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Organizational culture is an abstract, yet potent managerial concept. With roots in several disciplines, several perspectives and definitions of organizational culture have emerged. One perspective focuses on norms and expectations within the organization. In this article, the authors present a quantitative approach to measuring and interpreting organizational culture based on established norms and expected behavior.
This study examines how perceptions of organizational culture influence organizational outcomes, specially, individual employee job satisfaction. The study was conducted in the health care industry in the United States. It examined the data on employee perceptions of job attributes, organizational culture, and job satisfaction, collected by Press Ganey Associates from 88 hospitals across the country in 2002-2003. Hierarchical linear modeling was used to test how organizational culture affects individual employee job satisfaction. Results indicated that some dimensions of organizational culture, specifically, job security and performance recognition, play a role in improving employee job satisfaction.
With the advent of managed care and the restructuring of hospitals, health care is in a state of transition. In the past, healthcare executives seemed to believe that they were isolated from the changes that were occurring in corporate America. However, the need for change in both organizational culture and performance is here. To successfully navigate the "permanent white water" of health care change, examples from business are needed. These examples include work redesign, restructuring, and behavior modification to promote the changes needed for health care to move forward.
Organizational culture is a key ingredient in successfully managing monumental strategic change initiatives. Those who are successful in managing change are actively integrating organizational culture into their total planning process. Organizational cultures should be a forethought in the management of the change process. Managers should give the same care and thoroughness to culture that they allot to the other major aspects of a plan. The culture of any organization in the midst of rapid change will not tolerate an information vacuum. People affected by change want to be able to ask questions and be heard. Communication should be interactive. Create opportunities that allow people at all levels of the organization to close the past. Without closure, some of the best people may feel that the organization has betrayed them. Creating a process that allows people to work through the change and motivating people to reinvent their approach and role in the new ways of doing things is what healthcare leadership in the 1990s is all about. It is part of the critical skill set that is necessary to lead Catholic-sponsored health services into the future.
This study determined the type of organizational culture (bureaucratic, innovative, or supportive), and determined the relationships among organizational commitment, and behavioural outcomes (turnover, absenteeism, and productivity) in hospital foodservice departments. The sample included 423 foodservice employees from nine hospitals in eastern Canada and nine hospitals in East Tennessee. Two research instruments were used for data collection. The historical data instrument, completed by the department director, obtained data to calculate productivity, turnover, and absenteeism rates. The four-part employee instrument included the 24-item Organizational Culture Index, the 15-item Organizational Commitment Questionnaire, five questions to determine perceptions of job satisfaction, and demographic items. Multiple linear regression analysis tested relationships among variables. The predominant culture was bureaucratic (14.9 +/- 4.3 of a possible 24). Means were lower for innovative (13.2 +/- 4.3) and supportive (12.7 +/- 5.0) cultures. Supportive and innovative cultures had positive relationships with both job satisfaction and organizational commitment. Organizational culture was not related to turnover, absenteeism, or productivity. Mean productivity was 3.8 +/- 3.2 meals per labour hour, ranging from 0.8 to 15.1. Employees rated satisfaction with co-workers highest, and satisfaction with pay lowest. These findings will help hospital foodservice managers understand the relationship of culture to organizational and employee outcomes; changing culture may improve desired outcomes.
