Error management in health organizations: how high reliability organizations may implement organizational performance adopting a generating view of errors.

The recent construct of Error Culture (van Dyck, Frese, Baer & Sonnentag, 2005) suggests that organizations that have an effective approach to errors are more apt to learn from errors and to risk and experiment. So, in the long run, they are more likely to improve their performance and to innovate. In fact errors may be conceived not only as adverse events, because of the negative consequences they can result in (e.g. loss of quality, accidents), but also as a form of negative feedback. As such, they provide valuable information to develop the resilience of the system, to reduce new errors in future, and to foster the organizational learning (Hofmann & Frese, 2011). This is more relevant in High Reliability Organizations (Weick & Sutcliffe, 2007), as health contexts are: because of high internal uncertainty and job complexity (Morgeson & Humphrey, 2006), they have both a higher probability to do errors, and more disruptive error negative consequences (Pronovost et al, 2006). However, this theoretical framework has little empirical evidence (e.g. Harteis et al, 2008; Cigularov et al, 2010) and, to the best of our knowledge, none in the sanitary context. This contribution aims to verify the influence of the error management culture on organizational performance, both as an enabling factor of the organizational growth (goal achievement, innovation), as proved by authors (van Dyck et al, 2005) and as a protective factor (reduction of effective errors and of turnover intent), as suggested by literature. Our study examines the relation between organizational performance, error culture management and job complexity perception in the Health context. Data from 477 health workers of 20 health units from different Italian hospital were analysed using regression analyses. Results show that perception of job complexity (various, specialized and high-level skills) positively implements error management culture that, in turn, influences organizational performance (respectively, it has a positive influence on goal achievement, innovativeness and collective efficacy, and a negative influence on turnover intent and effective errors). When cultures are high in error management, promoting an active learning process, organizations reduces the errors made and better their performance. In addition, the mediational role of error culture management in the relation between job complexity and organizational performance confirms the relevance of this construct for High Reliability Organizations, such as health contexts.