Organizational culture change in U.S. hospitals: a mixed methods longitudinal intervention study

详细信息    查看全文

• 作者：Leslie A Curry (1) (2)
  Erika L Linnander (1)
  Amanda L Brewster (1)
  Henry Ting (3)
  Harlan M Krumholz (1) (2) (4) (5)
  Elizabeth H Bradley (1) (2)
  
  1. Department of Health Policy and Management ; Yale School of Public Health ; New Haven ; CT ; USA
  2. Robert Wood Johnson Clinical Scholars Program ; Department of Medicine ; Yale University School of Medicine ; New Haven ; CT ; USA
  3. New York Presbyterian Hospital ; New York ; NY ; USA
  4. Center for Outcomes Research and Evaluation ; Yale-New Haven Hospital ; New Haven ; CT ; USA
  5. Section of Cardiovascular Medicine ; Department of Medicine ; Yale University School of Medicine ; New Haven ; CT ; USA
  
• 关键词：Organizational culture ; Leadership ; Intervention ; Hospitals ; Quality ; Acute myocardial infarction
• 刊名：Implementation Science
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：10
• 期：1
• 全文大小：794 KB
• 参考文献：Medicare hospital quality chartbook. Centers for Medicare & Medicaid Services, Baltimore
  1. Bradley, EH, Curry, LA, Ramanadhan, S, Rowe, L, Nembhard, IM, Krumholz, HM (2009) Research in action: using positive deviance to improve quality of health care. Implement Sci 4: pp. 25 25" target="_blank" title="It opens in new window">CrossRef
  2. Curry, LA, Nembhard, IM, Bradley, EH (2009) Qualitative and mixed methods provide unique contributions to outcomes research. Circulation 119: pp. 1442-52 2775" target="_blank" title="It opens in new window">CrossRef
  3. Bradley, EH, Herrin, J, Mattera, JA, Holmboe, ES, Wang, YM, Frederick, P (2005) Quality improvement efforts and hospital performance: rates of beta-blocker prescription after acute myocardial infarction. Med Care 43: pp. 282-92 200503000-00011" target="_blank" title="It opens in new window">CrossRef
  4. Bradley, E, Holmboe, E, Mattera, J, Roumanis, S, Radford, M, Krumholz, H (2001) A qualitative study of increasing 尾-blocker use after myocardial infarction: why do some hospitals succeed?. JAMA 285: pp. 2604-11 285.20.2604" target="_blank" title="It opens in new window">CrossRef
  5. Bradley, EH, Curry, LA, Spatz, ES, Herrin, J, Cherlin, EJ, Curtis, JP (2012) Hospital strategies for reducing risk-standardized mortality rates in acute myocardial infarction. Ann Intern Med 156: pp. 618-221 26/0003-4819-156-9-201205010-00003" target="_blank" title="It opens in new window">CrossRef
  6. Bradley, EH, Nallamothu, BK, Herrin, J, Ting, HH, Stern, AF, Nembhard, IM (2009) National efforts to improve door-to-balloon time: results from the door-to-balloon alliance. J Am Coll Cardiol 54: pp. 2423-9 2009.11.003" target="_blank" title="It opens in new window">CrossRef
  7. Bradley, EH, Curry, LA, Webster, TR, Mattera, JA, Roumanis, SA, Radford, MJ (2006) Achieving rapid door-to-balloon times how top hospitals improve complex clinical systems. Circulation 113: pp. 1079-85 CrossRef
  8. Curry, LA, Spatz, E, Cherlin, E, Thompson, JW, Berg, D, Ting, HH (2011) What distinguishes top-performing hospitals in acute myocardial infarction mortality rates?. Ann Intern Med 154: pp. 384-30 26/0003-4819-154-6-201103150-00003" target="_blank" title="It opens in new window">CrossRef
  9. Davenport, DL, Henderson, WG, Mosca, CL, Khuri, SF, Mentzer, RM (2007) Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. J Am Coll Surg 205: pp. 778-84 2007.07.039" target="_blank" title="It opens in new window">CrossRef
  10. Shortell, SM, Jones, RH, Rademaker, AW, Gillies, RR, Dranove, DS, Hughes, EFX (2000) Assessing the impact of total quality management and organizational culture on multiple outcomes of care for coronary artery bypass graft surgery patients. Med Care 38: pp. 207-17 200002000-00010" target="_blank" title="It opens in new window">CrossRef
  11. Zimmerman, JE, Shortell, SM, Rousseau, DM, Duffy, J, Gillies, RR, Knaus, WA (1993) Improving intensive care: observations based on organizational case studies in nine intensive care units: a prospective, multicenter study. Crit Care Med 21: pp. 1443-51 246-199310000-00010" target="_blank" title="It opens in new window">CrossRef
  12. Baggs, JG, Schmitt, MH, Mushlin, AI, Mitchell, PH, Eldredge, DH, Oakes, D (1999) Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med 27: pp. 1991-8 246-199909000-00045" target="_blank" title="It opens in new window">CrossRef
  13. Gittell, JH, Fairfield, KM, Bierbaum, B, Head, W, Jackson, R, Kelly, M (2000) Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: a nine-hospital study of surgical patients. Med Care 38: pp. 807-19 200008000-00005" target="_blank" title="It opens in new window">CrossRef
  To err is human: building a safer health system. National Academies Press, Washington, D.C.
