Culture within any organization is a difficult thing to define. It can also be very complicated to change for the better. Healthcare culture is a set of behaviors, beliefs, policies, and actions that are regularly implemented within a particular setting, such as a doctor’s office or a large hospital. Larger healthcare settings may have multiple subcultures, with different opinions on providing care between physicians and managers for instance.

For patients the issue of culture is often overlooked but is important to be aware of to get the best care. The culture of a healthcare setting can be a deciding factor in where you receive medical care. Patients can choose between a hospital that prioritizes patient autonomy and safety, for example, or a hospital in which the culture is more traditional and keeps patients further outside the care decision-making process.

What is Healthcare Culture?

Organizational culture is a term that is used to describe many different aspects of how a company or group operates and the qualities or philosophies that dictate the behaviors of individuals within the group. The term is often used to describe companies, and that includes healthcare companies. Hospitals, medical centers, even doctor’s offices and insurance companies have a culture, whether it is formal and defined or more informal.

From a patient perspective culture is important because it effects how they are treated, the experiences they have getting healthcare, and the outcomes of their treatment, even their overall wellness. Culture is what a healthcare organization does regularly and frequently, the behavior patterns that are consistent and that impact patients. For example, a doctor’s office that values transparency may make that a part of the office culture by creating online patient portals where patients can access their medical records and even notes doctors have written during appointments. This clearly has a direct impact on patient care and wellness.

Traditional Healthcare Culture

The culture of healthcare in general has been changing for decades. In the past, and in many cases still today, the culture of medical care was very paternalistic. This means that the doctors acted like father figures, telling patients what was best for them. This was done without giving patients information or allowing them any level of autonomy or ability to make decisions.

For instance, a patient with a particular illness may have two options for treatment. In a paternalistic culture the doctor would choose the treatment without the patient ever knowing there was another option. The justification for this is that the doctor is acting in the patient’s best interest and is the one with the authority and knowledge to best make the decision.

Patient-Centered Culture

Today, the culture of paternalism in healthcare is shifting toward more autonomy for the patient. A patient-centered culture is more common now, although there are still many settings in which the culture remains more old-fashioned. And in many healthcare settings the culture is a mixture of paternalism and patient autonomy.

Patient-centered culture in healthcare isn’t just about autonomy, though. Organizations that truly focus on the patient have several factors in the culture that put the patient first: being kind and compassionate to patients, respecting patients and their individual cultures, keeping patients informed and educated, making enough time for patients, and others.

A Culture of Safety

Safety as a part of company culture is not unique to healthcare. Many industries in which safety can be a concern, such as manufacturing, chemical plants, or shipping, prioritize safety and develop a culture around it. A culture of safety means committing to practices that minimize risks and maximize safety. In healthcare this can include both employees and patients, but patients are often the focus.

There are several important elements in a culture of safety, including recognizing where the risks are, such as medical errors that can harm patients. It also includes making the environment blame-free, so that people can feel safe reporting errors that may cause harm. Collaboration and communication are also important elements of a safety culture. When everything is put in place to allow and encourage all medical professionals in a healthcare setting to communicate, errors that hurt patients are minimized.

In healthcare, according to studies, nurses and other professionals have cited the lack of a blame-free environment as a major barrier to safety. Lack of good ways to communicate is another factor often cited for safety issues. These are policy issues, but also issues of culture that can be practically changed to develop greater safety.

A Collaborative Culture

Another trend in healthcare culture is away from physicians and nurses working independently and toward more collaboration. This is a cultural shift that is beneficial to patients because it improves communication, a major barrier to safety, and because it puts more minds to work on each patient issue. It also helps to manage care continuation more smoothly and efficiently.

In medical settings in which collaboration has been made a priority, outcomes have been proven to be better for patients. These facilities, like the Cleveland Clinic and smaller medical centers, report more efficient delivery of services, lower overall healthcare costs, patients being discharged earlier, and fewer accidents and mistakes that cause patients harm.

What Impedes Healthcare Culture Shifts?

Research has found that changing culture in any organization is difficult and complicated. In healthcare, several things have been found to impede positive changes in culture. These include poor leadership or lack of leadership, employees who don’t feel empowered to make changes, constraints imposed by outside stakeholders, and differences in subcultures, such as between physicians and healthcare managers. Money can also be an issue. When profits drive a culture, patients can be left behind, and making the culture more patient-focused becomes difficult.

As a patient, you have a right to choose where and how you receive healthcare. While the culture is changing in general, there are still a lot of differences in how medical facilities operate and treat patients. Be aware of the culture of healthcare where you receive care, and be willing to speak up about what you don’t like or to change healthcare settings if the culture is not conducive to good care.

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