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.

A Multilevel Analysis of U.S. Hospital Patient Safety Culture Relationships With Perceptions of Voluntary Event Reporting.

Abstract: OBJECTIVES Patient safety events offer opportunities to improve patient care, but, unfortunately, events often go unreported. Although some barriers to event reporting can be reduced with electronic reporting systems, insight on organizational and cultural factors that influence reporting frequency may help hospitals increase reporting rates and improve patient safety. The purpose of this study was to evaluate the associations between dimensions of patient safety culture and perceived reporting practices of safety events of varying severity. METHODS We conducted a cross-sectional survey study using previously collected data from The Agency for Healthcare Research and Quality Hospital Survey of Patient Safety Culture as predictors and outcome variables. The dataset included health-care professionals in U.S. hospitals, and data were analyzed using multilevel modeling techniques. RESULTS Data from 223,412 individuals, 7816 work areas/units, and 967 hospitals were analyzed. Whether examining near miss, no harm, or potential for harm safety events, the dimension feedback about error accounted for the most unique predictive variance in the outcome frequency of events reported. Other significantly associated variables included organizational learning, nonpunitive response to error, and teamwork within units (all P < 0.001). As the perceived severity of the safety event increased, more culture dimensions became significantly associated with voluntary reporting. CONCLUSIONS To increase the likelihood that a patient safety event will be voluntarily reported, our study suggests placing priority on improving event feedback mechanisms and communication of event-related improvements. Focusing efforts on these aspects may be more efficient than other forms of culture change.

How guiding coalitions promote positive culture change in hospitals: a longitudinal mixed methods interventional study

Abstract: Background Quality collaboratives are widely endorsed as a potentially effective method for translating and spreading best practices for acute myocardial infarction (AMI) care. Nevertheless, hospital success in improving performance through participation in collaboratives varies markedly. We sought to understand what distinguished hospitals that succeeded in shifting culture and reducing 30-day risk-standardised mortality rate (RSMR) after AMI through their participation in the Leadership Saves Lives (LSL) collaborative. Procedures We conducted a longitudinal, mixed methods intervention study of 10 hospitals over a 2-year period; data included surveys of 223 individuals (response rates 83%–94% depending on wave) and 393 in-depth interviews with clinical and management staff most engaged with the LSL intervention in the 10 hospitals. We measured change in culture and RSMR, and key aspects of working related to team membership, turnover, level of participation and approaches to conflict management. Main findings The six hospitals that experienced substantial culture change and greater reductions in RSMR demonstrated distinctions in: (1) effective inclusion of staff from different disciplines and levels in the organisational hierarchy in the team guiding improvement efforts (referred to as the ‘guiding coalition’ in each hospital); (2) authentic participation in the work of the guiding coalition; and (3) distinct patterns of managing conflict. Guiding coalition size and turnover were not associated with success (p values>0.05). In the six hospitals that experienced substantial positive culture change, staff indicated that the LSL learnings were already being applied to other improvement efforts. Principal conclusions Hospitals that were most successful in a national quality collaborative to shift hospital culture and reduce RSMR showed distinct patterns in membership diversity, authentic participation and capacity for conflict management.

Paradigmatic Processes in Culture Change

Abstract: Paradigmatic processes in culture change are defined, in the sense of Thomas Kuhn, as the consequence of long-continued deliberate effort by numbers of persons to innovate within a recognized technical, artistic, or intellectual tradition (or “school” or “discipline”). The evolving paradigm will often, after a certain point of development, attract exploitation; there will then occur various functionally entailed social-cultural consequences; and ultimately efforts will be made to rationalize the change in religious, ethical, and philosophical terms.

Post-heroic leadership, tempered radicalism and senior leaders as change agents for gender equality

Abstract: Micro change agents for gender equality in organisations are often considered to be tempered radicals who work within an existing structure to change the status quo. However for gender equality to happen, it is often claimed that heroic leadership of top leaders, or macro change agents, is required. The aim of this article is to show how CEOs as macro change agents for gender equality can be conceptualised. Drawing on interviews with 20 global CEOs and a literature review, the article develops a framework to conceptualise how CEOs are fostering gender equality around accountability, building ownership, communicating, leading by example, initiating and driving culture change. The article questions the conceptualisation of change agents of gender equality as either tempered radicals, for micro change agents, or heroic leaders, for macro change agents, and argues instead that to be macro change agents for gender equality, CEOs need to display post-heroic leadership and tempered radicalism to foster change in regard to gender relations.