title: The Impact of Information Culture on Patient Safety Outcomes. Development of a Structural Equation Model.
abstract: BACKGROUND
  An organization's information culture and information management practices create conditions for processing patient information in hospitals. Information management incidents are failures that could lead to adverse events for the patient if they are not detected.
  
  
  OBJECTIVE
  To test a theoretical model that links information culture in acute care hospitals to information management incidents and patient safety outcomes.
  
  
  METHODS
  Reason's model for the stages of development of organizational accidents was applied. Study data were collected from a cross-sectional survey of 909 RNs who work in medical or surgical units at 32 acute care hospitals in Finland. Structural equation modeling was used to assess how well the hypothesized model fit the study data.
  
  
  RESULTS
  Fit indices indicated a good fit for the model. In total, 18 of the 32 paths tested were statistically significant. Documentation errors had the strongest total effect on patient safety outcomes. Organizational guidance positively affected information availability and utilization of electronic patient records, whereas the latter had the strongest total effect on the reduction of information delays.
  
  
  CONCLUSIONS
  Patient safety outcomes are associated with information management incidents and information culture. Further, the dimensions of the information culture create work conditions that generate errors in hospitals.
authors.affiliation: Virpi Jylhä, PhD, Department of Health and Social Management, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland, E-mail: virpi.jylha@hotus.fi.
authors.forename: Virpi
authors.initials: V
authors.lastname: Jylhä
authors.forename: Santtu
authors.initials: S
authors.lastname: Mikkonen
authors.forename: Kaija
authors.initials: K
authors.lastname: Saranto
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D003198:Computer Simulation; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005387:Finland / Q000453:epidemiology; D063005:Health Information Systems / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D015233:Models, Statistical; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data; D015279:Organizational Culture; D061214:Patient Safety / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D017751:Safety Management / Q000706:statistics & numerical data
keywords: Information management; adverse events; health information technology; medication administration error; patient complaint; patient safety; survey