Research Spotlight: Safety Culture
This month's Research Spotlight shines on recent work done by Jason Richter and his colleagues. Dr. Richter is an assistant professor in the Army-Baylor University at Fort Sam Houston, and he also serves as an adjunct faculty member at Trinity University, teaching the Operations Management course in the Executive program. His work on safety culture and minimizing infections, with Ann Scheck McAlearney from The Ohio State University, was recently published ahead of print in Health Care Management Review.
In their study, Richter and McAlearney focus upon hospital units that completed an intensive program referred to as CUSP (Comprehensive Unit-based Safety Program), working to identify whether certain factors of a unit's safety culture may be related to the reduction or elimination of central line-associated bloodstream infections. They indeed found that hospital units characterized by open communications, safe staffing levels, continuous organizational learning, and teamwork had lower infection rates following CUSP implementation, with those four factors significantly associated with zero or reduced infection rates. In short, "units with a stronger perceived safety culture prior to CUSP implementation are better prepared to fully employ the CUSP model" (p. 6).
The CUSP model has been widely used since its introduction in 2003 and has realized considerable success in saving lives and financial resources, with over 1,000 U.S. hospitals adopting the program. Its success draws from an emphasis on utilizing financial and intellectual resources to strengthen an organization's safety culture, improve teamwork, and enable clinical teams to better learn from their mistakes. Focusing on integrating safety practices within daily work, the model is interdisciplinary and brings together clinicians and administrators to address safety-related issues at the unit level collaboratively. Noting that CUSP is costly and resource intensive, the authors suggest that implementation of CUSP should be targeted to units with a strong existing safety culture in situations in which resources limit the ability to implement CUSP across all units. Furthermore, units should ensure they improve and enhance their safety culture prior to CUSP implementation in order to optimize success and maximize limited resources.
Richter and McAlearney's findings connect to a study published earlier in 2016 that Richter also contributed to. In an article in the Journal of Hospital Administration, scholars Olena Mazurenko, Jason Richter, Abby Swanson-Kazley, and Eric Ford examined how patient satisfaction is impacted by whether clinicians' and management's perspectives on patient safety culture are shared. They found that patient satisfaction was in fact significantly associated with instances in which managers and clinicians agreed on patient safety culture, specifically with respect to the openness of communication, teamwork between and across units, and feedback and communication surrounding errors. The authors pointed to their findings to suggest that administrators "should take into account the perspectives of clinicians who have a more frontline perspective" in evaluating their patient safety culture (p. 20).
It's often said that culture eats strategy for breakfast. These findings from Dr. Richter and his colleagues suggest that culture also sets the table for patient satisfaction and safety. How aware are we as administrators of the culture established within our organizations? Is culture a concept that receives lip service but fails to connect outside of Administration's offices? Or is culture shared and permeated across the entire organization? The answers to those questions carry significant importance and impact, for managers, clinicians, and patients alike.
Works cited:
Richter, J. P., & McAlearney, A. S. (2016). Targeted implementation of the Comprehensive Unit-Based Safety Program through an assessment of safety culture to minimize central line-associated bloodstream infections. Health Care Management Review. Published ahead-of-print, 1-8.
Mazurenko, O., Richter, J., Swanson-Kazley, A., & Ford, E. (2016). Examination of the relationship between management and clinician agreement on communication openness, teamwork, and patient satisfaction in the US hospitals. Journal of Hospital Administration, 5 (4), 20-27.
In their study, Richter and McAlearney focus upon hospital units that completed an intensive program referred to as CUSP (Comprehensive Unit-based Safety Program), working to identify whether certain factors of a unit's safety culture may be related to the reduction or elimination of central line-associated bloodstream infections. They indeed found that hospital units characterized by open communications, safe staffing levels, continuous organizational learning, and teamwork had lower infection rates following CUSP implementation, with those four factors significantly associated with zero or reduced infection rates. In short, "units with a stronger perceived safety culture prior to CUSP implementation are better prepared to fully employ the CUSP model" (p. 6).
The CUSP model has been widely used since its introduction in 2003 and has realized considerable success in saving lives and financial resources, with over 1,000 U.S. hospitals adopting the program. Its success draws from an emphasis on utilizing financial and intellectual resources to strengthen an organization's safety culture, improve teamwork, and enable clinical teams to better learn from their mistakes. Focusing on integrating safety practices within daily work, the model is interdisciplinary and brings together clinicians and administrators to address safety-related issues at the unit level collaboratively. Noting that CUSP is costly and resource intensive, the authors suggest that implementation of CUSP should be targeted to units with a strong existing safety culture in situations in which resources limit the ability to implement CUSP across all units. Furthermore, units should ensure they improve and enhance their safety culture prior to CUSP implementation in order to optimize success and maximize limited resources.
Richter and McAlearney's findings connect to a study published earlier in 2016 that Richter also contributed to. In an article in the Journal of Hospital Administration, scholars Olena Mazurenko, Jason Richter, Abby Swanson-Kazley, and Eric Ford examined how patient satisfaction is impacted by whether clinicians' and management's perspectives on patient safety culture are shared. They found that patient satisfaction was in fact significantly associated with instances in which managers and clinicians agreed on patient safety culture, specifically with respect to the openness of communication, teamwork between and across units, and feedback and communication surrounding errors. The authors pointed to their findings to suggest that administrators "should take into account the perspectives of clinicians who have a more frontline perspective" in evaluating their patient safety culture (p. 20).
It's often said that culture eats strategy for breakfast. These findings from Dr. Richter and his colleagues suggest that culture also sets the table for patient satisfaction and safety. How aware are we as administrators of the culture established within our organizations? Is culture a concept that receives lip service but fails to connect outside of Administration's offices? Or is culture shared and permeated across the entire organization? The answers to those questions carry significant importance and impact, for managers, clinicians, and patients alike.
Works cited:
Richter, J. P., & McAlearney, A. S. (2016). Targeted implementation of the Comprehensive Unit-Based Safety Program through an assessment of safety culture to minimize central line-associated bloodstream infections. Health Care Management Review. Published ahead-of-print, 1-8.
Mazurenko, O., Richter, J., Swanson-Kazley, A., & Ford, E. (2016). Examination of the relationship between management and clinician agreement on communication openness, teamwork, and patient satisfaction in the US hospitals. Journal of Hospital Administration, 5 (4), 20-27.
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