Hospital culture and organization of care, including factors like the values and goals of the organization, and senior management involvement, may explain the wide range in mortality rates among patients treated for heart attacks in US hospitals, says a new study.
Researchers at Yale University reviewed 11 hospitals through interviews and site visits. Those selected were among the best and worst performers, as rated by the federal agency that administers Medicare and Medicaid.
"We were particularly interested in the roles of social interactions and organizational culture, which are difficult to measure using common research approaches like surveys," said Leslie A. Curry, research scientist at the Yale Global Health Leadership Institute and lead author on the paper.
Hospitals in the high- and low-performing groups differed substantially in five ways: organizational values and goals, senior management involvement, broad staff presence and expertise in AMI care, communication and coordination, and problem solving.
Curry says that achieving high performance may require long-term investment and concerted efforts to create an organizational culture that supports full engagement in quality, strong communication and coordination among groups, and capacity for problem solving and learning across the organization.
The study appears in the March issue of the Annals of Internal Medicine.