1 23 Journal of Clinical Psychology in Medical Settings ISSN 1068-9583 J Clin Psychol Med Settings DOI 10.1007/s10880-016-9471-x Cultural Humility and Hospital Safety Culture Joshua N. Hook, David Boan, Don E. Davis, Jamie D. Aten, John M. Ruiz & Thomas Maryon
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
1 23
Journal of Clinical Psychology inMedical Settings ISSN 1068-9583 J Clin Psychol Med SettingsDOI 10.1007/s10880-016-9471-x
Cultural Humility and Hospital SafetyCulture
Joshua N. Hook, David Boan, DonE. Davis, Jamie D. Aten, John M. Ruiz &Thomas Maryon
1 23
Your article is protected by copyright and allrights are held exclusively by Springer Science+Business Media New York. This e-offprint isfor personal use only and shall not be self-archived in electronic repositories. If you wishto self-archive your article, please use theaccepted manuscript version for posting onyour own website. You may further depositthe accepted manuscript version in anyrepository, provided it is only made publiclyavailable 12 months after official publicationor later and provided acknowledgement isgiven to the original source of publicationand a link is inserted to the published articleon Springer's website. The link must beaccompanied by the following text: "The finalpublication is available at link.springer.com”.
Cultural Humility and Hospital Safety Culture
Joshua N. Hook1 • David Boan2 • Don E. Davis3 • Jamie D. Aten2 •
John M. Ruiz4 • Thomas Maryon5
! Springer Science+Business Media New York 2016
Abstract Hospital safety culture is an integral part ofproviding high quality care for patients, as well as pro-
moting a safe and healthy environment for healthcare
workers. In this article, we explore the extent to whichcultural humility, which involves openness to cultural
diverse individuals and groups, is related to hospital safety
culture. A sample of 2011 hospital employees from fourhospitals completed measures of organizational cultural
humility and hospital safety culture. Higher perceptions of
organizational cultural humility were associated withhigher levels of general perceptions of hospital safety, as
well as more positive ratings on non-punitive response to
error (i.e., mistakes of staff are not held against them),handoffs and transitions, and organizational learning. The
cultural humility of one’s organization may be an impor-
tant factor to help improve hospital safety culture. Weconclude by discussing potential directions for future
of city, % non-white, rural vs. urban, etc.) on perceptions of
cultural humility or hospital safety culture.In addition to utilizing more intensive research designs
and measurement strategies, there are several exciting
areas for future research. First, the current study examinedratings of cultural humility of the organization as a whole.
Future research could explore ratings of cultural humility
of particular individuals, such as doctors or work supervi-sors. Second, the current study examined one important
outcome (i.e., hospital safety culture), but future researchcould explore other outcomes, such as actual patient out-
comes or patient satisfaction ratings. Third, qualitative
research could explore in more depth what culturalhumility actually looks like in hospital interactions, and
what aspects of cultural humility are most important to
hospital workers and patients. Finally, cultural humilityinterventions could be developed and implemented into
medical training as a strategy to improve hospital safety
culture. The effects of these interventions on hospital andpatient outcomes could then be measured.
Improving hospital safety culture is an important aim as
hospitals attempt to provide high-quality medical care to allindividuals. In the present study, we found that perceptions
of organization cultural humility may be an important
factor to consider in regard to this aim. Indeed, culturalfactors have been understudied in research that explores
effective health care in the medical setting. The problem of
racial/ethnic disparities in health care is a major issue thatthe medical field must wrestle with as the United States
becomes increasingly diverse. It is important to provide the
highest quality of care to all individuals, irrespective oftheir cultural background. In the present investigation, we
presented cultural humility as one potential characteristic
of individuals and hospitals that may contribute to high-quality care for culturally diverse individuals and groups.
Compliance with Ethical Standards
Conflict of Interest Joshua N. Hook, David Boan, Don E. Davis,Jamie D. Aten, John M. Ruiz, and Thomas Maryon declare that theyhave no conflict of interest.
Human and Animal Rights and Informed Consent All proceduresperformed in studies involving human participants were in accor-dance with the ethical standards of the Institutional and/or NationalResearch Committee and with the 1964 Helsinki declaration and itslater amendments or comparable ethical standards. Informed consentwas obtained from all individual participants included in the study.
References
Agency for Healthcare Research and Quality. (2015). 2014 NationalHealthcare Quality and Disparities Report AHRQ PublicationNo. 15-0007. www.ahrq.gov/research/findings/nhqrdr/index.html.
