title: Organizational culture and its implications for infection prevention and control in healthcare institutions.
abstract: BACKGROUND
  It is not uncommon for infection prevention and control (IPC) interventions to be successful in one hospital yet fail, or have significantly less success, when implemented in another healthcare institution. Organizational factors have been postulated to be a major reason. As a result, there has been an increasing drive in recent years to understand and address organizational culture (OC) in order to achieve improved healthcare performance.
  
  
  OBJECTIVE
  To examine the inter-relationship between OC and behavioural attitudes by healthcare professionals; to determine whether and how OC may impact on IPC compliance; and to highlight the potential for OC modification interventions to improve IPC practices within hospitals.
  
  
  METHODS
  Previous literature is reviewed and synthesized, using both IPC journals as well as publications focusing on human behaviour and organizational change.
  
  
  RESULTS
  The article evaluates the theory of OC within healthcare settings and identifies how various elements appear to impact on IPC-related behaviour. It highlights the paucity of well-designed studies but identifies sporadic literature suggesting that well-designed and customized OC change initiatives can have a positive impact on IPC practices, such as hand hygiene.
  
  
  CONCLUSIONS
  OC change appears to be a promising, albeit challenging, target for IPC improvement campaigns - both from a theoretical perspective as well as from the results of the few available studies. However, more data and quality information are needed to identify effective strategies that can elicit effective and sustained change.
authors.affiliation: Maastricht School of Management, Maastricht, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: De Bono
authors.affiliation: Maastricht School of Management, Maastricht, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Heling
authors.affiliation: Mater Dei Hospital and University of Malta, Msida, Malta. Electronic address: michael.a.borg@gov.mt.
authors.forename: M A
authors.initials: MA
authors.lastname: Borg
mesh_terms: D001291:Attitude of Health Personnel; D003428:Cross Infection / Q000517:prevention & control*; D006268:Health Facilities; D006801:Humans; D017053:Infection Control / Q000379:methods*; D015279:Organizational Culture
keywords: Behaviour change; Empowerment; Leadership; Professional culture; Teamwork