ArticleBMJ open2021
Open organisational culture: what does it entail? Healthcare stakeholders reaching consensus by means of a Delphi technique.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Factors of the Nursing Practice Environment Shaping Nurses' Perceived Benefits of Adverse Event Reporting: A Cross-Sectional Study Among Primary Healthcare Nurses.Healthcare (Basel, Switzerland) · 2026Article
- Culture eats evidence for breakfast: how culture influences implementation of evidence-based practices.Implementation science communications · 2026Article
- Generative listening leading to generative action to enhance interdisciplinary connections in a specialized referral hospital setting.Clinics (Sao Paulo, Brazil) · 2026Article
- Enlightened Change Agents or Nuisance Power? A Qualitative Interview Study Exploring How Hospital Board Members Deal with Dissenting Opinions.Advances in medical education and practice · 2026Article
- Factors Influencing Clinical Reasoning Among Clinical Nurses: An Integrative Review Using the Decision-Making Ecology Model.Journal of nursing management · 2026Review
- Key tips to shift student perspectives through transformative learning in medical education.BMC medical education · 2025Review
- Unravelling clinicians' shared decision-making adoption: a qualitative exploration through the lens of diffusion of innovations theory.BMJ open · 2024Article
- How do cultural elements shape speak-up behavior beyond the patient safety context? An interprofessional perspective in an obstetrics and gynecology department.Frontiers in medicine · 2024Article
- Constructing a measure for self-perceived open organizational culture in a university hospital pharmacy.Frontiers in medicine · 2024Article
- Lessons learned spanning 17 years of experience with three consecutive nationwide competency based medical education training plans.Frontiers in medicine · 2024Article
- Article
- Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators.BMC medical education · 2022Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOpen organisational culture in hospitals is important, yet it remains unclear what it entails other than its referral to 'open communication' in the context of patient safety. This study aims to identify the elements of an open hospital culture.
methodsIn this group consensus study with a Delphi technique, statements were constructed based on the existing patient safety literature and input of 11 healthcare professionals from different backgrounds. A final framework consisting of 36 statements was reviewed on inclusion and exclusion, in multiple rounds by 32 experts and professionals working in healthcare. The feedback was analysed and shared with the panel after the group reached consensus on statements (>70% agreement).
resultsThe procedure resulted in 37 statements representing tangible (ie, leadership, organisational structures and processes, communication systems, employee attitudes, training and development, and patient orientation) and intangible themes (ie, psychological safety, open communication, cohesion, power, blame and shame, morals and ethics, and support and trust). The culture themes' teamwork and commitment were not specific for an open culture, contradicting the patient safety literature. Thereby, an open mind was shown to be a novel characteristic.
conclusionsOpen culture entails an open mind-set and attitude of professionals beyond the scope of patient safety in which there is mutual awareness of each other's (un)conscious biases, focus on team relationships and professional well-being and a transparent system with supervisors/leaders being role models and patients being involved. Although it is generally acknowledged that microlevel social processes necessary to enact patient safety deserve more attention, research has largely emphasised system-level structures and processes. This study provides practical enablers for addressing system and microlevel social processes to work towards an open culture in and across teams.
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