Beach, M. C., Price, E. G., Gary, T. L., Robinson, K. A., Gozu, A.,Palacio, A., … Cooper, L. A. (2005). Cultural competency: Asystematic review of health care provider educational interven-tions. Medical Care, 43, 356–373.
Brach, C., & Fraserirector, I. (2000). Can cultural competency reduceracial and ethnic health disparities? A review and conceptualmodel. Medical Care Research and Review, 57, 181–217.
Chang, E. S., Simon, M., & Dong, X. (2012). Integrating culturalhumility into health care professional education and training.Advances in Health Sciences Education: Theory and Practice,17, 269–278.
Davis, D. E., DeBlaere, C., Brubaker, K., Owen, J., Jordan, T., Hook,J. N., & Van Tongeren, D. R. (2016). Microaggressions andperceptions of cultural humility in counseling. Journal ofCounseling and Development, 94(4), 483–493.
Davis, D. E., Hook, J. N., Worthington, E. L., Jr., Van Tongeren, D.R., Gartner, A. L., Jennings, D. J., II, & Emmons, R. A. (2011).Relational humility: Conceptualizing and measuring humility asa personality judgment. Journal of Personality Assessment, 93,225–234.
Davis, D. E., Worthington, E. L., Jr., Hook, J. N., Emmons, R. A.,Hill, P. C., Bollinger, R. A., & Van Tongeren, D. R. (2013).Humility and the development and repair of social bonds: Twolongitudinal studies. Self and Identity, 12, 58–77.
Dorn, K., Hook, J. N., Davis, D. E., Van Tongeren, D. R., &Worthington, E. L., Jr. (2014). Behavioral methods of assessingforgiveness. Journal of Positive Psychology, 9, 75–80.
Grytdal, S. P., Kobeski, A., Kaplan, C., Flanagan, E., & Cousin, P.(2006). The relationship between hospital-based healthcarepersonnel perceptions of safety culture and the occurrence ofsharps injuries. American Journal of Infection Control, 34, E14.
Guldenmund, F. W. (2010). (Mis) understanding safety culture and itsrelationship to safety management. Risk Analysis, 30,1466–1480.
Hook, J. N., Davis, D. E., Owen, J., Worthington, E. L., Jr., & Utsey,S. O. (2013). Cultural humility: Measuring openness to cultur-ally diverse clients. Journal of Counseling Psychology, 60,353–366.
Hook, J. N., Farrell, J. E., Davis, D. E., DeBlaere, C., Van Tongeren,D. R., & Utsey, S. O. (2016). Cultural humility and racialmicroaggressions in counseling. Journal of Counseling Psychol-ogy, 63, 269–277.
Lie, D. A., Lee-Rey, E., Gomez, A., Bereknyei, S., & Braddock, C.H. I. I. I. (2011). Does cultural competency training of healthprofessionals improve patient outcomes? A systematic reviewand proposed algorithm for future research. Journal of GeneralInternal Medicine, 26, 317–325.
Mardon, R. E., Khanna, K., Sorra, J., Dyer, N., & Famolaro, T.(2010). Exploring relationships between hospital safety cultureand adverse events. Journal of Patient Safety, 6, 226–232.
Molenaar, K. R., Park, J. I., & Washington, S. (2009). Framework formeasuring corporate safety culture and its impact on construc-tion safety performance. Journal of Construction Engineeringand Management, 135, 488–496.
Nævestad, T. O. (2009). Mapping research on culture and safety inhigh-risk organizations: Arguments for a sociotechnical under-standing of safety culture. Journal of Contingencies and CrisisManagement, 17, 126–136.
Owen, J., Jordan, T. A., II, Turner, D., Davis, D. E., Hook, J. N., &Leach, M. M. (2014). Therapists’ multicultural orientation:Client perceptions of cultural humility, spiritual/religious com-mitment, and therapy outcomes. Journal of Psychology andTheology, 42, 91–98.
Sorra, J., Famolaro, T., Yount, N. D., et al. (2014). Hospital survey onpatient safety culture 2014 user comparative database report.Rockville, MD: Agency for Healthcare Research and Quality.
Sorra, J., & Nieva, V. F. (2004). Hospital survey on patient safetyculture. Rockville, MD: Agency for Healthcare Research andQuality.
Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder,A. M. B., Nadal, K. L., & Esquilin, M. (2007). Racial
microaggressions in everyday life: Implications for clinicalpractice. American Psychologist, 62, 271–286.
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versuscultural competence: A critical distinction in defining physiciantraining outcomes in multicultural education. Journal of HealthCare for the Poor and Underserved, 9, 117–125.