Who Applies an Intervention to Influence Cultural Attributes in a Quality Improvement Collaborative?
Abstract
Objectives: Organizational culture change has been recognized as one of the promising ways to reduce error and increase safety. However, it is still unclear what factors support health care teams implementing interventions aimed to influence the cultural attributes that bolster continuous quality improvement. This study aimed to identify factors related to teams' adoption of the Comprehensive Unit-based Safety Program (CUSP), an approach to improving patient safety culture among intensive care units (ICUs) participating in a bloodstream infection reduction collaborative. Methods: We analyzed data from the 103 ICUs participating in the Keystone ICU project. We conducted logistic regressions to assess baseline factors associated with ICU teams’ use of CUSP. Predictors included safety climate scales (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions) as measured by the Safety Attitudes Questionnaire, central line-associated bloodstream infection rates, bloodstream infection prevention intervention phase, ICU type, hospital bed size, and hospital teaching status. Results: Intensive care units with lower perceived safety climate, greater stress recognition, higher perceptions of management, and better working conditions were more likely to adopt CUSP. Intensive care units that implemented the infection prevention interventions late were less likely to adopt CUSP. Mixed ICUs and ICUs in large hospitals were also less likely to use CUSP. Conclusions: Staff-perceived safety climate, ICU type, and hospital size were related to ICUs’ implementation of CUSP. Better baseline safety climate or lower perceived organizational support reduced uptake. The findings can help hospital leaders and collaborative experts identify units that are less likely to implement cultural interventions.
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Teamwork climate was not significantly associated with adoption of a comprehensive safety program in intensive care units.
“The first study found that teamwork climate (i.e., perceived quality of collaboration between personnel) was not significantly associated with adoption of a comprehensive safety program in intensive care units, although there were associations between adoption and organizational constructs (e.g., lower safety climate, more management support) [59].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [59]
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- Authors
- Hsu, Y.-J., & Marsteller, J. A.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Marsteller, Jill A.
- Venue
- Journal of Patient Safety
- Published
- 2015-07-09
- Volume
- 16
- Issue
- 1
- Pages
- 1-6
- ISSN
- 1549-8417 (ISSN-L)
- 1549-8425
- OpenAlex
- W2321463437
- Cited by
- 8
- References
- 48
- Citations by year
- 2025: 1 · 2024: 4 · 2021: 1 · 2020: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Patient Safety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- Comprehensive Unit-based Safety Program, patient safety culture, organizational culture change, intensive care unit, central line-associated bloodstream infection, infection prevention interventions, safety climate, intervention adoption, teamwork climate, working conditions, hospital size
- MeSH terms
- Female, Humans, Male, Safety Management, Quality Improvement
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