Culture change

About: Culture change is a research topic. Over the lifetime, 1531 publications have been published within this topic receiving 41922 citations. The topic is also known as: cultural change & culture changes.

Implementing culture change in the NHS: contributions from occupational psychology

Abstract: “In the end, culture will trump rules, standards and control strategies every single time, and achieving a vastly safer NHS will depend far more on major cultural change than on a new regulatory regime”, Berwick Review, 2013, (p.11) Following the landmark publication of the Francis report on 6 February 2013, the result of a Public Inquiry into Mid Staffordshire NHS Foundation Trust, the monumental task of implementing its recommended culture change within the NHS has dominated the healthcare policy landscape. Indeed, more recently Francis has launched an independent review into creating an open and honest reporting culture in the NHS. This contribution from the British Psychological Society’s Division of Occupational Psychology presents a series of essays by Occupational Psychologists, each drawing on evidence and expertise from the field to address the question of how this culture change can be implemented within the NHS. Robert Francis QC identified an ‘unhealthy and dangerous culture’ as sitting at the heart of the serious failures uncovered at Mid Staffordshire hospital, and emphasised these as being symptomatic of a wider cultural problem within the health system. In particular, the Francis report highlighted a failure in many cases to put the patient first, and pinpointed several common characteristics of NHS hospital trusts which contributed to this failure, including a lack of candour; low staff morale; disengagement by medical leaders; and cultures of inward-looking secrecy and defensiveness. The report led to the release of several other landmark reports, among them Don Berwick’s influential review into ‘Improving the Safety of Patients in England’. Commissioned by the Government in response to the Francis report, the Berwick review powerfully distilled the lessons learned from the Francis Inquiry and detailed the necessary changes.

Worldviews, Ideologies and Social Experimentation: Clarification and Replication of "The Consciousness Reformation"

Abstract: This paper considers a number of conceptual and methodological ambiguities in the empirical study of culture change as exemplified in Robert Wuthnow's The Consciousness Reformation. Difficulties arise from the failure to distinguish between collective and individual-level manifestation of culture, and from the tendency to ignore the variable role of interacting collectivities for the development of symbol systems and their ability to affect behavior. An attempt is made to clarify ambiguities and replicate Wuthnow's findings using data from a sample of individuals who were members of communes inspired by social movements of the late 1960s. Participants in communal movements were overwhelmingly young and adhered to "non-traditional" worldviews, indicating a possible cultural shift. However, affiliation with a specific ideological group had greater influence on activism than cognitive framework as such. The importance of self-conscious ideological communities for the process of cultural change is discussed.

Choosing Privacy over Interaction: Restructuring Expectations and Interpretations of Community Integration in Canadian Small-House Long-Term Care Settings

Abstract: In Nova Scotia, Canada, the small-house model of care has been introduced as an alternative to institutional care settings, and the province has funded and built 11 new long-term care (LTC) communities in the small-house model. Each of the new facilities was built with multiple cottages housing 12 to 15 residents; each cottage features private bedrooms and a residentially scaled kitchen and dining area. Through smaller numbers of residents living in home areas, the goal of the Provincial Department of Health was to encourage relationship building, as well as to provide opportunities for autonomy and choice in resident daily living. A qualitative case study was conducted in one of these small-house communities, focusing on the model's impact on resident interaction and community integration. Thematic analysis revealed that while resident social patterns were directly impacted by the physical environment and culture of care in the new model, interpretations of these patterns by staff and family members were...

Culture change at the source: a medical school tackles patient safety.

Abstract: Health care professionals have always been dedicated to providing safe patient care and minimizing errors,but training in methods for attaining this complex goal has never been part of medical school curricula or practitioner education. The Institute of Medicine report, To Err Is Human, highlighted this serious gap in medical education and identified a need for interprofessional education that will be essential to transforming American health care delivery and achieving our national goals for health care quality and safety. Relatively few educational institutions or academic health centers provide leadership in interprofessional education on patient safety. A 2-pronged educational approach is needed, one that reaches physicians in training and seasoned practitioners alike. On the national level, one of the better teaching tools is Best Practices in Patient Safety Education Module Handbook. This module handbook is a compilation of materials for house officers oriented around Accreditation Council for Graduate Medical Education (ACGME) competencies. At Jefferson Medical College, the Department of Health Policy has engaged in an effort to develop educational programs for its medical students and faculty.These programs are designed to heighten awareness of patient safety issues, provide insights on potential solutions, and promote a systemwide culture of safety. A mandatory program for third-year medical students was instituted in January 2004. The annual Interclerkship Day, so named because it occurs during the break between clinical rotations, devotes an entire day to discussing patient safety. The highly rated program features nationally prominent speakers who emphasize the role of the physician in patient safety at every level of training and experience. On September 15, 2005, this successful formula was translated into a half-day program for faculty members. A trio of experts approached patient safety from 3 different perspectives, each conveying a compelling message with applicability in real-world medical practice. The following presentation summaries hint at the potential power of such a program as an efficient, effective approach to professional education targeting patient safety.