Research Activities, July 2011: Patient Safety and Quality: Hospitals with a teamwork culture have better patient safety climates

Research Activities, July 2011: Patient Safety and Quality: Hospitals with a teamwork culture have better patient safety climates: "Patient Safety and Quality
Hospitals with a teamwork culture have better patient safety climates

The culture of an organization can influence how well individuals and institutions adapt to change. This is particularly true in health care, where quality improvement depends heavily on teamwork and innovation. Overly bureaucratic institutions with hierarchical cultures and defined chain of command tend to favor stability and resist change. Recently, researchers examined whether institutional cultures that focus on teamwork have better patient safety climates. Although cultures varied by hospital, those with a group/teamwork culture had significantly higher safety climate scores compared with hierarchical culture hospitals.

The researchers distributed surveys to hospitals and to managers and providers in adult and pediatric intensive care units (ICUs). The surveys asked about organizational culture and the working safety climate. A total of 64 ICUs from 40 hospitals returned 1,406 completed surveys for analysis. Respondents were nurses (66.2 percent), physicians (5.3 percent), allied clinicians, and ancillary nursing staff.

Fifteen of the 40 hospitals were classified as having a hierarchical culture. Another 15 were determined to have a group/teamwork culture. The remaining 10 organizations had a balanced culture. A significant positive correlation was found between a high patient safety climate and a group/teamwork organizational culture. Alternatively, there was a high negative correlation between safety climate and institutions with a hierarchical culture. These hospitals had significantly lower average safety climate scores than hospitals with group culture environments.

The findings suggest that a hospital's cultural climate is critical to the success of quality improvement programs. Attempts to understand underlying factors and to foster a climate of teamwork will have a positive impact on a hospital's patient safety climate, conclude the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS15934).

See 'Organizational culture: Variation across hospitals and connection to patient safety climate,' by Theodore Speroff, Ph.D., Samuel Nwosu, M.S., Robert A. Greevy, Ph.D., and others in Quality & Safety in Health Care 19, pp. 592-596, 2010.

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