PT - JOURNAL ARTICLE AU - T Speroff AU - S Nwosu AU - R Greevy AU - M B Weinger AU - T R Talbot AU - R J Wall AU - J K Deshpande AU - D J France AU - E W Ely AU - H Burgess AU - J Englebright AU - M V Williams AU - R S Dittus TI - Organisational culture: variation across hospitals and connection to patient safety climate AID - 10.1136/qshc.2009.039511 DP - 2010 Dec 01 TA - Quality and Safety in Health Care PG - 592--596 VI - 19 IP - 6 4099 - http://qualitysafety.bmj.com/content/19/6/592.short 4100 - http://qualitysafety.bmj.com/content/19/6/592.full SO - Qual Saf Health Care2010 Dec 01; 19 AB - Context Bureaucratic organisational culture is less favourable to quality improvement, whereas organisations with group (teamwork) culture are better aligned for quality improvement.Objective To determine if an organisational group culture shows better alignment with patient safety climate.Design Cross-sectional administration of questionnaires.Setting 40 Hospital Corporation of America hospitals.Participants 1406 nurses, ancillary staff, allied staff and physicians.Main outcome measures Competing Values Measure of Organisational Culture, Safety Attitudes Questionnaire (SAQ), Safety Climate Survey (SCSc) and Information and Analysis (IA).Results The Cronbach alpha was 0.81 for the group culture scale and 0.72 for the hierarchical culture scale. Group culture was positively correlated with SAQ and its subscales (from correlation coefficient r=0.44 to 0.55, except situational recognition), ScSc (r=0.47) and IA (r=0.33). Hierarchical culture was negatively correlated with the SAQ scales, SCSc and IA. Among the 40 hospitals, 37.5% had a hierarchical dominant culture, 37.5% a dominant group culture and 25% a balanced culture. Group culture hospitals had significantly higher safety climate scores than hierarchical culture hospitals. The magnitude of these relationships was not affected after adjusting for provider job type and hospital characteristics.Conclusions Hospitals vary in organisational culture, and the type of culture relates to the safety climate within the hospital. In combination with prior studies, these results suggest that a healthcare organisation's culture is a critical factor in the development of its patient safety climate and in the successful implementation of quality improvement initiatives.