  14. Lukas, C, Holmes, S, Cohen, A, Restuccia, J, Cramer, I, Shwartz, M (2007) Transformational change in health care systems: an organizational model. Health Care Manage Rev 32: pp. 309-20 296785.29718.5d" target="_blank" title="It opens in new window">CrossRef
  15. McIntosh, N, Meterko, M, Burgess, JF, Restuccia, JD, Kartha, A, Kaboli, P (2014) Organizational predictors of coordination in inpatient medicine. Health Care Manage Rev 39: pp. 279-92 CrossRef
  16. Meterko, M, Mohr, DC, Young, GJ (2004) Teamwork culture and patient satisfaction in hospitals. Med Care 42: pp. 492-8 24389.58422.b2" target="_blank" title="It opens in new window">CrossRef
  17. Shortell, SM, Zimmerman, JE, Rousseau, DM, Gillies, RR, Wagner, DP, Draper, EA (1994) The performance of intensive care units: does good management make a difference?. Med Care 32: pp. 508-25 CrossRef
  18. Shwartz, M, Cramer, IE, Holmes, SK, Cohen, AB, Restuccia, JD, VanDeusen, LC (2010) Survey-assessed quality and organizational factors related to quality in pursuing perfection hospitals. Qual Manag Health Care 19: pp. 349-63 2" target="_blank" title="It opens in new window">CrossRef
  19. Singer, S, Lin, S, Falwell, A, Gaba, D, Baker, L (2009) Relationship of safety climate and safety performance in hospitals. Health Serv Res 44: pp. 399-421 2008.00918.x" target="_blank" title="It opens in new window">CrossRef
  20. Young, GJ, Charns, MP, Desai, K, Khuri, SF, Forbes, MG, Henderson, W (1998) Patterns of coordination and clinical outcomes: a study of surgical services. Health Serv Res 33: pp. 1211-36
  21. Parmelli, E, Flodgren, G, Schaafsma, ME, Baillie, N, Beyer, FR, Eccles, MP (2011) The effectiveness of strategies to change organisational culture to improve healthcare performance. Cochrane Database Syst Rev 1:
  22. Morey, JC, Simon, R, Jay, GD, Wears, RL, Salisbury, M, Dukes, KA (2002) Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res 37: pp. 1553-81 CrossRef
  23. McCulloch, P, Mishra, A, Handa, A, Dale, T, Hirst, G, Catchpole, K (2009) The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Qual Saf Health Care 18: pp. 109-15 2008.032045" target="_blank" title="It opens in new window">CrossRef
  24. Grogan, EL, Stiles, RA, France, DJ, Speroff, T, Morris, JA, Nixon, B (2004) The impact of aviation-based teamwork training on the attitudes of health-care professionals. J Am Coll Surg 199: pp. 843-8 2004.08.021" target="_blank" title="It opens in new window">CrossRef
  25. Haller, G, Garnerin, P, Morales, M-A, Pfister, R, Berner, M, Irion, O (2008) Effect of crew resource management training in a multidisciplinary obstetrical setting. Int J Qual Health Care 20: pp. 254-63 CrossRef
  26. Auerbach, AD, Sehgal, NL, Blegen, MA, Maselli, J, Alldredge, BK, Vittinghoff, E (2012) Effects of a multicentre teamwork and communication programme on patient outcomes: results from the Triad for Optimal Patient Safety (TOPS) project. BMJ Qual Saf 21: pp. 118-26 2011-000311" target="_blank" title="It opens in new window">CrossRef
  27. Nielsen, PE, Goldman, MBS, Mann, S, Shapiro, DE, Marcus, RG, Pratt, SD (2007) Effects of teamwork training on adverse outcomes and process of care in labor and delivery: a randomized controlled trial. Obstet Gynecol 109: pp. 48-55 250900.53126.c2" target="_blank" title="It opens in new window">CrossRef
