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The importance of culture is often emphasized for continuous learning and quality improvement within health care organizations. Limited empirical evidence for cultivating a culture that supports continuous learning and quality improvement in health care settings is currently available.

The purpose of this report is to characterize the evolution of a large division of physical therapists and occupational therapists in a pediatric hospital setting from 2005 to 2018 to identify key facilitators and barriers for cultivating a culture empowered to engage in continuous learning and improvement.

An ethnographic methodology was used including participant observation, document review, and stakeholder interviews to acquire a deep understanding and develop a theoretical model to depict insights gained from the investigation.

A variety of individual, social, and structural enablers and motivators emerged as key influences toward a culture empowered to support continuous learning and improvement. Features of the system that helped create sustainable, positive momentum (e.g., systems thinking, leaders with grit, and mindful design) and factors that hindered momentum (e.g., system uncertainty, staff turnover, slow barrier resolution, and competing priorities) were also identified.

Individual-level, social-level, and structural-level elements all influenced the culture that emerged over a 12-year period. Several cultural catalysts and deterrents emerged as factors that supported and hindered progress and sustainability of the emergent culture.

Cultivating a culture of continuous learning and improvement is possible. Purposeful consideration of the proposed model and identified factors from this report may yield important insights to advance understanding of how to cultivate a culture that facilitates continuous learning and improvement within a health care setting.

Research has shown that Indigenous people suffer significant health inequalities in comparison to dominant colonising cultures. Evidence shows that these inequalities can be addressed by gaining a deeper understanding of the social and cultural determinants of health, applying Indigenous views of health and developing better definitions of the term wellbeing. The following chapter draws on research exploring the relationship between Indigenous culture, the landscape and the connection with health and wellbeing. In Aotearoa/New Zealand, consideration of Indigenous Māori is a national imperative, enshrined in the Te Tiriti o Waitangi (Treaty of Waitangi) which establishes it as a bicultural country. Exploring three Māori health models, the chapter examines the factors that play a significant role in shaping Māori people's health. It relates how landscape is a foundational therapeutic aspect of Māori wellbeing using the models to express the forces that impact both positively and negatively on this relationship. The chapter concludes that all three concepts, culture, health and landscape, are interconnected and must be balanced to reduce Māori health inequalities and to provide a more sustainable model for health and wellbeing for all New Zealanders.

This paper examines how cultural holes that exist at the intersection of institutional fields influence the exploitation of entrepreneurial opportunities. Through an exploration of physician-founded ambulatory surgery centers in the United States, we examine how the presence of cultural holes presented doctors with alternative beliefs, values, and practices to overcome the cultural constraints around entrepreneurship within the medical profession. In doing so, this study extends cultural entrepreneurship research by bringing cultural holes to the forefront, empirically showing how they facilitate entrepreneurial action and proposing other contexts where cultural holes may affect entrepreneurial actions and outcomes.

Three important lessons can be drawn from the health situation in developing and democratizing world. First lesson is that the societal health does not occur in the vacuum of societal life or social structures, but it simultaneously inspires development of all major spheres of political, economic, and cultural life of society. Second, health policy transpires simultaneously in all major social institutions, including economy, political institutions, and culture. Furthermore, because all social institutions are interconnected, the initiation of health reforms causes enormous, multilevel changes in all social strata and affects the performance of all essential institutions. Third, according to the World Health Organization, health is considered an integral part of human security, human rights, and peace. Consequently, societal health is determined and depends on the fullest cooperation of governments, world-scale communities, and local health care providers.

This chapter analyzes key concepts involved in the development of a well-being organizational culture, as well as theoretical proposals to promote this type of culture at work. It reflects on how companies can – drawing from this effort – articulate the Sustainable Development Goals (SDGs) in their management, strengthen their sustainability, and contribute to sustainability in their societies and exemplify how this topic has been dealt with during the pandemic in several organizations.

Purpose: As biomedicine grants technology and quantification privileged roles in our cultural constructions of health, media and technology play an increasingly important role in mediating our everyday experiences of our bodies and may contribute to the reproduction of gendered norms.

Design: This study draws from a broad variety of disciplines to contextualize and interpret contemporary trends in self-quantification, focusing on metrics for health and fitness. I will also draw from psychology and feminist scholarship on objectification and body-surveillance.

Findings: I interpret body-tracking tools as biomedical technologies of self-surveillance that facilitate and encourage control of human bodies, while solidifying demands for standardization around neoliberal values of enhancement and optimization. I also argue that body-tracking devices reinforce and normalize the scrutiny of human bodies in ways that may reproduce and advance longstanding gender disparities in detriment of women.

Implications: A responsible conceptualization, design, implementation, and usage of health-tracking technologies requires us to recognize and better understand how technologies with widely touted benefits also have the potential to reinforce and extend inequalities, alter subjective experiences and produce damaging outcomes, especially among certain groups. I conclude by proposing some alternatives for devising technologies or encouraging practices that are sensitive to these differences and acknowledge the validity of alternative values.

This study examines the decision process of household members in visiting local health care providers. It also explores the effect of various household level socioeconomic factors on motivating rural people to visit traditional versus modern health care providers in rural Bangladesh. I used the Population, Environment, and Poverty data collected from eight villages of rural Bangladesh in 1998 in addition to self-collected ethnographic survey information. The data suggest that a large majority of rural households attempt to visit locally available untrained health care providers first, and then trained doctors as the sickness worsens. The data also suggest that socio-cultural and economic factors are important in shaping their decision to visit traditional as opposed to modern health care providers. Training the traditional and untrained health care providers will be a wise option to ensure health care to the villagers.

The needs for health system change and improved patient safety have been pointed out by policymakers, researchers, and managers for several decades. Patient safety is now widely accepted as being fundamental to all aspects of health care. The question motivating this special volume on patient safety is: How can the increased emphasis on patient safety among health care managers be more effectively translated into better policy and reduced clinical risk? The 12 contributions in this volume are divided into four sections: (1) theoretical perspectives on managing patient safety; (2) top management perspectives on patient safety; (3) health information technology (HIT) perspectives on patient safety; and (4) organizational behavior and change perspectives on patient safety. Patient safety is a topic that provides a fertile niche for management researchers to test existing theories and develop new ones. For example, the patient safety goals of reducing medical errors while maximizing health outcomes draws upon the tenets of evidence-based medicine (EBM), as well as the managerial theories of human relations, organizational culture, organizational development, organizational learning, organizational structure, quality improvement, and systems thinking. Indeed, these and other managerial theories are drawn upon and applied in different ways by the various contributors. Overall, the authors of this volume demonstrate that the future of patient safety for health care management requires health care professionals and managers who can successfully engage in multi-faceted projects that are socially and technically complex.

The incipient HIV/AIDS epidemic in Chile poses challenges for responsiveness of the Chilean national health care system, Fondo Nacional de Salud (FONASA) (National Health Funds), especially given the sociocultural forces for inertia in FONASA. Thus, the issue is what is the nature of the forces for change. A grounded theory approach was applied to interview data from two qualitative studies, one with HIV/AIDS advocates and activists as interviewees and the other with Chilean low-income women. The stories of their experiences with and perceptions of FONASA revealed major issues facing FONASA, including quality of care and ethics. Ways in which these issues are being addressed by the activists result in constructed environmental dynamism. A conceptual model of the forces for change was developed including actors, strategies, and targets of change that constitutes organizational environmental dynamism. The construct of environmental dynamism has international applicability, particularly to governmental health systems, which are influenced by strong sociocultural forces.