The Effect of the Fit Between Organizational Culture and Structure on Medication Errors in Medical Group Practices

Details

• Personal Author:
  Dowd B ; Heaton A ; Kaissi A ; Kralewski J
• Description:
  BACKGROUND: It is widely acknowledged that many prescription drug errors occur in the ambulatory care setting and that they have serious quality of care implications. Previous research examining this issue has focused on hospitals and on individual-level factors. This study adopts an organizational perspective to assess the effects of organizational culture, organizational structure, and their fit (i.e., their congruence) on medication errors in medical group practices. METHODOLOGY/APPROACH: Variables that measure the organizational culture and structure were taken from two surveys of medical group practices in Minnesota in 2001. Medication errors data were obtained using a computerized drug utilization review system. Seventy-eight medical group practices were included in the analyses. FINDINGS: Results revealed that the use of benchmarking and practice guidelines was associated with decreased error rates in group practices that encourage "patient emphasis" and "collegiality." However, the relationship between information processing capacity and the cultural dimensions was not statistically significant. PRACTICE IMPLICATIONS: The interaction between specific cultural traits and structural dimensions can help understand some of the relationships between organizational culture, structure, and medication errors. Organizational structures do not exist in a vacuum, but rather their effect on patient safety outcomes is "moderated" by the organizational culture. The implications are that medical group practice administrators and medical directors have alternate ways to prevent or reduce medication errors and that they should be attentive to the cultures of their practices when considering those options. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Health Care Facilities Workforce And Services Health Personnel Occupational Health Preventive Medicine Risk Assessment Safety Safety Management Surveys And Questionnaires
• Keywords:
  Health-care Health-protection Health-services Health-surveys Medical-care Medical-facilities Medical-personnel Medical-services Medical-surveys Medical-treatment Preventive-medicine Prophylaxis Quantitative-analysis Risk-analysis Safety-education Safety-measures Safety-practices Standards Statistical-analysis Treatment Work-operations Work-organization Work-practices

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• ISSN:
  0361-6274
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Minnesota ; OSHA Region 5 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  12-21
• Volume:
  32
• Issue:
  1
• NIOSHTIC Number:
  nn:20037549
• Citation:
  Health Care Manage Rev 2007 Jan-Mar; 32(1):12-21
• Contact Point Address:
  Amer Kaissi, Department of Health Care Administration, Trinity University, San Antonio, Texas
• Email:
  amer.kaissi@trinity.edu
• Federal Fiscal Year:
  2007
• Performing Organization:
  University of Minnesota Twin Cities
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Health Care Management Review
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:52291d832fbc307b8dab61e6d1c5c8e55d9d387a5906d4fc5c4494ca39f2b01420ccbd282a5f0be1037bb80ec35838fbf0f40bc44a758d3ee1bdc38fd2924145
• Download URL:
  https://stacks.cdc.gov/view/cdc/188626/cdc_188626_DS1.pdf
• File Type:
  [PDF - 160.12 KB ]