2011 Implementation Science - The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review

Background

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Increasing emphasis has been placed during recent years on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains under specified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance.

Results

The search strategy yielded 4239 records. After the full text assessment, two CBA ( controlled before and after studies) studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of bias. Both reported positive results.

Conclusions

Current available evidence does not identify any effective, generalisable strategies to change organisational culture. Healthcare organisations considering implementing interventions aimed at changing culture should seriously consider conducting an evaluation (using a robust design, e.g. ITS) to strengthen the evidence about this topic.