title: Organizational and safety culture in Canadian intensive care units: relationship to size of intensive care unit and physician management model.
abstract: OBJECTIVE
  The objectives of this study are to describe organizational and safety culture in Canadian intensive care units (ICUs), to correlate culture with the number of beds and physician management model in each ICU, and to correlate organizational culture and safety culture.
  
  
  METHODS
  In this cross-sectional study, surveys of organizational and safety culture were administered to 2374 clinical staff in 23 Canadian tertiary care and community ICUs. For the 1285 completed surveys, scores were calculated for each of 34 domains. Average domain scores for each ICU were correlated with number of ICU beds and with intensivist vs nonintensivist management model. Domain scores for organizational culture were correlated with domain scores for safety culture.
  
  
  RESULTS
  Culture domain scores were generally favorable in all ICUs. There were moderately strong positive correlations between number of ICU beds and perceived effectiveness at recruiting/retaining physicians (r = 0.58; P < .01), relative technical quality of care (r = 0.66; P < .01), and medical director budgeting authority (r = 0.46; P = .03), and moderately strong negative correlations with frequency of events reported (r = -0.46; P = .03), and teamwork across hospital units (r = -0.51; P = .01). There were similar patterns for relationships with intensivist management. For most pairs of domains, there were weak correlations between organizational and safety culture.
  
  
  CONCLUSIONS
  Differences in perceptions between staff in larger and smaller ICUs highlight the importance of teamwork across units in larger ICUs.
authors.affiliation: Center for Health Evaluation and Outcome Sciences and Division of Critical Care Medicine, Providence Health Care and University of British Columbia, Vancouver, British Columbia, Canada V6Z 1Y6. pedodek@interchange.ubc.ca
authors.forename: Peter M
authors.initials: PM
authors.lastname: Dodek
authors.forename: Hubert
authors.initials: H
authors.lastname: Wong
authors.forename: Danny
authors.initials: D
authors.lastname: Jaswal
authors.forename: Daren K
authors.initials: DK
authors.lastname: Heyland
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Cook
authors.forename: Graeme M
authors.initials: GM
authors.lastname: Rocker
authors.forename: Demetrios J
authors.initials: DJ
authors.lastname: Kutsogiannis
authors.forename: Craig
authors.initials: C
authors.lastname: Dale
authors.forename: Robert
authors.initials: R
authors.lastname: Fowler
authors.forename: Najib T
authors.initials: NT
authors.lastname: Ayas
mesh_terms: D002170:Canada; D003430:Cross-Sectional Studies; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D017146:Models, Organizational; D015279:Organizational Culture; D017751:Safety Management