Major cultural-compatibility complex: considerations on cross-cultural dissemination of patient safety programmes
- 1Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- 2Department of Emergency Medicine, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- 3Department of Anesthesiology and Critical Care Medicine, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- 4Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 5Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Correspondence to Dr Heon-Jae Jeong, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N Broadway, Room 406, Baltimore, MD 21205, USA;
Contributors H-JJ and JCP brought together their cumulative experiences and initiated this manuscript, for which they are the guarantors. MK contributed the business perspective and theoretical background of social sciences to the manuscript. CE's work experience from the patient safety programme and global hand hygiene campaign at WHO enriched the manuscript with examples dealing with conflicts intercultural dissemination may encounter. PJP provided insights from his experience disseminating patient safety movements in diverse cultural settings. H-JJ and MK drafted the manuscript, which was then reviewed and augmented by JCP and PJP.
- Accepted 25 December 2011
- Published Online First 10 February 2012
As the importance of patient safety has been broadly acknowledged, various improvement programmes have been developed. Many of the programmes with proven efficacy have been disseminated internationally. However, some of those attempts may encounter unexpected cross-cultural obstacles and may fail to harvest the expected success. Each country has different cultural background that has shaped the behavior of the constituents for centuries. It is crucial to take into account these cultural differences in effectively disseminating these programmes. As an organ transplantation requires tissue-compatibility between the donor and the recipient, there needs to be compatibility between the country where the program was originally developed and the nation implementing the program. Though no detailed guidelines exist to predict success, small-scale pilot tests can help evaluate whether a safety programme will work in a new cultural environment. Furthermore, a pilot programme helps reveal the source of potential conflict, so we can modify the original programme accordingly to better suit the culture to which it is to be applied. In addition to programme protocols, information about the cultural context of the disseminated programme should be conveyed during dissemination. Original programme designers should work closely with partnering countries to ensure that modifications do not jeopardise the original intention of the programme. By following this approach, we might limit barriers originating from cultural differences and increase the likelihood of success in cross-cultural dissemination.
- Patient safety
- health policy
- healthcare quality improvement
- human error
- safety culture
- emergency department
- adverse events
- epidemiology and detection
- critical care
- evidence-based medicine
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.