Culture matters: indigenizing patient safety in Bhutan
Abstract Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan’s traditional (core) cultural values on the attitudes a...
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Veröffentlicht in: | Health policy and planning 2017-09, Vol.32 (7), p.1042-1048 |
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description | Abstract
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan’s traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan’s traditional cultural values on staff attitudes towards patient safety and quality care. Undertaken as a qualitative exploratory descriptive inquiry, a purposeful sample of 94 healthcare professionals and managers were recruited from three levels of hospitals, a training institute and the Ministry of Health. Interviews were transcribed verbatim and analysed using thematic analysis strategies. The findings of the study suggest that Bhutanese traditional cultural values have both productive and counterproductive influences on staff attitudes towards healthcare delivery and the processes that need to be in place to ensure patient safety. Productive influences encompassed: karmic incentives to avoid preventable harm and promote safe patient care; and the prospective adoption of the ‘four harmonious friends’ as a culturally meaningful frame for improving understanding of the role and importance of teamwork in enhancing patient safety. Counterproductive influences included: the adoption of hierarchical and authoritative styles of management; unilateral decision-making; the legitimization of karmic beliefs; differential treatment of patients; and preferences for traditional healing practices and rituals. Although problematic in some areas, Bhutan’s traditional cultural values could be used positively to inform and frame an effective model for improving patient safety in Bhutan’s hospitals. Such a model must entail the institution of an ‘indigenized’ patient safety program, with patient safety research and reporting systems framed around local patient safety concerns and solutions, including religious and cultural concepts, values and perspectives. |
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Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan’s traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan’s traditional cultural values on staff attitudes towards patient safety and quality care. Undertaken as a qualitative exploratory descriptive inquiry, a purposeful sample of 94 healthcare professionals and managers were recruited from three levels of hospitals, a training institute and the Ministry of Health. Interviews were transcribed verbatim and analysed using thematic analysis strategies. The findings of the study suggest that Bhutanese traditional cultural values have both productive and counterproductive influences on staff attitudes towards healthcare delivery and the processes that need to be in place to ensure patient safety. Productive influences encompassed: karmic incentives to avoid preventable harm and promote safe patient care; and the prospective adoption of the ‘four harmonious friends’ as a culturally meaningful frame for improving understanding of the role and importance of teamwork in enhancing patient safety. Counterproductive influences included: the adoption of hierarchical and authoritative styles of management; unilateral decision-making; the legitimization of karmic beliefs; differential treatment of patients; and preferences for traditional healing practices and rituals. Although problematic in some areas, Bhutan’s traditional cultural values could be used positively to inform and frame an effective model for improving patient safety in Bhutan’s hospitals. Such a model must entail the institution of an ‘indigenized’ patient safety program, with patient safety research and reporting systems framed around local patient safety concerns and solutions, including religious and cultural concepts, values and perspectives.</description><identifier>ISSN: 0268-1080</identifier><identifier>EISSN: 1460-2237</identifier><identifier>DOI: 10.1093/heapol/czx042</identifier><identifier>PMID: 28430978</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adoption ; Attitude of Health Personnel ; Attitudes ; Bhutan ; Cultural values ; Culture ; Decision making ; Employee attitude ; Friendship ; Healing ; Health administration ; Health care ; Health care delivery ; Health Personnel - psychology ; Health services ; Hospital Administration ; Hospitals ; Hospitals - standards ; Humans ; Incentives ; Legitimacy ; Medical personnel ; Medical treatment ; Medicine, Traditional - utilization ; Patient Safety ; Patients ; Professional attitudes ; Professionals ; Qualitative Research ; Quality of care ; Quality of Health Care ; Religious beliefs ; Rituals ; Safety ; Safety programs ; Safety research ; Teamwork ; Traditional medicine ; Training ; Treatment preferences ; Unilateralism</subject><ispartof>Health policy and planning, 2017-09, Vol.32 (7), p.1042-1048</ispartof><rights>The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2017</rights><rights>The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.