Organizational factors associated with high performance in quality and safety in academic medical centers.
Academic medical centers (AMCs) face unique challenges in translating their innovation in safety and quality research into clinical performance. This study examined discharge data from 79 AMCs to generate a scoring method for measures of safety, mortality, clinical effectiveness, and equity of care. After identifying three top performers and three average performers, a group of surveyors visited each site without knowledge of their score and made an objective assessment of the factors associated with their performance. The authors highlight the importance of a shared sense of purpose, a hands-on leadership style, accountability systems for quality and safety, a focus on results, and a culture of collaboration as key predictors of top performers. Similar to a past study that evaluated safety culture in AMCs, the authors emphasize that the actions of senior executives and department chairs do impact care at the bedside.