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Qual Saf Health Care 2004;13:ii22-ii27
© 2004 BMJ Publishing Group Ltd & Institute for Healthcare Improvement


ORIGINAL ARTICLE

A typology of organisational cultures

R Westrum

Correspondence to:
Professor R Westrum
Department of Sociology, Eastern Michigan University, Ypsilanti,MI 48197, USA; ronwestrum{at}aol.com There is wide belief that organisational culture shapes many aspects of performance, including safety. Yet proof of this relationship in a medical context is hard to find. In contrast to human factors, whose contributions are many and notable, culture’s impact remains a commonsense, rather than a scientific, concept. The objectives of this paper are to show that organisational culture bears a predictive relationship with safety and that particular kinds of organisational culture improve safety, and to develop a typology predictive of safety performance. Because information flow is both influential and also indicative of other aspects of culture, it can be used to predict how organisations or parts of them will behave when signs of trouble arise. From case studies and some systematic research it appears that information culture is indeed associated with error reporting and with performance, including safety. Yet this relationship between culture and safety requires more exploration before the connection can be considered definitive.


Keywords: organisational cultures; pathological pattern; bureaucratic; generative pattern




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