Work Environment and Organizational Behavior

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Let's take a closer look at these interesting questions from various perspectives, which you can draw on for your final copy.

1. Describe the culture in a non-punitive work environment and the shift of focus from individual error to process improvement (350-400 words).

This is the process of moving the focus from individual error to process improvement. For example, in the punitive work environment, which needs to be left behind, is the Error Reporting System which has specific identified characteristics that challenge error reporting and therefore quality and process improvements. You cannot fix something when it is left unknown. For example, the punitive work environment involves a paper system that requires identification of the person who is doing the reporting and the individual involved in the situation. This type of reporter ID system is seen as threatening and is a block to error reporting, and therefore a challenge to quality control and assurance, and thus, patient safety. It is also not a very efficient process as it is time consuming and time intensive. It is also a very accusatory with employees feeling they have been subjected to a system like a court system and that they have been "written up?(Butts, 2003, http://journals.lww.com/clinicalobgyn/Abstract/2008/12000/Event_Reporting__The_Value_of_a_Nonpunitive.3.aspx). This "punitive?work environment is problematic, as the employees perceive a punitive environment, which then contributes to limited error reporting because of the accusatory nature of reporting system, which acts as a deterrent and inhibits reporting.

In the work environment, culture shapes patient safety in a number of other ways, and looks very different than a punitive approach. In a non-punitive environment, leaders shape culture by persuading employee readiness to challenge and question the actions of others, to challenge authority when appropriate and feel free to disclose individual mistakes (Helmreich & Merritt, 1998). Culture needs to shift away from the past beliefs that infiltrated healthcare consciousness that when mistakes the employee must be blamed or punished. This also demands changing the reporting system and an analytic process to identify the root causes of problems as opposed to individual errors and the "blame game" tactics used. This shifts the focus from individual error to process improvement and a culture of patient safety. A non-punitive culture often results in several process improvements, such as increasing error reporting rate, reducing the perception of a punitive culture, increasing employees understanding of the underlying causes of error, as well as to change the system in a ways that separates errors from employee competence (Butts, 2003). This process improvement mentality also acts to reduce harm to patients and therefore, malpractice risk as well (Butt, 2003, http://journals.lww.com/clinicalobgyn/Abstract/2008/12000/Event_Reporting__The_Value_of_a_Nonpunitive.3.aspx).

However, to transition towards an organizational culture of safety and quality requires the commitment of leaders, physicians and staff. In fact, changing an ingrained culture is time consuming and requires perseverance, education and patience. It is important to provide the employees with concrete examples and management meetings to promote understanding accountability, competency and educational issues, which are essential and keys to success (Butts, 2003). This new environment encourages employers to also actively seek from trained people where failures result in inquiry and new ideas are welcomed (Zboril-Benson & Magee, 2005). In this environment, employees are actively involved in changing the process in a more improved way. ...