Author(s)

Lane F. Donnelly^1,2,3*, Karen Frush^1,4,5, John Shook^1,6, Peter A. Schein^1,7, Edgar H. Schein^1,7

¹Stanford Medicine Center for Improvement, School of Medicine, Stanford University, Palo Alto, USA.
²Department of Radiology, School of Medicine, Stanford University, Palo Alto, USA.
³Center for Pediatric and Maternal Value, Lucile Packard Children’s Hospital—Stanford, Stanford Children’s Health, Palo Alto, USA.
⁴Department of Emergency Medicine, School of Medicine, Stanford University, Palo Alto, USA.
⁵Office of the Chief Quality Officer, Stanford Health Care, Palo Alto, USA.
⁶Lean Enterprise Institute, Boston, USA.
⁷Organizational Culture and Leadership Institute, Menlo Park, USA.

Driving improvement in healthcare can be challenging related in part related to the degree of complexity. We break down the aspects of culture needed to accelerate improvement into a technical domain and a social domain. Task processes can be considered an organization’s technical domain. The social processes, how those doing the work interact, can be thought of as the organization’s social domain. The technical domain focuses on the work related to tasks and the social domain on the relationships that make efficient and effective work possible. We argue that work requirements and social relations are inexorably intertwined—each profoundly impacting, reflecting, and even determining the other. In this review, we argue that in order to accelerate healthcare system improvement, focus must be given to processes that take into consideration both on the social and technical domains.

Improvement, Culture, Sociotechnical

Donnelly, L. , Frush, K. , Shook, J. , Schein, P. and Schein, E. (2020) The Importance of Both the Technical and Social Domains in Creating a Culture That Accelerates Improvement in Healthcare. Health, 12, 1575-1582. doi: 10.4236/health.2020.1212114.