Hospitals as Cultures of Entrapment: A Re-Analysis of the Bristol Royal Infirmary
研究了组织文化如何导致决策者陷入不良行动模式，以布里斯托尔皇家医院儿科心脏手术持续14年低质量绩效为例，揭示行为承诺过程如何使文化心态产生并持续。
High performance is often attributed to an organization's culture. However, culture can just as easily undermine performance when it blinds decision makers to important performance issues and entraps them in unfortunate courses of action from which they cannot disengage. The dynamics of cultural entrapment are explored in the case of the Bristol Royal Infirmary, in which pediatrie cardiac surgeries continued for over a fourteen-year period despite evidence of poor quality care and performance that was far below that of other comparable pediatrie surgical centers. A single organizational process of behavioral commitment explains how the cultural mindset originated and why it persisted. The sequence of small, public, volitional, and irrevocable action; socially acceptable justification for that action; and the potential for subsequent activities to validate or threaten the justification created a causal loop that stabilized subsequent action patterns.