The Culture of Healthcare Organizations
In the healthcare environment there are many competing variables in the culture of an organization. The conflicting needs of patients, families, providers, institutions, regulators, etc. create many inconsistencies and mixed messages. In addition to the issues of hierarchy mentioned earlier, there are “silos,” where each role or unit operates independently, without understanding the full implications of its actions on others.
Many have said that a culture of blame has been pervasive in healthcare. Because medicine was often viewed as the work of a sole physician (or other professional) working with an individual patient, when something did not go well the automatic reaction was to try to determine who was at fault and, often, to discipline them. This “shame and blame” approach leads to hiding rather than reporting of errors, and thus is the antithesis of a culture of safety. Recent efforts have tried to change this—to encourage people to report problems rather than hide them, so they can be addressed. Forward-thinking healthcare organizations remember that their primary reason for existence is to take care of patients, and they want to keep them as safe and healthy as possible.