Document Detail

"The People not the Policy": Quality Improvement, Junior Doctors, and Cultural Change.
MedLine Citation:
PMID:  21725215     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: : Health care is a highly regulated environment. This has driven what could be characterized as a paper-safe approach, whereby organizations are required to demonstrate to a multiplicity of regulators, inspectorates, and accrediting bodies that they are paper safe. However, for many organizations, this has not produced a system that is actually patient safe; rather, it has in practice operated as a parallel system that does not reflect the true state of safety. This project looks at a quality improvement and patient safety program and critically asks the question of whether it is flawed because of failure to address issues surrounding doctors and cultural change.
METHODS: : Johnson & Schole's cultural web framework was used to explore the attitudes of junior doctors toward a patient safety and quality improvement program. Data collection was through the use of focus groups backed up with quantitative data from a web based questionnaire survey.
RESULTS: : It has been demonstrated that doctors represent a dominant subculture within the National Health Service and their beliefs, attitudes, and value are often at odds or unrecognized by senior health care managers.
CONCLUSIONS: : Unless the cultural differences are adequately addressed, transformational change projects such as "Best & Safest Care" are unlikely to succeed. A better understanding of the organizational context allows for more appropriate change interventions to be developed.
Paul Grant
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Quality management in health care     Volume:  20     ISSN:  1550-5154     ISO Abbreviation:  Qual Manag Health Care     Publication Date:    2011 Jul-Sep
Date Detail:
Created Date:  2011-07-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9306156     Medline TA:  Qual Manag Health Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  168-75     Citation Subset:  H    
St. Thomas' Hospital, Lambeth Palace Road, London, England.
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