  28. Schein, EH (2004) Organizational culture and leadership. Jossey-Bass, San Francisco
  29. Gale, NK, Shapiro, J, McLeod, HST, Redwood, S, Hewison, A (2014) Patients-people-place: developing a framework for researching organizational culture during health service redesign and change. Implement Sci 9: pp. 106 2-014-0106-z" target="_blank" title="It opens in new window">CrossRef
  30. Aarons, GA, Glisson, C, Green, PD, Hoagwood, K, Kelleher, KJ, Landsverk, JA (2012) The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study. Implement Sci 7: pp. 1-15 CrossRef
  31. Scott, T, Mannion, R, Davies, H, Marshall, M (2003) The quantitative measurement of organizational culture in health care: a review of the available instruments. Health Serv Res 38: pp. 923-45 CrossRef
  32. Bradley, EH, Curry, LA, Taylor, LA, Pallas, SW, Talbert-Slagle, K, Yuan, C (2012) A model for scale up of family health innovations in low-income and middle-income settings: a mixed methods study. BMJ Open 2: pp. e000987 2012-000987" target="_blank" title="It opens in new window">CrossRef
  33. Curry, L, Taylor, L, Pallas, SW, Cherlin, E, P茅rez-Escamilla, R, Bradley, EH (2013) Scaling up depot medroxyprogesterone acetate (DMPA): a systematic literature review illustrating the AIDED model. Reprod Health 10: pp. 39 2-4755-10-39" target="_blank" title="It opens in new window">CrossRef
  34. Pallas, SW, Minhas, D, P茅rez-Escamilla, R, Taylor, L, Curry, L, Bradley, EH (2013) Community health workers in low- and middle-income countries: what do we know about scaling up and sustainability?. Am J Public Health 103: pp. e74-82 2105/AJPH.2012.301102" target="_blank" title="It opens in new window">CrossRef
  35. P茅rez-Escamilla, R, Curry, L, Minhas, D, Taylor, L, Bradley, E (2012) Scaling up of breastfeeding promotion programs in low- and middle-income countries: the 鈥渂reastfeeding gear鈥?model. Adv Nutr 3: pp. 790-800 2.002873" target="_blank" title="It opens in new window">CrossRef
  36. Talbert-Slagle, K, Berg, D, Bradley, EH (2013) Innovation spread: lessons from HIV. Int J Qual Health Care 25: pp. 352-6 CrossRef
  37. Ness, PH, Fried, TR, Gill, TM (2011) Mixed methods for the interpretation of longitudinal gerontologic data: insights from philosophical hermeneutics. J Mix Methods Res 5: pp. 293-308 2973" target="_blank" title="It opens in new window">CrossRef
  38. Brown, D, McCormack, BG (2011) Developing the practice context to enable more effective pain management with older people: an action research approach. Implement Sci 6: pp. 9 CrossRef
  39. Chambers, DA, Glasgow, RE, Stange, KC (2013) The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci 8: pp. 117 CrossRef
  40. Edmondson, A (1999) Psychological safety and learning behavior in work teams. Adm Sci Q 44: pp. 350-83 2307/2666999" target="_blank" title="It opens in new window">CrossRef
  41. Garvin, DA (2000) Learning in action: a guide to putting the learning organization to work. Harvard Business School Press, Boston
  42. Leykum, LK, Parchman, M, Pugh, J, Lawrence, V, No毛l, PH, McDaniel, RR (2010) The importance of organizational characteristics for improving outcomes in patients with chronic disease: a systematic review of congestive heart failure. Implement Sci 5: pp. 66 CrossRef
