Évaluation de la culture et de l'organisation des services de réanimation

Culture and organisation are often considered as variables which can explain differences of ICUs performance. This article explores this assumption. After a brief description of the concepts of culture and organisation in the area of management science, results from a research led in a PHRC and using a regional database (Cub-Réa) are presented. Main results are: (i) elaboration and validation of a questionnaire allowing to measure these two concepts; (ii) a benchmarking approach between the 26 services of the study based on the results of the answers of the respondents to the questionnaire (N = 1000), pointing out the difference of cultural profile between the responsible of the unit (Head-physician/Head-nurse) and the other members of the unit; (iii) a comparison of these results with similar studies, showing that the French ICUs of this panel can be characterized as high reliability organizations in which members express a high level of burn-out; (iv) analysis of the differences of the organisation ICUs quality. Such a questionnaire must be tested for its reliability in other ICUs. The link between culture/organisation and results such as adjusted mortality/technical efficiency must also be studied.