A new study published in the Annals of Internal Medicine offers insights into what distinguishes high-performing and low performing with regard to deaths of heart attack patients under their care. It’s not the training of the doctors or the investment in high-tech equipment. It’s the organizational culture that makes the greatest difference.
As Dr. Pauline Chen reports in her blog posting in the NY Times this week:
While business executives have long understood the impact of an organization’s culture on the bottom line, it has not been clear if those same qualities could affect how well patients do.
“It’s how people communicate, the level of support and the organizational culture that trump any single intervention or any single strategy that hospitals frequently adopt,” said Elizabeth H. Bradley, senior author and faculty director of the Yale Global Health Leadership Institute at Yale University.
Rather, it was the approach to challenging patient care issues that seemed to set institutions apart. A hospital might discover, for example, that a heart attack patient who returned to the hospital with severe edema, or swelling, might have been discharged without her prescribed diuretic.
At a low-performing hospital, such an error might result in doctors, nurses and pharmacists on the front lines blaming one another and hospital leaders taking care to remain uninvolved. But clinicians and leaders at a high-performing hospital would be eager to address the error, acknowledging it without disparaging one another and working together to re-examine and, if necessary, reconfigure the hospital’s discharge process.
Culture Saves Lives!