Organizational culture, critical success factors, and the reduction of hospital errors

The problem of errors in patient care is a critical issue facing hospitals today. An Institute of Medicine [To err is human, building a safer health system. Washington DC: National Academy Press.] study estimates that medical errors are linked to more than 98,000 deaths annually, and that 58% of these error-related deaths are preventable. This paper investigates how organizational culture and specific management techniques (termed critical success factors (CSFs) in this paper) may lead to the reduction of medical errors in US hospitals. We draw on several different streams of literature, including medical safety, total quality management (TQM), and organizational culture, to develop a conceptual framework for the reduction of hospital errors. The results of a survey of more than 500 hospitals suggest that some characteristics of organizational culture are more likely to be associated with error reduction than other characteristics. In addition, the implementation of a set of CSFs is associated with error reduction as well. We conclude with implications and suggestions for future research. r 2006 Elsevier B.V. All rights reserved.