title: Culture and quality care perceptions in a Pakistani hospital.
abstract: 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.
authors.affiliation: Aga Khan University Hospital, Karachi, Pakistan. fauziah.rabbani@aku.edu
authors.forename: Fauziah
authors.initials: F
authors.lastname: Rabanni
authors.forename: S M Wasim
authors.initials: SM
authors.lastname: Jafri
authors.forename: Farhat
authors.initials: F
authors.lastname: Abbas
authors.forename: Firdous
authors.initials: F
authors.lastname: Jahan
authors.forename: Nadir Ali
authors.initials: NA
authors.lastname: Syed
authors.forename: Gregory
authors.initials: G
authors.lastname: Pappas
authors.forename: Syed Iqbal
authors.initials: SI
authors.lastname: Azam
authors.forename: Mats
authors.initials: M
authors.lastname: Brommels
authors.forename: Göran
authors.initials: G
authors.lastname: Tomson
mesh_terms: 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