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Medical Care Research and Review
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What's this?

Relationship of Hospital Organizational Culture to Patient Safety Climate in the Veterans Health Administration

Christine W. Hartmann

Center for Health Quality, Outcomes, and Economic Research, Bedford, MA and Boston University, christine.hartmann{at}va.gov

Mark Meterko

Boston University and Center for Organization, Leadership, and Management Research, Boston, MA

Amy K. Rosen

Center for Health Quality, Outcomes, and Economic Research, Bedford, MA and Boston University

Shibei Zhao

Center for Health Quality, Outcomes, and Economic Research, Bedford, MA

Priti Shokeen

Center for Health Quality, Outcomes, and Economic Research, Bedford, MA

Sara Singer

Harvard School of Public Health, Boston, MA

David M. Gaba

Stanford University and VA Palo Alto Healthcare System, Palo Alto, CA

Improving safety climate could enhance patient safety, yet little evidence exists regarding the relationship between hospital characteristics and safety climate. This study assessed the relationship between hospitals' organizational culture and safety climate in Veterans Health Administration (VA) hospitals nationally. Data were collected from a sample of employees in a stratified random sample of 30 VA hospitals over a 6-month period (response rate = 50%; n = 4,625). The Patient Safety Climate in Healthcare Organizations (PSCHO) and the Zammuto and Krakower surveys were used to measure safety climate and organizational culture, respectively. Higher levels of safety climate were significantly associated with higher levels of group and entrepreneurial cultures, while lower levels of safety climate were associated with higher levels of hierarchical culture. Hospitals could use these results to design specific interventions aimed at improving safety climate.

Key Words: patient safety • safety culture • safety climate • organizational culture • survey research

This version was published on June 1, 2009

Medical Care Research and Review, Vol. 66, No. 3, 320-338 (2009)
DOI: 10.1177/1077558709331812
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