Assessing organizational performance in intensive care units: a French experience.
OBJECTIVE
The objective of the study was to assess and to explain variation of organizational performance in intensive care units (ICUs).


METHODS
This was a prospective multicenter study.


METHODS
The study involved 26 ICUs located in the Paris area, France, participating in a regional database.


METHODS
Data were collected through answers of 1000 ICU personnel to the Culture, Organization, and Management in Intensive Care questionnaire and from the database. Organizational performance was assessed through a composite score related to 5 dimensions: coordination and adaptation to uncertainty, communication, conflict management, organizational change, and organizational learning, Skills developed in relationship with patients and their families. Statistical comparisons between ICUs were performed by analysis of variance with a Scheffé pairwise procedure. A multilevel regression model was used to analyze both individual and structural variables explaining differences of ICU's organizational performance.


RESULTS
The organizational performance score differed among ICUs. Some cultural values were negatively correlated with a high level of organizational performance, suggesting improvement potential. Several individual and structural factors were also related to the quality of ICU organization, including absence of burnout, older staff, satisfaction to work, and high workload (P < .02 for each).


CONCLUSIONS
A benchmarking approach can be used by ICU managers to assess the organizational performance of their ICU based on a validated questionnaire. Differences are mainly explained by cultural values and individual well-being factors, introducing new requirements for managing human resources in ICUs.
Centre for Medical Research, Medicine, Health and Society (INSERM U750/CNRS 8169), 94276 Le Kremlin-Bicêtre cedex, France. minviel@kb.inserm.fr <minviel@kb.inserm.fr>
Etienne
E
Minvielle
Philippe
P
Aegerter
Benoît
B
Dervaux
Ariane
A
Boumendil
Aurélia
A
Retbi
Marie Claude
MC
Jars-Guincestre
Bertrand
B
Guidet
D000328:Adult; D019985:Benchmarking / Q000379:methods*; D002055:Burnout, Professional / Q000209:etiology / Q000523:psychology*; D003469:Culture; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D017146:Models, Organizational; D010297:Paris; D011446:Prospective Studies; D011795:Surveys and Questionnaires