**6. The importance of organizational culture and leadership**

Good leadership is paramount to organizational success. Rapidly evolving modern healthcare environment requires leaders to be highly flexible and well-versed in change management skills, with focus on the delivery of high-quality, safe patient care. The establishment of a culture of safety is critical to the leadership's ability to bring about institutional change, enhanced quality of care, and ultimately better patient outcomes [3, 4, 8]. Moreover, healthcare leaders must make patient safety a top organizational priority [8], and through such prioritization, a positive "trickle-down" effect will help gradually facilitate the desired institutional transformation. High-reliability organizations (HRO) can be defined as being able to successfully implement changes required to make them more efficient, safer, and cost-effective. This, in turn, exemplifies the "big picture" view of value-driven health care.

**References**

Croatia: InTech; 2017

2014;**208**(1):65-72

AHRQ; 2008

AHRQ; 2005

2012

Affairs. 2008;**27**(3):759-769

Wolters Kluwer Health (India) Pvt Ltd; 2014

Operations Management. 2009;**27**(5):390-404

NHS. London: The Health Foundation; 2015

[1] Gaba DM. Structural and organizational issues in patient safety: A comparison of health care to other high-hazard industries. California Management Review. 2000;**43**(1):83-102

Introductory Chapter: Medical Error and Associated Harm: The Critical Role of Team…

http://dx.doi.org/10.5772/intechopen.78014

9

[2] Tolentino JC et al. Introductory chapter: Developing patient safety champions. In:

[3] Stawicki SP, Firstenberg MS. Introductory chapter: The decades long quest continues toward better, safer healthcare systems. In: Vignettes in Patient Safety. Vol. 1. Rijeka,

[4] Stawicki S et al. Fundamentals of Patient Safety in Medicine and Surgery. New Delhi:

[5] Stawicki SP et al. Natural history of retained surgical items supports the need for team training, early recognition, and prompt retrieval. American Journal of Surgery.

[6] Morath JM, Turnbull JE. To Do No Harm: Ensuring Patient Safety in Health Care

[7] Berwick DM, Nolan TW, Whittington J. The triple aim: Care, health, and cost. Health

[8] McFadden KL, Henagan SC, Gowen III CR. The patient safety chain: Transformational leadership's effect on patient safety culture, initiatives, and outcomes. Journal of

[9] Emanuel L et al. What Exactly Is Patient Safety? In: Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 1: Assessment). Rockville, Maryland:

[10] Bisognano M, Kenney C. Pursuing the Triple Aim: Seven Innovators Show the Way to Better Care, Better Health, and Lower Costs. Somerset, New Jersey: John Wiley & Sons;

[11] Illingworth J. Continuous improvement of patient safety. In: The Case for Change in the

[12] Sirio CA et al. Shared Learning and the Drive to Improve Patient Safety: Lessons Learned from the Pittsburgh Regional Healthcare Initiative. In: Advances in Patient Safety: From Research to Implementation (Volume 3: Implementation Issues). Rockville, Maryland:

[13] O'Leary D, Leape L. Teaching physicians to provide safe patient care. In: Patient Safety

[14] Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. Journal of

Handbook. 2nd ed. US: Jones and Bartlett Learning; 2012. pp. 425-451

the American Medical Association. 1992;**267**(16):2221-2226

Vignettes in Patient Safety-Volume 2. Rijeka, Croatia: InTech; 2018

Organizations. Somerset, New Jersey: John Wiley & Sons; 2005

Organizational culture defines the parameters of the work environment. For each healthcare institution and system, poorly managed variability within and between individuals, teams, departments, etc. has the potential to create a dangerous mix of both active and latent systemic contributors to patient safety events. In order to reconfigure the culture of an organization, not only does it takes broad-based staff buy-in but also effective leaders who are able to inspire individuals and teams to pursue both personal and operational excellence.
