Exploring the Association Between Organizational Culture and Large-Scale Adverse Events: Evidence from the Veterans...

Area of Science:

• Healthcare management
• Patient safety
• Organizational psychology

Background:

• Large-scale adverse events (LSAEs) are system-related patient safety incidents.
• A supportive organizational culture is theorized to mitigate LSAEs, but this link is understudied.
• This research investigates the association between staff perceptions of organizational culture and LSAE incidence.

Purpose of the Study:

• To determine if staff perceptions of organizational culture are associated with the occurrence of LSAEs.
• To explore specific cultural factors, including employee engagement, that may influence LSAE incidence.
• To identify potential protective factors within organizational culture against system-related patient safety events.

Main Methods:

• Exploratory analysis of 2008-2010 US Department of Veterans Affairs All Employee Survey (AES) data.
• Comparison of two facilities with LSAEs against four matched facilities without LSAEs.
• Logistic regression analysis of workgroup-level and hospital-level cultural factors, with individual staff as the unit of analysis.

Main Results:

• Facilities with LSAEs reported significantly lower mean scores for 9 out of 10 assessed cultural factors compared to control facilities.
• Employee engagement emerged as a significant predictor of LSAE incidence (OR=0.58, 95% CI=0.37-0.90).
• Staff at LSAE facilities perceived their organizational culture as less supportive.

Conclusions:

• A less supportive organizational culture, characterized by lower employee engagement, may be a contributing factor to LSAEs.
• Enhancing employee engagement and fostering a supportive culture could be key strategies to prevent LSAEs.
• Findings underscore the critical role of organizational culture in large-scale patient safety.