“Hear ye, hear ye, this court is now in session…”

On Friday, June 5, 2015, CRICO put organizational culture “on trial” by examining its culpability in contributing to preventable adverse events, unsafe practices, and increasing the risk of malpractice allegations. During the day’s proceedings we heard from “expert witnesses” who drew on their experiences in Ambulatory, Surgical, OB and Emergency Medicine, to represent both the plaintiff and the defense sides of the critical debate: Is culture the guilty party in unsafe care? Expert witness testimony was supplemented by medical malpractice claims data from the Comparative Benchmark System (CBS), that demonstrates how culture impedes the delivery of safe care. Or does it?

Through the use of an audience response system, the jury considered evidence and weighed in on “arguments” that included such cultural issues as communication among providers and between providers and patients, adherence to policies and procedures, management of disruptive clinicians, and team factors including supervision, and issues related to hierarchical factors.

The goal of Putting Culture on Trial was to help illustrate: 1) how negative culture may present challenges to maintaining patient safety, 2) how improving culture can ultimately enhance safety and, 3) what you can do to identify risks and institute effective changes. Presentations from faculty (our expert witnesses) who have experienced some of these barriers, and in many cases have implemented solutions to overcome them, helped to:

• identify the barriers to an optimal care environment,
• understand the individual components that make up “culture” and how they can impede or enhance the care environment,
• assess the correlation between culture and safe care,
• present actual case scenarios where positive culture has fostered improved outcomes, and
• summarize with review of everyone’s role in culture, from leaders to front line providers.