Factors influencing embedding of organization-wide culture change programs in health care: a scoping review.

Objective: The objective of this scoping review was to identify the key factors that influence embedding organization-wide culture change programs (OWCCP) in health care.

Introduction: OWCCP have been used as a mechanism in health care to assist the workforce to embed safe quality care. There is little research on the embedding phase of sustaining OWCCP.

Inclusion criteria: This review included studies explicitly on embedding OWCCP in health care at an organizational or facility level.

Methods: Searches were conducted in Scopus, Web of Science, MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), ProQuest, OpenGrey, World Cat, and Bielefeld Academic Search Engine (BASE) for studies published between January 2013 and March 2024. Data from the full-text articles were extracted and reported according to the SQUIRE 2.0 guidelines. Factors that influence embedding were inductively coded, interpreted, and grouped into categories.

Results: Of the 7,922 studies screened, 17 were included in the final review. Ten key factors emerged as influencing the embedding of OWCCP in health care. These included education and training; integrating the change program into business; measurement, monitoring, and feedback of outcomes; supportive leadership; resources to support the change; alignment with organizational culture; shared and defined accountability; adaptable change programs; engaging key stakeholders; and alignment with the external environment.

Conclusions: Our findings can be used to guide and support sustaining OWCCP in health care. The review identified important gaps in the knowledge base of embedding OWCCP in health care, including a need for future studies to clearly define what embedding OWCCP entails, and investigate how the different populations, settings, systems, and processes influence the embedding of OWCCP.

Spanish abstract: http://links.lww.com/IJEBH/A319.