title: Organisational readiness: exploring the preconditions for success in organisation-wide patient safety improvement programmes.
abstract: BACKGROUND
  Patient safety has been high on the agenda for more than a decade. Despite many national initiatives aimed at improving patient safety, the challenge remains to find coherent and sustainable organisation-wide safety-improvement programmes. In the UK, the Safer Patients' Initiative (SPI) was established to address this challenge. Important in the success of such an endeavour is understanding 'readiness' at the organisational level, identifying the preconditions for success in this type of programme. This article reports on a case study of the four NHS organisations participating in the first phase of SPI, examining the perceptions of organisational readiness and the relationship of these factors with impact by those actively involved in the initiative.
  
  
  METHODS
  A mixed-methods design was used, involving a survey and semistructured interviews with senior executive leads, the principal SPI programme coordinator and the four operational leads in each of the SPI clinical work areas in all four organisations taking part in the first phase of SPI.
  
  
  CONCLUSIONS
  This preliminary work would suggest that prior to the start of organisation-wide quality- and safety-improvement programmes, organisations would benefit from an assessment of readiness with time spent in the preparation of the organisational infrastructure, processes and culture. Furthermore, a better understanding of the preconditions that mark an organisation as ready for improvement work would allow policymakers to set realistic expectations about the outcomes of safety campaigns.
authors.affiliation: Centre for Patient Safety and Service Quality, Department of Surgery, Division of Surgery and Cancer, Faculty of Medicine, Room 508, Medical School Building, St Mary's Campus, Norfolk Place, London W2 1PG, UK. s.burnett@imperial.ac.uk
authors.forename: Susan
authors.initials: S
authors.lastname: Burnett
authors.forename: Jonathan
authors.initials: J
authors.lastname: Benn
authors.forename: Anna
authors.initials: A
authors.lastname: Pinto
authors.forename: Anam
authors.initials: A
authors.lastname: Parand
authors.forename: Sandra
authors.initials: S
authors.lastname: Iskander
authors.forename: Charles
authors.initials: C
authors.lastname: Vincent
mesh_terms: D003625:Data Collection; D017598:Efficiency, Organizational; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D015279:Organizational Culture; D061214:Patient Safety; D015397:Program Evaluation; D058996:Quality Improvement; D017751:Safety Management / Q000592:standards*; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom