Bridging the gap between culture and safety in a critical care context: The role of work debate spaces

From the beginning, studies on reliability and safety have highlighted the crucial role of organizational culture. However, culture, context and groups of individuals are highly intertwined, making the culture difficult to manipulate and steer. Like Hopkins (2019), this study considers that taking only a "hearts and minds" approach to safety is ineffective without appropriate organizational structures. An interesting research avenue is therefore to understand the relationship between organizational structure and culture over time. This research took the form of an ethnographic study carried out in a French critical care unit to examine how structural spaces - in the form of "work debate spaces" - can connect safe medical practices and organizational culture. The study shed light on two types of work debate spaces: formal and informal spaces. These inter-related work debate spaces enable a more refined approach to understanding the relationship between structure and culture.