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Table 1 Characteristics of included studies

From: The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review

  Larson Kinjerski
Study design CBA CBA
Providers Manager, medical and nurse leaders RNs; LPNs; RNAs; other (admin, housekeeping, food service, physio)
Patients Adult and neonatal Elderly long-term care residents
Setting Two hospitals in mid-Atlantic region Two long-term care units, Canada
Unit of allocation Adult intensive care unit (ICU) and neonatal ICU Long-term care unit
Unit of analysis Hospital Long-term care unit
Intervention Top-level administrative intervention using a framework for changing organisational culture. Interventions included dissemination of key messages, marketing approaches (distribution of samples), education interventions, audit and feedback, opinion leaders (supervisors). Organizational intervention through education sessions to 'boost morale' and improve provider satisfaction with their work, offering psychic rewards.
- 1-day workshop on 'cultivating spirit at work in long-term care'
- 1-hour booster sessions each week at shift changes
Control Standard care Standard care
Target behaviour Handwashing practice Employee spirit at work, employee wellness, job satisfaction, organizational commitment, turnover, absenteeism.
Outcomes a) Handwashing frequency
b) Nosocomial infection associated with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE).
a) Health professional outcomes/process measures: decrease in turnover and absenteeism; improved employee spirit at work, employee wellness, job satisfaction and organizational commitment.
b) Patient outcomes: increased focus on residents with implications for Quality of Care (not stated as an outcome to be measured, but reported on as a result of the program).
Risk of Bias assessment
Allocation sequence adequately generated NO NO
Allocation adequately concealed NO NO
Baseline outcome measurements similar NO YES
Baseline characteristics similar UNCLEAR UNCLEAR
Incomplete outcome data adequately addressed YES YES
Knowledge of the allocated interventions adequately prevented NO NO
Protection against contamination UNCLEAR UNCLEAR
Free from selective outcome reporting YES UNCLEAR
Free from other risks of bias NO (one site CBA) NO (one site CBA)