  43. Nembhard, IM, Edmondson, AC (2006) Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Organ Behav 27: pp. 941-66 2/job.413" target="_blank" title="It opens in new window">CrossRef
  44. Pronovost, PJ, Berenholtz, SM, Goeschel, CA, Needham, DM, Sexton, JB, Thompson, DA (2006) Creating high reliability in health care organizations. Health Serv Res 41: pp. 1599-617 2006.00567.x" target="_blank" title="It opens in new window">CrossRef
  45. Tucker, AL, Edmondson, AC, Spear, S (2002) When problem solving prevents organizational learning. J Org Change Mgmt 15: pp. 122-37 210423008" target="_blank" title="It opens in new window">CrossRef
  46. Katz, D, Kahn, RL (1978) The social psychology of organizations. Wiley, New York
  47. Rice, AK (1963) The enterprise and its environment: a system theory of management organization. Tavistock Publications, London
  48. Miller, EJ, Rice, AK (1967) Systems of organization: the control of task and sentient boundaries E.J. Miller and A.K. Rice. Tavistock Publications, London
  49. Nembhard, IM, Cherian, P, Bradley, EH (2014) Deliberate learning in health care: the effect of importing best practices and creative problem solving on hospital performance improvement. Med Care Res Rev 71: pp. 450-71 CrossRef
  50. Damschroder, LJ, Aron, DC, Keith, RE, Kirsh, SR, Alexander, JA, Lowery, JC (2009) Fostering implementation of health services research findings into practice: a consolidated framework for advancing. Implement Sci 4: pp. 50 CrossRef
  51. Greenhalgh, T, Robert, G, Macfarlane, F, Bate, P, Kyriakidou, O (2004) Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 82: pp. 581-629 2004.00325.x" target="_blank" title="It opens in new window">CrossRef
  52. McCannon, C, Berwick, D, Massoud, M (2007) The science of large-scale change in global health. JAMA 298: pp. 1937-9 298.16.1937" target="_blank" title="It opens in new window">CrossRef
  53. Rogers EM. Diffusion of innovations, 4th Edition. Simon and Schuster; 2010.
  54. McCannon, CJ, Perla, RJ (2009) Learning networks for sustainable, large-scale improvement. Jt Comm J Qual Patient Saf 35: pp. 286-91
  55. Yuan, CT, Nembhard, IM, Stern, AF, Brush, JE, Krumholz, HM, Bradley, EH (2010) Blueprint for the dissemination of evidence-based practices in health care. Issue Brief. The Commonwealth Fund.
  56. Lewin, S, Glenton, C, Oxman, AD (2009) Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ 339: pp. b3496-6 CrossRef
  57. Murray, E, Treweek, S, Pope, C, MacFarlane, A, Ballini, L, Dowrick, C (2010) Normalisation process theory: a framework for developing, evaluating and implementing complex interventions. BMC Med 8: pp. 63 CrossRef
  58. Creswell, JW, Clark, VLP (2011) Designing and conducting mixed methods research. Sage Publications, Thousand Oaks
  59. Fetters, MD, Curry, LA, Creswell, JW (2013) Achieving integration in mixed methods designs鈥攑rinciples and practices. Health Serv Res 48: pp. 2134-56 2117" target="_blank" title="It opens in new window">CrossRef
  60. Plano-Clark V, Anderson N, Wertz J, Zhou Y, Schumacher K, Miaskowski C. Conceptualizing longitudinal mixed methods designs: a methodological review of health sciences research. Journal of Mixed Methods Research 2014, Advance online publication.
