Healthcare organization performance is a function of many variables. This study measured relationships among culture, the built environment, and outcome variables in a healthcare provider organization. A culture survey composed of existing scales and custom scales was used as the principal measurement instrument. Results supported culture strength's links with higher performance levels and identified the built environment's role as a moderating variable that can lead to improved processes and outcomes. Job satisfaction and patient satisfaction were found to be significantly and positively correlated with culture strength and with ratings of the built environment.

The critical incident technique (CIT) provides a means to produce rich cultural information from organizational members in an effort to describe the organization's culture. Very few published studies have used CIT to diagnose culture. In combination with other methods, CIT can be an integral element of a larger study of an organization's culture. In this study, CIT was used in a US acute care hospital that had recently occupied a new $181 million replacement hospital having an emphasis on patient-centered care and a healing environment. Individual CIT``stories'' supplied rich detail about the hospital's culture, providing opportunities to communicate how people behave with respect to the culture. Consequently, CIT results provide specific information on what people do that supports the culture and what they do that works against the culture.

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Evidence from past studies supports the proposition that air ambulance crews are at risk for musculoskeletal injury. We evaluated the association between musculoskeletal discomfort and lifting tasks in air ambulance crews, through the use of a body map discomfort survey and a 25-question demographic/lifting activities questionnaire. Male and female full-time employees of two hundred seventy-one air ambulance services throughout the continental United States were surveyed. Participants self-reported discomfort levels for twenty-five body locations. Data for seven of these locations indicated pain with an average value greater than three on a 10-point scale, and 39 (19.6%) of the two hundred participants had been diagnosed with discogenic back pain. Eighty-seven (44.3%) stated they had lifted over 50 pounds of distributed weight more than six times in the last thirty days. Sixty-two (31.2%) reported that their air ambulance service used no mechanical lifting aids. Furthermore, 28 (45.2%) of those with no lifting aids observed a particularly challenging lifting task within the past 30 days. There is considerable evidence that air ambulance crews experience body discomfort related to their lifting tasks. Potential ergonomic improvements are discussed.

Ergonomics researchers investigate musculoskeletal problems in an occupation largely ignored by lifting standards.