SynthesisBMJ open quality2020
What do we really assess with organisational culture tools in healthcare? An interpretive systematic umbrella review of tools in healthcare.
Synthesis in BMJ open quality, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Cultural competency education for healthcare professionals: an umbrella review.BMC medical education · 2025Pooled it
- Trial
- An exploration of organisational culture in a regional trauma network, in Northern Ireland.European journal of psychotraumatology · 2026Article
- No effect of learning from excellence on patient safety culture in a postanaesthesia care unit: a longitudinal quasi-experimental study.BMC health services research · 2026Observational
- Generative listening leading to generative action to enhance interdisciplinary connections in a specialized referral hospital setting.Clinics (Sao Paulo, Brazil) · 2026Article
- Patient safety culture and climate in Estonian hospitals: a cross-sectional study on employees and background characteristics.BMC health services research · 2026Article
- Changing organizational culture in community sport: a systematic review.Frontiers in sports and active living · 2026Review
- Perceptions of patient safety culture in a teaching hospital in Brazil.BMC health services research · 2025Article
- Patient safety culture through the lenses of surgical patients: a qualitative study.BMC health services research · 2025Article
- Designing an Intervention to Improve Medication Safety for Nursing Home Residents Based on Experiential Knowledge Related to Patient Safety Culture at the Nursing Home Front Line: Cocreative Process Study.JMIR formative research · 2024Article
- Effect of the Green Cross method on patient safety culture in a postanaesthesia care unit: a longitudinal quasi-experimental study.BMJ open quality · 2024Article
- The anatomy of safe surgical teams: an interview-based qualitative study among members of surgical teams at tertiary referral hospitals in Norway.Patient safety in surgery · 2024Article
- Constructing a measure for self-perceived open organizational culture in a university hospital pharmacy.Frontiers in medicine · 2024Article
- Factors determining safety culture in hospitals: a scoping review.BMJ open quality · 2023Article
- Safe Medication in Nursing Home Residents Through the Development and Evaluation of an Intervention (SAME): Protocol for a Fully Integrated Mixed Methods Study With a Cocreative Approach.JMIR research protocols · 2023Article
- The association between patient safety culture and adverse events - a scoping review.BMC health services research · 2023Article
- Open organisational culture: what does it entail? Healthcare stakeholders reaching consensus by means of a Delphi technique.BMJ open · 2021Article
- Overcoming Obstacles to Develop High-Performance Teams Involving Physician in Health Care Organizations.Healthcare (Basel, Switzerland) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA toxic organisational culture (OC) is a major contributing factor to serious failings in healthcare delivery. Poor OC with its consequences of unprofessional behaviour, unsafe attitudes of professionals and its impact on patient care still need to be addressed. Although various tools have been developed to determine OC and improve patient safety, it remains a challenge to decide on the suitability of tools for uncovering the underlying factors which truly impact OC, such as behavioural norms, or the unwritten rules. A better understanding of the underlying dimensions that these tools do and do not unravel is required.
objectivesThe aim of this study is to provide an overview of existing tools to assess OC and the tangible and intangible OC dimensions these tools address.
methodsAn interpretive umbrella review was conducted. Literature reviews were considered for inclusion if they described multiple tools and their dimensional characteristics in the context of OC, organisational climate, patient safety culture or climate. OC tools and the underlying dimensions were extracted from the reviews. A qualitative data analysis software program (MAX.QDA 2007) was used for coding the dimensions, which resulted in tangible and intangible themes.
resultsFifteen reviews met our inclusion criteria. A total of 127 tools were identified, which were mainly quantitative questionnaires covering tangible key dimensions. Qualitative analyses distinguished nine intangible themes (commitment, trust, psychological safety, power, support, communication openness, blame and shame, morals and valuing ethics, and cohesion) and seven tangible themes (leadership, communication system, teamwork, training and development, organisational structures and processes, employee and job attributes, and patient orientation).
conclusionThis umbrella review identifies the essential tangible and intangible themes of OC tools. OC tools in healthcare do not seem to be designed to determine deeper underlying dimensions of culture. We suggest approaching complex underlying OC problems by focusing on the intangible dimensions, rather than putting the tangible dimensions up front.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.