ArticleBMC health services research2017
Understanding middle managers' influence in implementing patient safety culture.
Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- The moderating role of self-efficacy in influencing the level of competencies among Middle Nurse Managers: A cross-sectional study.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Article
- Evaluations of nurse managers' work environment: a descriptive study.BMC nursing · 2026Article
- Managerial perceptions of core competencies for healthcare middle managers in Bahrain and Saudi Arabia: a qualitative study.International journal of medical education · 2026Article
- First Line Managers' Experiences of Shaping Organisational and Relational Preconditions for Patient Safety in Swedish Intensive Care Units During the COVID-19 Pandemic: A Qualitative Study.Journal of nursing management · 2026Article
- First-line managers' experience of guideline implementation during the COVID-19 pandemic.Journal of advanced nursing · 2025Article
- The Effect of Work Environment and Work-Related Characteristics on Perceived Individual Work Performance of Front-Line Nurse Managers: A Cross-Sectional Study.Research in nursing & health · 2025Article
- First-line managers' experience of guideline implementation in orthopaedic nursing and rehabilitation: a qualitative study.BMC health services research · 2024Article
- Managing patient safety and staff safety in nursing homes: exploring how leaders of nursing homes negotiate their dual responsibilities-a case study.Frontiers in health services · 2024Article
- Patient safety culture in neonatal intensive care units: A qualitative content analysis.Frontiers in public health · 2023Article
- Use of Performance Data by Mid-Level Hospital Managers in Ontario: Results of a Province-Wide Survey and a Comparison with Hospital Managers in Europe.Healthcare policy = Politiques de sante · 2022Article
- The roles, activities and impacts of middle managers who function as knowledge brokers to improve care delivery and outcomes in healthcare organizations: a critical interpretive synthesis.BMC health services research · 2022Review
- Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.Learning health systems · 2021Article
- Staying ahead of the curve: avigating changes and maintaining gains in patient safety culture - a mixed-methods study.BMJ open · 2021Article
- Acting between guidelines and reality- an interview study exploring the strategies of first line managers in patient safety work.BMC health services research · 2021Article
- Exploring the role of managers in the development of a safety culture in seven French healthcare facilities: a qualitative study.BMC health services research · 2020Article
- Article
- Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey.BMJ open · 2019Article
- Using Phenomenological Hermeneutics to Understand the Experiences of Managers Working with Quality Improvement Strategies in an Assisted Living Facility.Healthcare (Basel, Switzerland) · 2019Article
- Associations among unit leadership and unit climates for implementation in acute care: a cross-sectional study.Implementation science : IS · 2018Article
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Authors and funding
2 authors.
Funding
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Abstract
backgroundThe past fifteen years have been marked by large-scale change efforts undertaken by healthcare organizations to improve patient safety and patient-centered care. Despite substantial investment of effort and resources, many of these large-scale or "radical change" initiatives, like those in other industries, have enjoyed limited success - with practice and behavioural changes neither fully adopted nor ultimately sustained - which has in large part been ascribed to inadequate implementation efforts. Culture change to "patient safety culture" (PSC) is among these radical change initiatives, where results to date have been mixed at best. DISCUSSION: This paper responds to calls for research that focus on explicating factors that affect efforts to implement radical change in healthcare contexts, and focuses on PSC as the radical change implementation. Specifically, this paper offers a novel conceptual model based on Organizational Learning Theory to explain the ability of middle managers in healthcare organizations to influence patient safety culture change. We propose that middle managers can capitalize on their unique position between upper and lower levels in the organization and engage in 'ambidextrous' learning that is critical to implementing and sustaining radical change. This organizational learning perspective offers an innovative way of framing the mid-level managers' role, through both explorative and exploitative activities, which further considers the necessary organizational context in which they operate.
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