Organizational culture has been shown by organizational psychology to influence important aspects of staff behaviour. In particular, mismatches between staff perceptions of real and ideal organizational cultures have been shown to be associated with a range of negative outcomes for staff, such as stress, sickness and staff turnover. The present study investigates organizational culture in services for people with intellectual disabilities. The aim was to discover the prevalent organizational cultures in these services, and associations between organizational culture and staff outcomes. As part of a large-scale survey of staff in services for people with intellectual disabilities, information concerning organizational culture and staff outcomes was collected from 450 staff. A self-report measure of real and ideal organizational culture produced nine dimensions of organizational culture: (I) tolerant/staff-oriented; (2) achievement-oriented; (3) innovative; (4) analytical; (5) social relationships; (6) rewarding staff; (7) stable work environment; (8) demanding; and (9) conflict management. These nine dimensions of organizational culture showed generally adequate psychometric properties. While there was some variation in organizational culture across services, there is little variation across staff with different job titles. Overall, the staff rated real organizational cultures to be relatively high in achievement orientation and fostering social relationships, and relatively low in managing conflict and providing rewards for staff. Staff rated ideal organizational cultures to be high in rewarding staff, being tolerant/staff-oriented and fostering social relationships, and low in demands on staff. Except for the dimension of making demands on staff, where staff rated organizations as considerably higher than ideal, staff generally rated organizations as being less than ideal on all dimensions of organizational culture. Organizational psychology theory predicts that poor 'person-organization fit' (i.e. a greater mismatch between real and ideal organizational culture) will be associated with a range of negative staff outcomes. This theory was largely supported by findings of the present study. The implications for practice and for future research are discussed.
AIM: This paper reports a critical review of nursing organizational culture research studies with the objectives of: (1) reviewing theoretical and methodological characteristics of the studies and (2) drawing inferences specific to the state of knowledge in this field. BACKGROUND: Organizational culture is regarded as significant in influencing research use in clinical practice yet it is not understood how culture shapes practitioners' behaviours. Only one review of this empirical literature in nursing has been completed. METHOD: Using selected computerized databases, published nursing research studies in English that examine organizational culture were accessed. Organizational culture studies were categorized using Hatch's three perspectives on organizational culture: (1) modern, (2) symbolic-interpretive and (3) postmodern. The review was conducted in 2005. RESULTS: Twenty-nine studies were in the final data set. Results pointed to variations in cultural definitions and incorporation of organizational sciences theory. In classifying the studies, modern perspectives dominated (n = 22), symbolic-interpretive approaches were an emerging group (n = 6) and one study was unclassifiable. Our results expand current cultural instrument reviews by pinpointing tools that have been previously overlooked and by identifying ongoing theoretical and methodological challenges for researchers. CONCLUSION: An exclusive reliance on modernistic approaches in organizational culture research cannot yield a complete understanding of the phenomenon. Rather, the field could benefit from a variety of cultural approaches. In a similar vein, researchers need to be mindful of the terminology and the unit of analysis they use in their research, as these are the two largest research challenges.
OBJECTIVES: A study was undertaken to determine the relationships among organizational culture, organizational commitment, and organizational readiness in a sample of employees participating in a hospital-wide redesign process. METHODS: Employees of an organization undergoing patient-focused redesign were surveyed after a 6-month period of preparation and before the initiation of the new care delivery model. RESULTS: Organizational readiness, a variable rarely described in organizational change literature, was the strongest predictor of employee commitment to the organization. Constructive culture also was predictive, but less so than readiness for change. CONCLUSIONS: Additional research is needed to clarify how an organization's history and culture of change contribute to employee willingness to work for the goals of the organization. Findings suggest that when change is seen as a positive characteristic of the environment, employees are more likely to commit to the work of the institution.
The organizational structure of many hospitals conflicts with the practice of professional nursing, adversely affecting patient outcomes. The ability of nurses to practise in a professional manner may be influenced by the organizational culture of their work environment. Personal attributes may also play a role. Patient outcomes depend on the identification and promotion of scarce health resources. Personal investment theory was used as the conceptual foundation for this study because of its ability to blend environmental context and personal behaviours associated with motivation. Secondary data analysis was undertaken to determine whether organizational culture and personal sense of accomplishment can predict nursing professionalism. Multiple regression analysis showed that organizational culture predicted over 16% of the variance in nursing professionalism. Therefore, nursing professionalism and hospital environment featuring a strong organizational culture are two health resources that can promote improved patient outcomes.
BACKGROUND: The importance of organizational culture in shaping everyday organizational life is well accepted, but little work has focused on organizational culture in pharmacy. Examining new pharmacists' experiences at various practice sites may help us to understand how these shape their professional ethos and practice habits. OBJECTIVES: (1) Present development and assessment of the Pharmacy Service Orientation (PSO) measure, a tool for assessing pharmacists' impressions of pharmacy practice sites. (2) Use data gathered from a sample of new pharmacists to explore potential predictors of PSO, including type of practice site, type of pharmacy work experience, and type of pharmacy degree. METHODS: Mail survey of randomly selected class of 1999 pharmacy graduates within 3 months of graduation (response rate: 259 of 1,850; 14%), each of whom reported on up to 6 different pharmacy practice sites for a total of 1,192 pharmacy observations. Pharmacy Service Orientation is scored on a 1-10 semantic differential scale and reliability was assessed using Cronbach's alpha. Predictors of PSO were explored using t test and ordinary least squares regression procedures. RESULTS: Reliability of the PSO across all observations was 0.86. When divided according to recency of experience and type of experience, reliabilities ranged from 0.78 to 0.87. Analysis of potential predictors of PSO showed that non-corporate-community sites had significantly greater pharmaceutical care-oriented cultures (mean PSOs of 7.42 and 5.13, respectively; P<.001). The same pattern was seen for academic and nonacademic worksites (mean PSOs of 7.46 and 6.01, respectively; P<.001). The pharmacist's pharmacy degree type was not predictive of PSO. Multivariate regression results showed that type of practice site and type of pharmacy work experience explained more than 25% of the observed variance in PSO. CONCLUSIONS: Pharmacy Service Orientation is a reliable measure. Statistically significant differences in PSO comparisons by degree and by experience type are explained by significant differences between the PSOs of corporate-community and non-corporate-community sites.
It is still not clear that organizational culture in hospitals is linked to patient or provider outcomes. However, measurement of organizational culture in nursing units within hospitals and for entire hospitals is common. Two instruments frequently used to measure hospital culture or work group culture within hospitals are the Organizational Culture Inventory (OCI) (Cooke & Lafferty, 1987) and the Nursing Unit Cultural Assessment Tool (NUCAT-2) (Coeling & Simms, 1993a). The purpose of this paper is to review selected empirical studies of organizational and work group culture in hospitals and critique these two measurement instruments. The paper discusses the issues of unit of analysis/aggregation bias and sample size when using these two instruments. It was concluded that OCI has been widely used in many types of organizations and has substantial data supporting the reliability and validity. However, the instrument does not always capture variation in nursing units. The NUCAT-2 has less reliability and validity data but researchers have reported wide variation among units. Individual items can be selected for use from the NUCAT-2 and it is less expensive to use than the OCI.
Many health care organizations are considering or undergoing work redesign or other workplace change. The result is profound changes in the organizational culture. In addition, change is also required in the work unit cultures. Understanding organizational culture results in better planning and implementation of change.
BACKGROUND: Increasing attention has been given to the role of organizational culture in influencing medication safety practices across healthcare settings. The lack of widely accepted standardized instrumentation makes operational measurement of organizational culture and medication safety challenging. The purpose of this systematic review was to examine the impact of organizational culture on medication safety within community healthcare settings. METHODS: MEDLINE, CINAHL, Scopus, and Nursing & Allied Health were searched in August 2025 using keywords, subject terms, field codes, and Boolean operators to identify papers relevant to the review question; bibliographies of included studies were also reviewed. Screening and full-text review were completed independently by two reviewers with a third to adjudicate conflicts. The Critical Appraisal Skills Programme was used for quality assessment. The PRISMA statement guided the development and implementation of the review. RESULTS: Thirteen articles were included representing various community settings. Most studies reported on untoward medication events, but few measured systematically collected safety data before and after an intervention. Organizational culture was seldom defined or operationalized. Most studies were methodologically sound, but the overall level of evidence was weak to moderate. CONCLUSION: Organizational culture influences medication safety through aspects such as communication channels, teamwork, training, and an environment that allows error and near-miss reporting. Few studies explicitly evaluate the causal impact of culture interventions on measurable medication safety outcomes in community healthcare settings. Further research should incorporate standardized measurement tools and intervention-based, pre-post designs to better understand how organizational culture influences medication safety in community healthcare settings.
