Literature DB >> 25502553

Organizational culture affecting quality of care: guideline adherence in perioperative antibiotic use.

Naoto Ukawa1, Masayuki Tanaka1, Toshitaka Morishima1, Yuichi Imanaka1.   

Abstract

OBJECTIVE: The objective of this work was to elucidate aspects of organizational culture associated with hospital performance in perioperative antibiotic prophylaxis using quantitative data in a multicenter and multidimensional study.
DESIGN: Cross-sectional retrospective study using a survey data and administrative data.
SETTING: Eighty-three acute hospitals in Japan. PARTICIPANTS: A total of 4856 respondents in the organizational culture study, and 23 172 patients for the quality indicator analysis. MAIN OUTCOME MEASURE: Multilevel models of various cultural dimensions were used to analyze the association between hospital organizational culture and guideline adherence. The dependent variable was adherence or non-adherence to Japanese and CDC guidelines at the patient level and main independent variable was hospital groups categorized according to organizational culture score. Other control variables included hospital characteristics such as ownership, bed capacity, region and urbanization level of location.
RESULTS: The multilevel analysis showed that hospitals with a high score in organizational culture were more likely to adhere to the Japanese and CDC guidelines when compared with lower scoring hospitals. In particular, the hospital group with high scores in the 'collaboration' and 'professional growth' dimensions had three times the odds for Japanese guideline adherence in comparison with low-scoring hospitals.
CONCLUSIONS: Our study revealed that various aspects of organizational culture were associated with adherence to guidelines for perioperative antibiotic use. Hospital managers aiming to improve quality of care may benefit from improving hospital organizational culture.
© The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Entities:  

Keywords:  antibiotic use; health-care-associated infections; multilevel model; quality culture; quality indicators

Mesh:

Year:  2014        PMID: 25502553     DOI: 10.1093/intqhc/mzu091

Source DB:  PubMed          Journal:  Int J Qual Health Care        ISSN: 1353-4505            Impact factor:   2.038


  6 in total

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6.  Development and Pilot Testing of Quality Indicators for Primary Care in Japan.

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