title: The Impact of Cross-Unit Coordination and Process Improvement Efforts in Anatomic Pathology: A Systems Perspective.
abstract: The impact of coordination and problem solving on health care quality has become increasingly prevalent within the literature. However, few studies have empirically investigated the impact of these factors across organizational boundaries.
  
  
  
  This was an embedded, single-case study conducted within a large, academic Anatomic Pathology department. We surveyed 96 team members within 18 distinct processing or specialty units within the department and forward the Network Alignment Approach to measure coordination between units. In addition, we measure perceived safety culture and frequency of error in specimen documentation and preparation.
  
  
  
  Regression results suggest that downstream cross-unit coordination between units (clarity of customer requirements) significantly improves safety culture (P < .001). In addition, within-unit process improvement efforts improved safety culture (P < .001). These 2 factors alone accounted for 30% of the variation in the regression model, with safety culture as our dependent variable.
  
  
  
  Clarity of customer requirements and process improvement efforts significantly improve safety culture within the system. This approach to understanding and analyzing connections within complex systems provides insight into specific ways that leaders can begin to understand how each unit or department can improve as both a customer and a supplier within the larger system.
authors.affiliation: Department of Marketing and Management, SUNY Oswego School of Business, Oswego, New York; and Department of Industrial and Operations Engineering, College of Engineering, University of Michigan, Ann Arbor (Dr Liker).
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Bonzo
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Liker
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D003299:Cooperative Behavior; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D015279:Organizational Culture; D010337:Pathology Department, Hospital / Q000458:organization & administration; D061214:Patient Safety; D011340:Problem Solving; D058996:Quality Improvement / Q000458:organization & administration*; D012044:Regression Analysis