| Learning Objective #1: Discuss challenges with secondary data analyses | |||
| Learning Objective #2: Identify critical components of organizational culture |
The objective is to explore organizational (hospital) cultures from a differentiation perspective (nurse specialty subcultures within and across hospitals) and to test a model for causal relationships between subcultures and selected patient outcomes.
It is a comparative, cross-sectional study based on secondary data.
The target population represents nurses working in one of six specialties in acute care hospitals in Alberta. The sample consists of 3,839 randomly selected registered nurses in 109 hospitals. The survey data were collected in 1998-99 as part of the International Hospital Outcomes Study, whose major purpose was to investigate the impact of practice environments on patient and nurse outcomes.
Organizational subculture is defined as shared assumptions, values and beliefs. Specialty subcultures (independent variables) are identified by three kinds of cultural manifestations: formal and informal practices, and inferred values. Patient outcomes (dependent variables) include adverse patient occurrences such as medication errors, nosocomial infections and patient/family complaints, and overall quality of care.
Nurses interpretations related to their professional practice environment were measured using the Nursing Work Index. Nurses also reported on other issues such as quality of care, job satisfaction, and outcomes. A model linking the variables was developed based on a systematic literature review of practice environment and organizational culture. Structural equation modeling with LISREL will be conducted to test the theory.
Findings and conclusions will be presented at the conference.
Nurses are generally familiar with the concept of culture and its importance in the provision of individualized patient care. Organizational culture, however, is less well understood and has been largely ignored as an important component of practice environment. It is suggested that nurses and managers consider organizational culture as a variable influencing quality of care and patient outcomes, and a tool that can be used for better nurse, patient, and system outcomes including improved workplace environments.
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Sigma Theta Tau International