Influencing organisational culture to improve hospital performance in care of patients with acute myocardial infarction: a mixed-methods intervention study.

Organizational culture affects patient safety and can be difficult to change. This pre–post study examined how a multimodal quality improvement intervention changed organizational culture, adherence to evidence-based practices, and risk-adjusted mortality for patients with acute myocardial infarction (AMI). The intervention was a learning collaborative model that involved off-site and site-based training and a web-based peer communication platform, all focused on enhancing safety culture. Out of the 10 participating hospitals, 6 demonstrated improvements in culture, and these same hospitals reduced their AMI mortality risk. The hospitals without culture change also had no significant change in AMI mortality risk. The study did not have a concurrent control group to account for secular trends in AMI mortality risk. The authors suggest that investing in organizational culture change may improve clinical outcomes.