Culture and quality care perceptions in a Pakistani hospital.
OBJECTIVE
Organizational culture is a determinant for quality improvement. This paper aims to assess organizational culture in a hospital setting, understand its relationship with perceptions about quality of care and identify areas for improvement.


METHODS
The paper is based on a cross-sectional survey in a large clinical department that used two validated questionnaires. The first contained 20 items addressing perceptions of cultural typology (64 respondents). The second one assessed staff views on quality improvement implementation (48 faculty) in three domains: leadership, information and analysis and human resource utilization (employee satisfaction).


RESULTS
All four cultural types received scoring, from a mean of 17.5 (group), 13.7 (developmental), 31.2 (rational) to 37.2 (hierarchical). The latter was the dominant cultural type. Group (participatory) and developmental (open) culture types had significant positive correlation with optimistic perceptions about leadership (r = 0.48 and 0.55 respectively, p < 0.00). Hierarchical (bureaucratic) culture was significantly negatively correlated with domains; leadership (r = -0.61,p < 0.00), information and analysis (-0.50, p < 0.00) and employee satisfaction (r = -0.55, p < 0.00). Responses reveal a need for leadership to better utilize suggestions for improving quality of care, strengthening the process of information analysis and encouraging reward and recognition for employees.


CONCLUSIONS
It is likely that, by adopting a participatory and open culture, staff views about organizational leadership will improve and employee satisfaction will be enhanced. This finding has implications for quality care implementation in other hospital settings.


CONCLUSIONS
The paper bridges an important gap in the literature by addressing the relationship between culture and quality care perceptions in a Pakistani hospital. As such a new and informative perspective is added.
Rabanni
Fauziah
F
Aga Khan University Hospital, Karachi, Pakistan. fauziah.rabbani@aku.edu
Jafri
S M Wasim
SM
Abbas
Farhat
F
Jahan
Firdous
F
Syed
Nadir Ali
NA
Pappas
Gregory
G
Azam
Syed Iqbal
SI
Brommels
Mats
M
Tomson
Göran
G
D003430:Cross-Sectional Studies; D003625:Data Collection; D004526:Efficiency; D005260:Female; D016304:Hospitals, Private / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007857:Leadership; D008297:Male; D015279:Organizational Culture; D010154:Pakistan; D011787:Quality of Health Care / Q000592:standards*; D012938:Social Perception; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017749:Total Quality Management