[No SPF Record] [IMPROVEDX] Culture

Rory Jaffe rjaffe at CHPSO.ORG
Mon Jun 11 16:58:50 UTC 2018

Here's a few references on the relationship between culture and outcomes. Note this is a random selection and not a review of the literature.

Farup PG. Are measurements of patient safety culture and adverse events valid and reliable? Results from a cross sectional study. BMC Health Serv Res. 2015;15:186. doi:10.1186/s12913-015-0852-x.

Fan CJ, Pawlik TM, Daniels T, et al. Association of Safety Culture with Surgical Site Infection Outcomes. J Am Coll Surg. 2016;222(2):122-128. doi:10.1016/j.jamcollsurg.2015.11.008.

Huang DT, Clermont G, Kong L, et al. Intensive care unit safety culture and outcomes: a US multicenter study. Int J Qual Health Care. 2010;22(3):151-161. doi:10.1093/intqhc/mzq017.

Mardon RE, Khanna K, Sorra J, Dyer N, Famolaro T. Exploring relationships between hospital patient safety culture and adverse events. J Patient Saf. 2010;6(4):226-232. doi:10.1097/PTS.0b013e3181fd1a00.

Chang Y, Mark B. Effects of learning climate and registered nurse staffing on medication errors. Nurs Res. 2011;60(1):32-39. doi:10.1097/NNR.0b013e3181ff73cc.

Weaver SJ, Lubomksi LH, Wilson RF, Pfoh ER, Martinez KA, Dy SM. Promoting a culture of safety as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158(5 Pt 2):369-374. doi:10.7326/0003-4819-158-5-201303051-00002.


From: ROBERT M BELL <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>
Sent: Saturday, June 09, 2018 3:51 PM
Subject: [No SPF Record] [IMPROVEDX] Culture

Dear all,

Over the years I have often thought that a Good Culture in a hospital, medical facility reduced errors.

I did a google search and there are significant posts suggesting that a  good culture reduces errors. However, I have no idea what is the scientific evidence for this.

I assumed it was accurate and came up with my own list, gathered from many sources, of words/phrases of what kind of hospital, if given the chance, I would like to work in and/or be a patient.

excellent standards, compassion,
flexibility, compromise, transparency,
courtesy, kindness, fairness, time-related goals,
conflict resolution procedures, encourages creativity,
good feedback mechanisms, defined mission and goals,
defined strategy, team concepts, good communications,
collaboration, compromise, embracing diversity.

And one would ask, how meaningful are these, and what others should be added or removed?

These are not ranked is any order and begs the question should they be?  What are the most important to prevent error.

There seem to be barriers to introducing the right culture into a hospital and this article discusses that.


Are these culture barriers meaningful? And what can anything be done about the obstacles to make it easier for hospitals?

While we are waiting to find good ways to prevent diagnostic errors (and errors in general) could we support moving to good cultures for all in medical facilities.

Would that help in any way?

One fantasizes of reducing the error rate by 1 - 5%

Or is this being done successfully already?

Rob Bell, M.D.



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