CULTURE WARRIOR Your staff's attitude toward patient safety determines patient outcomes, says Dr. Makary.

A hospital's culture of safety plays as big a role in improving surgical outcomes and patient care quality as its surgeons' skills or its OR equipment do, but it's often overlooked in favor of these technical factors, say researchers.

For a study published online by the Journal of the American College of Surgeons, researchers from Johns Hopkins University School of Medicine in Baltimore examined whether non-technical, organizational components of care had an impact on preventing surgical site infections after colon surgery.

Tracking cases at 7 Minnesota hospitals, they found that a surgical team's ability to communicate among itself, adopt best practices, track results, voice concerns, learn from mistakes and other behaviors correlated with a reduction in SSIs.

"The study supports what many surgeons have known for a long time, and that is that the organizational culture matters," says lead author Martin Makary, MD, MPH, FACS, a professor of surgery and health policy and management at the university. "While we have traditionally only studied the incremental patient benefits of different medications and surgical interventions, it turns out that organizational culture has a big impact on patient outcomes."

David Bernard