitals had significantly higher safety climate scores than hierarchical culture hospitals. The magnitude of these relationships was not affected after adjusting for provider job type and hospital characteristics.

CONCLUSIONS: Hospitals vary in organisational culture, and the type of culture relates to the safety climate within the hospital. In combination with prior studies, these results suggest that a healthcare organisation's culture is a critical factor in the development of its patient safety climate and in the successful implementation of quality improvement initiatives.

PMID: 21127115 [PubMed - indexed for MEDLINE]

Organisational culture: variation across hospitals... [Qual Saf Health Care. 2010] - PubMed result

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