Association between organisational and workplace cultures, and patient outcomes: systematic review protocol

Braithwaite, Jeffrey; Herkes, Jessica; Ludlow, Kristiana; Lamprell, Gina; Testa, Luke

doi:10.1136/bmjopen-2016-013758

Cited by 101 publications

(18 citation statements)

References 95 publications

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“…In healthcare, a recent review across a variety of settings showed a consistent association between workplace culture and patient outcomes. However, most of the included studies were cross-sectional, using a wide range of different definitions and measurements of culture, environment and patient outcomes, and most studies were conducted in hospital settings 22. Safety culture in home healthcare has not yet been widely explored 23.…”

Section: Discussionmentioning

confidence: 99%

Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers

2018

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ObjectiveHome healthcare is the fastest growing arena in the healthcare system but patient safety research in this context is limited. The aim was to explore how patient safety in Swedish specialised home healthcare is described and adressed from multidisciplinary teams’ and clinical managers’ perspectives.DesignAn explorative qualitative study.SettingMultidisciplinary teams and clinical managers were recruited from three specialised home healthcare organisations in Sweden.MethodsNine focus group interviews with multidisciplinary teams and six individual interviews with clinical managers were conducted, in total 51 participants. The data were transcribed verbatim and analysed using qualitative content analysis.ResultsPatient safety was inherent in the well-established care ideology which shaped a common mindset between members in the multidisciplinary teams and clinical managers. This patient safety culture was challenged by the emerging complexity in which priority had to be given to standardised guidelines, quality assessments and management of information in maladapted communication systems and demands for required competence and skills. The multiple guidelines and quality assessments that aimed to promote patient safety from a macro-perspective, constrained the freedom, on a meso-level and micro-level, to adapt to challenges based on the care ideology.ConclusionPatient safety in home healthcare is dependent on adaptability at the management level; the team members’ ability to adapt to the varying conditions and on patients being capable of adjusting their homes and behaviours to reduce safety risks. A strong culture related to a patient’s value as a person where patients’ and families’ active participation and preferences guide the decisions, could be both a facilitator and a barrier to patient safety, depending on which value is given highest priority.

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Section: Discussionmentioning

confidence: 99%

Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers

2018

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“…In secondary care, culture is also a key determinant of behaviors. In a systematic review published in 2016, Braithwaite and colleagues identified a positive organizational culture (defined as values, norms, and beliefs) with positive patient outcomes [49]. The decline effect [50], where promising effects of an intervention are difficult to replicate in different settings, is a prime example of the influence of culture and context on behavioral outcomes.…”

Section: The Role Of Culture and Team Dynamics In Antibiotic Stewamentioning

confidence: 99%

Antibiotic Stewardship—Twenty Years in the Making

Charani

Holmes

2019

Antibiotics

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In the last 20 years, efforts were made to optimize antibiotic use in hospitals across the world as a means of addressing the increasing threat of antibiotic resistance. Despite robust evidence supporting optimal practice, antibiotic decision-making remains sub-optimal in many settings, including in hospitals. Globally, resources remain a limiting factor in the implementation of antibiotic stewardship programs. In addition, antibiotic decision-making is a social process dependent on cultural and contextual factors. Cultural boundaries in healthcare and across specialties still limit the involvement of allied healthcare professionals in stewardship interventions. There is variation in the social norms and antibiotic-prescribing behaviors between specialties in hospitals. The cultural differences between specialties and healthcare professionals (1) shape the shared knowledge within and across specialties in the patient pathway, and (2) result in variation in care, thus impacting patient outcomes. Bespoke stewardship interventions that account for contextual variation in practice are necessary.

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“…However, the 17 studies were heterogeneous concerning methods and measures. Braithwaite et al (2017) indicated similar results in another review.…”

Section: Connection Between Patient Safety Culture and Patient Safetysupporting

confidence: 77%

Patient Safety - Cultural Perspectives

Danielsson¹

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Background: Shared values, norms and beliefs of relevance for safety in health care can be described in terms of patient safety culture. This concept overlaps with patient safety climate, but culture represents the deeprooted values, norms and beliefs, whereas climate refers to attitudes and more superficial manifestations of culture. There may be numerous subcultures within an organization, including different professional cultures. In recent years, increased attention has been paid to patient safety culture in Sweden, and the patient safety culture/climate in health care is regularly measured based on the assumption that patient safety culture/climate can influence various patient safety outcomes. Aim: The overall aim of the thesis is to contribute to an improved understanding of patient safety culture and subcultures in Swedish health care. To my beloved husband and my children, Magnus, Anton and Simon, I have no words for what you mean to me. We struggle every day together and share happiness and sorrows. Without your support and understanding I would not have been able to present this thesis. I love you and the most important thing in my life is that I am able to give you the feeling of being loved.

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Association between organisational and workplace cultures, and patient outcomes: systematic review protocol

Cited by 101 publications

References 95 publications

Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers

Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers

Antibiotic Stewardship—Twenty Years in the Making

Patient Safety - Cultural Perspectives

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