TY - JOUR
T1 - Hospitals as cultures of entrapment
T2 - A re-analysis of the Bristol Royal Infirmary
AU - Weick, Karl E.
AU - Sutcliffe, Kathleen M.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2003
Y1 - 2003
N2 - High performance is often attributed to an organization's culture. However, culture can just as easily undermine performance when it blinds decision makers to important performance issues and entraps them in unfortunate courses of action from which they cannot disengage. The dynamics of cultural entrapment are explored in the case of the Bristol Royal Infirmary, in which pediatric cardiac surgeries continued for over a fourteen-year period despite evidence of poor quality care and performance that was far below that of other comparable pediatric surgical centers. A single organizational process of behavioral commitment explains how the cultural mindset originated and why it persisted. The sequence of small, public, volitional, and irrevocable action; socially acceptable justification for that action; and the potential for subsequent activities to validate or threaten the justification created a causal loop that stabilized subsequent action patterns.
AB - High performance is often attributed to an organization's culture. However, culture can just as easily undermine performance when it blinds decision makers to important performance issues and entraps them in unfortunate courses of action from which they cannot disengage. The dynamics of cultural entrapment are explored in the case of the Bristol Royal Infirmary, in which pediatric cardiac surgeries continued for over a fourteen-year period despite evidence of poor quality care and performance that was far below that of other comparable pediatric surgical centers. A single organizational process of behavioral commitment explains how the cultural mindset originated and why it persisted. The sequence of small, public, volitional, and irrevocable action; socially acceptable justification for that action; and the potential for subsequent activities to validate or threaten the justification created a causal loop that stabilized subsequent action patterns.
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U2 - 10.2307/41166166
DO - 10.2307/41166166
M3 - Review article
AN - SCOPUS:0037412612
SN - 0008-1256
VL - 45
SP - 73
EP - 84
JO - California Management Review
JF - California Management Review
IS - 2
ER -