</rights><rights>The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c426t-9bf98379377b1f761440e156436ea625a439e59e4d1e9fa60fc5873aa100a5cb3</citedby><cites>FETCH-LOGICAL-c426t-9bf98379377b1f761440e156436ea625a439e59e4d1e9fa60fc5873aa100a5cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1605,27871,27929,27930,31004,33779</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/heapol/czx042$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28430978$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pelzang, Rinchen</creatorcontrib><creatorcontrib>Johnstone, Megan-Jane</creatorcontrib><creatorcontrib>Hutchinson, Alison M</creatorcontrib><title>Culture matters: indigenizing patient safety in Bhutan</title><title>Health policy and planning</title><addtitle>Health Policy Plan</addtitle><description>Abstract
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan’s traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan’s traditional cultural values on staff attitudes towards patient safety and quality care. Undertaken as a qualitative exploratory descriptive inquiry, a purposeful sample of 94 healthcare professionals and managers were recruited from three levels of hospitals, a training institute and the Ministry of Health. Interviews were transcribed verbatim and analysed using thematic analysis strategies. The findings of the study suggest that Bhutanese traditional cultural values have both productive and counterproductive influences on staff attitudes towards healthcare delivery and the processes that need to be in place to ensure patient safety. Productive influences encompassed: karmic incentives to avoid preventable harm and promote safe patient care; and the prospective adoption of the ‘four harmonious friends’ as a culturally meaningful frame for improving understanding of the role and importance of teamwork in enhancing patient safety. Counterproductive influences included: the adoption of hierarchical and authoritative styles of management; unilateral decision-making; the legitimization of karmic beliefs; differential treatment of patients; and preferences for traditional healing practices and rituals. Although problematic in some areas, Bhutan’s traditional cultural values could be used positively to inform and frame an effective model for improving patient safety in Bhutan’s hospitals. Such a model must entail the institution of an ‘indigenized’ patient safety program, with patient safety research and reporting systems framed around local patient safety concerns and solutions, including religious and cultural concepts, values and perspectives.</description><subject>Adoption</subject><subject>Attitude of Health Personnel</subject><subject>Attitudes</subject><subject>Bhutan</subject><subject>Cultural values</subject><subject>Culture</subject><subject>Decision making</subject><subject>Employee attitude</subject><subject>Friendship</subject><subject>Healing</subject><subject>Health administration</subject><subject>Health care</subject><subject>Health care delivery</subject><subject>Health Personnel - psychology</subject><subject>Health services</subject><subject>Hospital Administration</subject><subject>Hospitals</subject><subject>Hospitals - standards</subject><subject>Humans</subject><subject>Incentives</subject><subject>Legitimacy</subject><subject>Medical personnel</subject><subject>Medical treatment</subject><subject>Medicine, Traditional - utilization</subject><subject>Patient Safety</subject><subject>Patients</subject><subject>Professional attitudes</subject><subject>Professionals</subject><subject>Qualitative Research</subject><subject>Quality of care</subject><subject>Quality of Health Care</subject><subject>Religious beliefs</subject><subject>Rituals</subject><subject>Safety</subject><subject>Safety programs</subject><subject>Safety research</subject><subject>Teamwork</subject><subject>Traditional medicine</subject><subject>Training</subject><subject>Treatment preferences</subject><subject>Unilateralism</subject><issn>0268-1080</issn><issn>1460-2237</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkD1PwzAQQC0EoqUwsqJILCyh59hxbDao-JIqscBsOemlTZUmwR8S7a8nKAUkFqYb7und6RFyTuGagmLTFZqurafF7gN4ckDGlAuIk4Rlh2QMiZAxBQkjcuLcGoByztNjMkokZ6AyOSZiFmofLEYb4z1adxNVzaJaYlPtqmYZdcZX2PjImRL9tt9Fd6vgTXNKjkpTOzzbzwl5e7h_nT3F85fH59ntPC54Inys8lJJlimWZTktM9HfB6Sp4EygEUlqOFOYKuQLiqo0AsoilRkzhgKYtMjZhFwN3s627wGd15vKFVjXpsE2OE2lor1USujRyz_oug226b_TCWcUaEZ79YTEA1XY1jmLpe5stTF2qynor6B6CKqHoD1_sbeGfIOLH_q74O-Hbej-cX0CUD9_NA</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Pelzang, Rinchen</creator><creator>Johnstone, Megan-Jane</creator><creator>Hutchinson, Alison M</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T2</scope><scope>7TQ</scope><scope>7U4</scope><scope>8BJ</scope><scope>BHHNA</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>DWI</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>WZK</scope><scope>7X8</scope></search><sort><creationdate>20170901</creationdate><title>Culture matters: indigenizing patient safety in Bhutan</title><author>Pelzang, Rinchen ; Johnstone, Megan-Jane ; Hutchinson, Alison M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-9bf98379377b1f761440e156436ea625a439e59e4d1e9fa60fc5873aa100a5cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adoption</topic><topic>Attitude of Health Personnel</topic><topic>Attitudes</topic><topic>Bhutan</topic><topic>Cultural values</topic><topic>Culture</topic><topic>Decision making</topic><topic>Employee attitude</topic><topic>Friendship</topic><topic>Healing</topic><topic>Health administration</topic><topic>Health care</topic><topic>Health care delivery</topic><topic>Health Personnel - psychology</topic><topic>Health services</topic><topic>Hospital Administration</topic><topic>Hospitals</topic><topic>Hospitals - standards</topic><topic>Humans</topic><topic>Incentives</topic><topic>Legitimacy</topic><topic>Medical personnel</topic><topic>Medical treatment</topic><topic>Medicine, Traditional - utilization</topic><topic>Patient Safety</topic><topic>Patients</topic><topic>Professional attitudes</topic><topic>Professionals</topic><topic>Qualitative Research</topic><topic>Quality of care</topic><topic>Quality of Health Care</topic><topic>Religious beliefs</topic><topic>Rituals</topic><topic>Safety</topic><topic>Safety programs</topic><topic>Safety research</topic><topic>Teamwork</topic><topic>Traditional medicine</topic><topic>Training</topic><topic>Treatment preferences</topic><topic>Unilateralism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pelzang, Rinchen</creatorcontrib><creatorcontrib>Johnstone, Megan-Jane</creatorcontrib><creatorcontrib>Hutchinson, Alison M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>Sociological Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>Sociological Abstracts</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Sociological Abstracts (Ovid)</collection><collection>MEDLINE - Academic</collection><jtitle>Health policy and planning</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Pelzang, Rinchen</au><au>Johnstone, Megan-Jane</au><au>Hutchinson, Alison M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Culture matters: indigenizing patient safety in Bhutan</atitle><jtitle>Health policy and planning</jtitle><addtitle>Health Policy Plan</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>32</volume><issue>7</issue><spage>1042</spage><epage>1048</epage><pages>1042-1048</pages><issn>0268-1080</issn><eissn>1460-2237</eissn><abstract>Abstract
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan’s traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan’s traditional cultural values on staff attitudes towards patient safety and quality care. Undertaken as a qualitative exploratory descriptive inquiry, a purposeful sample of 94 healthcare professionals and managers were recruited from three levels of hospitals, a training institute and the Ministry of Health. Interviews were transcribed verbatim and analysed using thematic analysis strategies. The findings of the study suggest that Bhutanese traditional cultural values have both productive and counterproductive influences on staff attitudes towards healthcare delivery and the processes that need to be in place to ensure patient safety. Productive influences encompassed: karmic incentives to avoid preventable harm and promote safe patient care; and the prospective adoption of the ‘four harmonious friends’ as a culturally meaningful frame for improving understanding of the role and importance of teamwork in enhancing patient safety. Counterproductive influences included: the adoption of hierarchical and authoritative styles of management; unilateral decision-making; the legitimization of karmic beliefs; differential treatment of patients; and preferences for traditional healing practices and rituals. Although problematic in some areas, Bhutan’s traditional cultural values could be used positively to inform and frame an effective model for improving patient safety in Bhutan’s hospitals. Such a model must entail the institution of an ‘indigenized’ patient safety program, with patient safety research and reporting systems framed around local patient safety concerns and solutions, including religious and cultural concepts, values and perspectives.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>28430978</pmid><doi>10.1093/heapol/czx042</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adoption Attitude of Health Personnel Attitudes Bhutan Cultural values Culture Decision making Employee attitude Friendship Healing Health administration Health care Health care delivery Health Personnel - psychology Health services Hospital Administration Hospitals Hospitals - standards Humans Incentives Legitimacy Medical personnel Medical treatment Medicine, Traditional - utilization Patient Safety Patients Professional attitudes Professionals Qualitative Research Quality of care Quality of Health Care Religious beliefs Rituals Safety Safety programs Safety research Teamwork Traditional medicine Training Treatment preferences Unilateralism |
title | Culture matters: indigenizing patient safety in Bhutan |
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