Every 40 seconds someone in the United States suffers a heart attack—also known as an acute myocardial infarction (AMI)–making heart disease the number one killer in America.
And whether a person lives or dies may depend on the hospital at which they are treated. According to a new Yale School of Public Health study, not only can a hospital change its organizational culture for the better, but such improvement allows more patients to survive heart attacks.
The findings, published in The BMJ Quality and Safety, are a result of the Leadership Saves Lives (LSL) program led by Yale professionals who worked with hospitals to test strategies to improve hospital patient care through culture change.
“From previous work, we know that a positive hospital culture impacts AMI mortality rates,” said Leslie Curry, Ph.D., M.P.H., senior research scientist at the Yale School of Public Health and the study’s lead author. “Now we can see that organizational culture can in fact be changed in positive ways, often with very little expense to the hospital.”
The study describes specific strategies–of little or no cost to a hospital–that can be used to improve the organizational culture of a hospital with team collaboration being a key factor in a hospital’s success. Whether strategies could or would work depended on “buy in” from senior management, said Curry. “Most notably, we saw that if hospital administration was open to communication and suggestions from employees–without any fear of retaliation—the team collaboration and success improved.”
Of the 10 hospitals included in the LSL program, six that showed positive organizational culture changes saw faster improvement in AMI survival rates. Although several of the strategies incorporated into the hospital culture were of no expense to the hospital, in some cases, they did mean significant changes in ways of working with both internal and external teams. For instance, hospitals that increased communication with emergency medical teams and pharmacists could provide better care.
Curry noted that when a patient arrives to an emergency room whether the team is working as a cohesive unit is a huge factor in being able to save a heart attack victim. Likewise, when a patient was discharged, those hospitals that followed up to ensure a patient was taking medications and following other instructions had higher success rate.
“We know culture matters–and we can create good culture with little or no cost strategies,” Curry emphasized. “It's a matter of the hospital teams wanting to work together from the top down and across all departments, and beyond hospital walls into the community.”
The LSL team is now creating a toolkit of strategies and resources for cultural change that will be available to hospitals nationwide.
All hospitals participating in the LSL program were part of the Mayo Clinic Care Network. “We developed the care network to build on a shared commitment to improve the delivery of health care,” said David L. Hayes, M.D., cardiologist and medical director at the Mayo Clinic Care Network. “This commitment among strong regional health care organizations proved to be an ideal testing ground for the concept that Leadership Saves Lives.”