A Typology of Organisational Cultures

Westrum · Safety & Error, Origins, Culture & Context · Quality and Safety in Health Care · 2004 · Open access

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Westrum's statement, for a medical audience, of the pathological, bureaucratic and generative typology, which he says he created in 1988 to compare how organisations process information, following his earlier work on social intelligence about hidden events such as the battered child syndrome. The 1988 original was a conference presentation, available from Westrum on request. Culture is defined as an organisation's pattern of response to the problems and opportunities it encounters, and the issue the paper treats as most critical for safety is the flow of information: not merely how much moves from A to B but its relevance, timeliness and appropriateness to the recipient. Three types follow from what leaders are preoccupied with. A focus on personal power, needs and glory produces the pathological, a focus on rules, positions and departmental turf the bureaucratic, and a focus on the mission itself the generative. Leaders signal their preferences through symbolic action, reward and punishment; the workforce reads the signs and the culture follows. The paper's table sets the three side by side: power, rule or performance oriented; messengers shot, neglected or trained; bridging discouraged, tolerated or encouraged; failure leading to scapegoating, justice or inquiry; novelty crushed, leading to problems, or implemented.

The climate's effects are said to be pervasive because it shapes three variables. Alignment, meaning whether people identify with the mission, with their own unit or function, or with a person or clique. Awareness, whether people are kept informed about what bears on their work, illustrated on the bureaucratic side by Hubble technicians jury-rigging a critical measuring rod without realising they were causing a multi-billion dollar problem. And empowerment, which generative organisations need for maximum performance, while in bureaucratic ones thinking may stop at the department's boundary; the ability to think, Westrum notes, is often coextensive with the ability to act. Columbia's managers, feeling they could do nothing if the shuttle was damaged, made few efforts to get in-flight photographs and even interfered with those seeking them. Westrum suggests that responses to anomaly might be classified as suppression, encapsulation, public relations, local fix, global fix or inquiry; suppression appears to mark the pathological, inquiry and global fixes the generative, and bureaucracies prefer the rest.

The paper carries its own qualifications. The relationship between climate and performance is statistical rather than deterministic, many effective organisations are not generative, and the scheme is silent on training, structure and problem-solving style. Westrum is open about where the evidence falls short: case studies plentiful but systematic tests rare, proof of a link to safety scarce, a 1986 study suggesting that cooperation in intensive care lowered mortality unsupported on follow-up, and the correlation called a hypothesis, though one based on considerable observation and study, whose reasons are still being explored. What he calls a most striking confirmation is Edmondson's 1996 study of nursing supervision in eight hospital departments, not designed to test the typology. He treats its tenfold difference in error reporting between the best and worst cases as suggestive, not definitive, since reported errors are a share of those that occur, a share that may vary with the culture. Work by Edmondson and colleagues on cardiac surgery teams adopting a new minimally invasive technique is cited as further support: the teams that encouraged information flow were more successful at institutionalising it.

The key messages say culture is mutable, and the paper qualifies this. A change of leader can change a culture, as on the USS Benfold in only a few months, but the Italian regional cultures Putnam studied have been in place for centuries. Westrum's impression is that leadership shows most at the extremes, with bureaucratic culture a kind of default. An isolated generative unit can become the target of hostile jibes and political actions, as happened to the naval laboratory Westrum studied, while pathological units can survive on political connections, grants or publication rates. The discussion ends on the point that context matters.

Westrum, R. (2004) 'A typology of organisational cultures', Quality and Safety in Health Care, 13(Suppl II), pp. ii22-ii27.

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