Improving quality and safety in the hospital: The link between organizational culture, burnout, and quality of care

摘要

The need to improve quality of care represents a major goal of all health care systems. The objective of this series is to illuminate how the contextual factors of hospitals from eight European countries, and the well-being of their healthcare professionals, contribute to either construct or degrade quality of care. The studies reported here provide an important bottom-up perspective on quality of care, and the way that burnout and organizational culture are intertwined within it. Overall, the collected studies represent an in-depth examination through focus groups of the experiences of 153 physicians, 133 nurses, and 46 patients from Greece, Portugal, Bulgaria, Romania, Ireland, Turkey, Croatia, and the Republic of Macedonia. Each paper makes a unique contribution to the understanding of how institutional contexts, organizational management, and job characteristics impose constrains, both on the capacity of health workers for better treatment decisions and choices, but also on their day-to-day professional satisfaction and quality of life. Taken as a whole, the papers make an even greater contribution, by pointing out the underlying similarities and differences across these eight European countries. Statement of contribution What is already known on this subject? Organizational factors play a crucial role in the development of health professionals' job burnout, which in turn impacts the patient experience and quality of care. What does this study add? We discuss the impact of highly contextualized organizational cultures in hospitals from eight European countries on health professionals' burnout and quality of medical care.Despite the diversity of the countries reporting research data, significant patterns with regard to quality of care and job strain were identified. We propose that improving quality of care requires not only the understanding of the clinical environment, health workers' motivation and commitment, but also patients' needs and literacy, health policy, and the social and political context in which health services are delivered.