Dr. Ron Westrum was one of the first to observe the importance of organizational culture on safety and performance. He observed that in healthcare organizations, the presence of “generative” cultures was one of the top predictors of patient safety. Dr. Westrum defined three types of culture: Pathological organizations are characterized by large amounts of fear and threat. People often hoard information, withhold it for political reasons, or distort it to make themselves look better. Failure is often hidden. Bureaucratic organizations are characterized by rules and processes, often to help
  
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