5 Culture Mistakes to Avoid in Hospitals

Posted on February 22, 2022 by Kylene Ordway

From reducing medical errors, staff turnover, or increasing patient collections, there are common areas that hospitals tend to focus on when wanting to reduce errors and improve their bottom line. But one area that is often overlooked is hospital culture.

Culture is hard to define but is essentially the collective behavior of your workforce. It is the behavior your hospital — whether consciously or unconsciously — rewards, encourages, or tolerates and can have a huge impact on everything from staff turnover to the bottom line.

These five mistakes could be damaging the culture of your hospital. Here’s how to identify them and work toward a healthier staff culture.

Acceptance of shortcuts as complexity grows

Hospitals are high-stress environments. Patients require varying degrees of complex care and urgency. This can lead to a stretching of resources and an attitude that staff must work around obstacles to save time rather than work through them.

Unfortunately, working outside the system can lead to medical or financial errors and put staff at risk if something goes wrong. Hospital staff needs to know that they can follow procedures and that this behavior is noticed and rewarded. Too often staff feels pressured into taking shortcuts to deal with increased patient complexities or time constraints.

Standardization is seen as bureaucracy

One way to reduce shortcuts is to introduce protocols or guidelines for staff to follow. Unfortunately, some staff will see standardization of procedures as undermining their abilities or as bureaucratic measures that don’t provide the protection they seek to instill.

It is up to hospitals to collaboratively work to bring in protocols that staff will see a need for, belief will make a difference, and will actively work to implement. Buy-in is needed from leaders on the ground as well as at the C-suite level. Safety and efficiency protocols should be developed with staff input. The end result should be guidelines that exist to save lives, and improve processes and not just create extra work for the staff.

Lack of internal oversight to proactively improve measures

In industries where companies are considered solely responsible for the safety of their products, risk management focuses on preventing errors and detecting situations that lead to them. In healthcare, hospitals are usually focused on ensuring they have the staffing and resources to function adequately. With much focus on external factors, they often lack the internal insight needed to proactively prevent errors before they happen. Developing internal procedures that can analyze areas for improvement is essential.

Personal failure is viewed as unacceptable

It may sound counterintuitive, but cultures that only accept a perfectionist attitude don’t breed perfection. Instead, secrecy and a sense of shame tend to flourish. Operating within a culture that has a zero-tolerance of mistakes only leads to an increase in stress and a belief that making mistakes makes your staff bad at their job.

Mistakes can and will happen amongst all levels of your staff. Creating a culture that fosters transparency, personal responsibility, and reporting of errors is the only way to improve. A culture that also views mistakes as opportunities for improvement is more likely to see an increase in reporting. Staff are more likely to report the barriers that make their jobs more difficult if they know that reporting will lead to improvements.

Focusing on personal accountability rather than system accountability

Hospitals that seek to introduce more transparency into their organizations should do so by focusing on making systems accountable rather than individual persons. A culture where staff self-report mistakes will only improve if the mistakes are analyzed from a system or process point of view.

A high-reliability culture should seek to improve the outcomes of the organization as a whole, not just focus on how one individual was responsible for the error. An environment that punishes or focuses heavily on the individual could result in a lack of reporting or an environment where peers may feel responsible for their co-workers losing their job if they report errors. Of course, there will always be times when a person’s individual actions were the error. However, a culture of transparency will not take hold without looking at how individuals work inside the larger system.

Identifying and fixing these cultural mistakes will have a positive flow-on effect from many other parts of your practice — from staff turnover to fewer medical and financial errors, and an improved bottom line.

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