BACKGROUND AND OBJECTIVES: A 1999 precursor to this study, published in Family Medicine, suggested that the organizational culture of practices was potentially important to health care providers and patients. In this research, we examined the experiences of people working in exemplary community health center practices to explore the components and maintaining factors of positive medical organizational culture. METHODS: Two exemplary practices were identified through a process of nominations and selection with respect to a presumptive definition of positive organizational culture. Interpretive categories and themes were developed through qualitative content analysis of semi-structured interviews, along with field observation. RESULTS: Categories of culture in these practices included Community Mission and Values, Leadership and Organizational Dynamics, Relationships, and Physical Space. Cultural qualities were nurtured by leadership approaches, collaborative staff meetings, and shared values about mission and workplace relationships. Staff consistently indicated that the spirit or culture in their practices was beneficial for employees, patients, and the process of clinical care. CONCLUSIONS: The positive organizational culture in these practices was substantially characterized and cultivated by specific values, attitudes, behaviors, and relationships of employees. Further work is indicated in approaches to assessment and intervention with organizational culture in medical settings and in evaluating associations with medical outcomes.
Presents a study of organizational culture in a community health-care Trust in the UK. The Trust has been involved in attempting to create what was described as an information-led culture and is concurrent with the implementation of a new information system. Describes some of the recent management initiatives which were intended to improve communications within the Trust and to provide employees with a better understanding of the changes which have been taking place. Identifies findings which suggest that there was some distance between the perceptions of management and those of employees. While the senior management team appear to have been in earnest in attempting to ensure that staff have the information and understanding they need, the results of an organizational culture survey suggest that these efforts may have been ineffective.
Managers can do many things to improve organizational performance, but the accomplishments of the most skillful employees often are most important. This article makes the point that managers should be aware of employee expertise and its relationship to organizational performance. The article also describes the components of an organizational culture of employee expertise. An organizational culture of employee expertise builds on the learning organization metaphor that has frequently appeared in the management literature. How employees develop expertise to do their jobs is emerging as a critical issue for organizations, and managers will likely play a key role in that process.
In this study, the author examines the relationship between staff perceptions of organizational culture and their work-related attitudes in assisted living. Data were collected from 317 staff in 61 facilities using self-administered questionnaires. Staff who had more favorable perceptions of organizational culture reported greater job satisfaction, coworker satisfaction, and organizational commitment. Among the dimensions of organizational culture, perceptions of teamwork had the strongest influence on satisfaction with coworkers, and perceptions of organizational morale had the strongest influence on job satisfaction and organizational commitment. Those who want to improve staff attitudes should focus on creating organizational cultures that promote teamwork and high organizational morale.
OBJECTIVE: This study investigated "thinking and behavioral" styles that are used to measure the concept of organizational culture among registered nurses (RNs) and unlicensed assistive personnel (UAPs) in acute care hospitals. BACKGROUND: The Organizational Culture Inventory has been used in numerous industries, including hospitals, to describe aspects of organizational culture in order to better understand and manage change. Evidence shows that nursing unit and hospital culture tends to be "constructive" but little evidence indicates whether workers in different job categories influence the culture differently. METHOD: This survey was conducted in five tertiary care hospitals on the west coast of the United States. The design is cross-sectional and analytic. A convenience sample was recruited from staff members working at least 20 hours per week in the adult medical-surgical and specialty nursing units. Analyses include descriptive statistics and multiple regression. RESULTS: Staff members of color, regardless of position, scored higher on the thinking and behavioral styles of approval, avoidance, and competitiveness. Unlicensed assistive personnel, regardless of race or ethnicity, scored higher on the thinking and behavioral styles dependence and opposition. CONCLUSION: Nurse administrators and managers should be aware of how the addition of unlicensed assistive personnel or people of color can change the culture of the nursing unit or hospital. Explicit management strategies may be necessary to promote employee behaviors that are desirable for patient care and for the organization.