Culture Improvement in Surgery
Culture refers to shared attitudes, beliefs, and patterns of behaviour that determine what is normal or expected, and ultimately determine how a group or organization functions. It’s “the way we do things around here.” In healthcare, culture includes topics like teamwork, communication, dedication to safety, stress recognition, just culture, and leadership.
A positive culture is associated with better outcomes for patients and a better experience for providers. The Joint Commission identified communication breakdown as the most common factor implicated in adverse events. Academic evidence shows a correlation between strong teamwork and high quality of care. We are beginning to see culture-related interventions improve clinical outcomes and reduce adverse events.
How do we make culture change a part of our work?
Any hospital, unit, or individual can make a difference. Culture is about the way we work, so we can apply a culture lens to everything and anything we do. For example, if there is a scheduled in-service education session you could deliver content on communication or teamwork. If you’re working on clinical changes (catheter insertion to reduce UTIs, antibiotic timing to reduce SSIs, oral care to reduce ventilator-associated pneumonia, to name a few) you could look at the role of culture as part of your improvement plan.
See the Resources page for ideas and tools.
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 Disease-Specific Care Certification – National Patient Safety Goals. Oak Brook Terrace (IL): The Joint Commission; 2008. Available from: http//www.jointcommision.org.
Manser, T. 2009. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand 53: 143–151.
 Neily, J. 2010. Association Between Implementation of a Medical Team Training Program and Surgical Mortality JAMA 304(15): 1693-1700.