| The guiding principles of the Culture of Patient Safety in healthcare include promotion of an environment where teamwork is fostered; there is unfettered communication between team members, and openness about errors. Declining scores on the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety led leadership to look for additional ways to evaluate culture. This quantitative, non-experimental correlational study was carried out in the Pharmacy at Maine Medical Center. The purpose of this study was to understand the underlying organizational culture and any influence that has on the perceptions of the culture of patient safety. The Organizational Culture Assessment Inventory (OCAI) survey tool with Competing Values Framework (CVF) ipsative forced choice scaling (0-100) was administered via Survey Monkey to all 140 members of the Department. This study compared previously collected AHRQ Patient Survey (26 questions using Likert 1 -- 5 scale) data with OCAI survey responses that measured the structure and the leadership of the Pharmacy in the realms of Dominant Characteristics, Organizational Leadership, Management of Employees, Organizational Glue, Strategic Emphasis, Criteria of Success, and the Dominant Culture. The OCAI survey responses then divide into the subsets of Clan (Collaborate), Adhocracy (Create), Market (Compete), and Hierarchical (Control) Culture. One hundred and three people from the Pharmacy contributed to the OCAI survey data. Clan culture, characterized by teamwork and collaboration, ranked highest for Dominant Culture, Dominant Characteristics, and Management of Employees. Adhocracy, which emphasizes vision and innovation, ranked highest in Strategic Emphasis. Market culture's orientation on competition and market share, ranked highest in Organizational Leadership. Hierarchy, the culture of control, efficiency, and uniformity, rated highest in Organizational Glue and Criteria of Success. One hundred and twenty seven people participated the AHRQ survey. AHRQ raw scores were converted in Percent of Possible Maximum score and analyzed with the OCAI raw scores on an equal 0 -- 100 scale. After establishing non-normality of the data, correlation was completed using Spearman's which calculated correlation between AHRQ Patient Safety Scores and OCAI quadrants: Clan culture (r (228) = 0.05, p > 0.05), Adhocracy (r (228) = 0.03, p > 0.05), Market (r (228) = -0.02, p > 0.05) and Hierarchy (r = (228) 0.03, p > 0.71). No statistically significant findings were found on correlation testing which supported the hypothesis that, in this small study, none of the OCAI culture quadrants were interrelated with scores of the perception of patient safety. The reasons for the declining scores of the perceptions of patient safety could not be elicited from this study. Future research looking at sub-sets of the AHRQ survey questions and their correlation with OCAI quadrants could provide more specific information on the cultural factors that could be influencing the perception of patient safety. |