  61. Banaszak-Holl, J, Nembhard, , Ingrid, ME, Taylor, L, Bradley, EH (2011) Leadership and management: a framework for action. Shortell and Kaluzny鈥檚 Healthcare management: organization design and behavior. Cengage Learning, Clifton Park
  62. Basecamp [https://basecamp.com/].
  63. Patton, MQ (2002) Qualitative research and evaluation methods. Sage Publications, Thousand Oaks
  64. Willis, GB (2005) Cognitive interviewing: a tool for improving questionnaire design. Sage Publications, Thousand Oaks
  American Hospital Association Annual Survey of Hospitals. American Hospital Association, Chicago, IL
  65. Bradley, EH, Curry, LA, Devers, KJ (2007) Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res 42: pp. 1758-72 2006.00684.x" target="_blank" title="It opens in new window">CrossRef
  66. Glaser, BG, Strauss, AL (1967) The discovery of grounded theory: strategies for qualitative research. Aldine, Chicago, IL
  67. O鈥機athain, A, Murphy, E, Nicholl, J (2010) Three techniques for integrating data in mixed methods studies. BMJ 341: pp. c4587-7 CrossRef
  68. Wisdom, JP, Cavaleri, MA, Onwuegbuzie, AJ, Green, CA (2012) Methodological reporting in qualitative, quantitative, and mixed methods health services research articles. Health Serv Res 47: pp. 721-45 2011.01344.x" target="_blank" title="It opens in new window">CrossRef
  69. Malterud, K (2001) Qualitative research: standards, challenges, and guidelines. Lancet 358: pp. 483-8 27-6" target="_blank" title="It opens in new window">CrossRef
  70. Lincoln, YS, Guba, EG (1985) Naturalistic inquiry. SAGE, Newbury Park, CA
  71. English, M, Schellenberg, J, Todd, J (2011) Assessing health system interventions: key points when considering the value of randomization. Bull World Health Organ 89: pp. 907-12 2471/BLT.11.089524" target="_blank" title="It opens in new window">CrossRef
  72. Sudman, S, Bradburn, NM, Schwarz, N (1995) Thinking about answers: the application of cognitive processes to survey methodology. Jossey-Bass, San Francisco
  73. Jones, SRG (1992) Was there a Hawthorne effect?. Am J Sociol 98: pp. 451-68 230046" target="_blank" title="It opens in new window">CrossRef
  74. Denison, DR, Mishra, AK (1995) Toward a theory of organizational culture and effectiveness. Organ Sci 6: pp. 204-23 287/orsc.6.2.204" target="_blank" title="It opens in new window">CrossRef
  75. Kotter, JP, Heskett, JL (2011) Corporate culture and performance. Free Press, New York
  
• 刊物主题：Health Promotion and Disease Prevention; Health Administration; Health Informatics;
• 出版者：BioMed Central
• ISSN：1748-5908

文摘

Background Improving outcomes for patients with acute myocardial infarction (AMI) is a priority for hospital leadership, clinicians, and policymakers. Evidence suggests links between hospital organizational culture and hospital performance; however, few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with AMI. We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL). Methods This manuscript describes the methodology of LSL, a 2-year intervention study using a concurrent mixed methods design, guided by open systems theory and the Assess, Innovate, Develop, Engage, Devolve (AIDED) model of diffusion, implemented in 10 U.S. hospitals and their peer hospital networks. The intervention has three primary components: 1) annual convenings of the ten intervention hospitals; 2) semiannual workshops with guiding coalitions at each hospital; and 3) continuous remote support across all intervention hospitals through a web-based platform. Primary outcomes include 1) shifts in key dimensions of hospital organizational culture associated with lower mortality rates for patients with AMI; 2) use of targeted evidence-based practices associated with lower mortality rates for patients with AMI; and 3) in-hospital AMI mortality. Quantitative data include annual surveys of guiding coalition members in the intervention hospitals and peer network hospitals. Qualitative data include in-person, in-depth interviews with all guiding coalition members and selective observations of key interactions in care for patients with AMI, collected at three time points. Data integration will identify patterns and major themes in change processes across all intervention hospitals over time. Conclusions LSL is novel in its use of a longitudinal mixed methods approach in a diverse sample of hospitals, its focus on objective outcome measures of mortality, and its examination of changes not only in the intervention hospitals but also in their peer hospital networks over time. This paper adds to the methodological literature for the study of complex interventions to promote hospital organizational culture change.