Organizational culture measurability

In the next chapter we will explore the nine dimensions of organizational culture—measurable dimensions that have been shown to influence and predict organizational safety most reliably. 

Safety climate and organizational culture measures will be taken annually to give senior leaders and trustees an objective measure of the organizational culture and the tone at the top. 

Demel (1991) and Demel and Meshkati (1989) conducted an extensive field study to explore how the performance of U.S.-owned manufacturing plants in other countries is affected by both the national culture of the host country and the organizational culture of the subsidiary plant. A manufacturing plant division of a large American multinational corporation was examined in three countries Puerto Rico, the United States, and Mexico. Hofstede s (1980a) Values Survey Module for national culture and Reynolds s (1986) Survey of Organizational Culture were administered. Performance measures (i.e., production, safety, and quahty) were collected through the use of secondary research. 

Gershon, R.R.M., Stone, P.W., Bakken, S. and Larson, E. 2004. Measurement of organizational culture and climate in healthcare. Journal of Nursing Administration, 34(1), 33-40. 

Hofstede, G., Neuijen, B., Ohayv, D. and Sanders, G. 1990. Measuring organizational cultures A qualitative and quantitative study across twenty cases. Administrative Science Quarterly, 35, 286-316. 

Several references were made in Chapter 3, Serious Injury Prevention, to human errors as the causal factors for accidents. And it was said that many serious injuries result from recurring but potentially avoidable human errors, and that organizational, cultural, technical, and management systems deficiencies often lead to those errors. Emphasizing human error reduction above the worker level, although proposed many years ago as a preventive measure, is not prominent in the work of safety professionals. 

Schriber, J.B., and Gutek, B.A. 1987. Some time dimensions of work measurement of an underlying aspect of organizational culture. Journal of Applied Psychology 72, 642-50. 

In safety almost everyone looks at incidents. They are observed in a variety of ways. We measure frequency, severity, and cost. We try, sometimes with success, to understand the causes. Most companies with significant risks also use audits. Again, these are done in a variety of ways. Less frequently, companies observe and record the behavior of woikers, typically classifying the observed behavior into safe and at-risk categories. Finally, there are occasional attempts to measure the management system or the organizational culture, using written surveys and interviews. 

The leader s role is to define the healthcare safety issue for the organization and the terms of the organization s engagement with it. The leader marshals the constituencies that must cooperate to create a strong safety climate and an organizational culture that supports safety. In subsequent chapters we address how this is done well, what it is made up of, and how such efforts are measured. 

We can define the attributes of a healthy organizational culture and safety climate and specify how to measure them (to be discussed in chapter 3). 

Measuring culture with the Organizational Culture Diagnostic Instrument... 

Certain other healthcare-related instruments fall between a true diagnostic instrument and an opinion survey. The Agency for Healthcare Research and Quality s (AHRQ s) Hospital Survey on Patient Safety Culture is an example, It measures some aspects of team functioning and safety climate it does not measure the dimensions of organizational culture known to predict performance, AHRQ maintains a database of other hospitals that have used the survey as a benchmark, but the survey has not been shown to have predictive validity,... 

Finally, improvement efforts are most successful when the organizational culture is well understood by leaders. It is then possible to build upon favorable dimensions and undertake targeted improvement where the culture is weak. It is also possible for the administrative leadership to measure dimensions of the culture in tangible terms and report the results over time as a means of communicating the tone at the top, in the middle, and at the bedside in order to fulfill the board s responsibility to monitor the culture and oversee the emergence of safety hazards and ethical risks. 

How can a leader know where he or she stands in terms of these best practices We have found that the most effective way to measure leadership best practices (and leadership style) is by systematically asking people around the leader about their perceptions of the leader. This makes sense because the growth of organizational culture depends on how others experience and internalize the leader s influence. 

How will people act differently from the way they do now In terms of the dimensions of the Organizational Culture Diagnostic Instrument (OCDI), for example, the quality and frequency of both upward communication and approaching others will measurably improve. How will priorities be different Safety itself will move from a priority to a value, and the gathering of information on near misses and recurring hazards will command new importance and attention. 

Strengthen the organizational culture and safety climate as measured by the OCDI. 

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