Background/Purpose: The efficiency and effectiveness of patient progression through an episode of hospital care remains a concern after almost three decades of focus. Complex adaptive systems theory suggests that a hospital’s culture is a preeminent factor in the success and sustainability of large scale change and one that is often not well understood by change agents. The purpose of this study was to develop a better understanding of attitudes, beliefs, values, and practices related to transitions in patient care and to determine if any demographic variables were predictors of these key components of culture.
Methods: We conducted a quantitative correlational, cross-sectional study utilizing a convenience sample. The instrument used in the study was the Hospital Survey on Culture of Transitions in Patient Care developed by M. McClelland DNP, RN, CPHQ. The instrument included a series of 23 statements using a Likert scale. All employees were invited to participate. Volunteers, students, and contracted workers were excluded from the study.
Results: Sixty-one respondents answered the survey questions with a broad variability in demographics, including role, department, tenure at the hospital and years of experience. Questions were aggregated into seven domains suggested by the instrument developer with descriptive statistics to examine frequencies. Spearman correlations between demographic variables and question responses showed no significance. However, moderate to strong correlations were found in questions within each domain as expected. Additionally, correlations in many questions between do-mains were significant, most notably between the “My Unit Culture” and “Other Units Culture” do-mains.
Conclusion/Recommendations: To be effective and sustainable, large scale change in hospitals relies on all affected members of the organization to implement and sustain the change to achieve the desired outcome. The study found that the attitudes, beliefs, values, and practices related to transitions in patient care are not influenced by individual roles, departments, tenure, or years of experience. Instead, this finding indicates that they are influenced by a particular organizational culture and not a culture defined by their demographics. In addition, the descriptive and correlational findings provide a baseline to better understand this hospital’s culture related to transitions in patient care for incorporation into change strategy designs.
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Burley, Gwen; McCue, Victoria; Kreiner, Ronye; and Kressly, Dawn, "Hospital Survey on Culture of Transitions in Patient Care at a Community Hospital" (2019). All Publications. 3290.
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