title: The relationship between organizational culture of nursing staff and quality of care for residents with dementia: questionnaire surveys and systematic observations in nursing homes.
abstract: BACKGROUND
  Since the 1990s, several studies have shown that organizational culture is an important characteristic in long-term care. However, at the moment little is known about organizational culture and its relationship with quality of care.
  
  
  OBJECTIVE
  In this study, the relationship between organizational culture and quality of care in long-term care was investigated using the competing values framework. Thereto, two independent measurements of quality of care were applied: the perceived quality of care by nursing staff of dementia units and the observed quality of care on the units by researchers.
  
  
  METHODS
  The study used a cross-sectional design.
  
  
  METHODS
  Data were collected on 11 dementia units in 11 Dutch nursing homes.
  
  
  METHODS
  All nursing staff on the units were asked to complete a questionnaire, of whom 248 staff members responded. The average response rate on the 11 units was 63%.
  
  
  METHODS
  Data were collected during two days of field-work on each unit. Systematic observations were performed, and questionnaires were distributed among nursing staff. Data were analyzed using multilevel analyses.
  
  
  RESULTS
  Organizational culture was related to both perceived and observed quality of care on the units. Units that are characterized by a clan culture provide better quality of care, both in the eyes of the nursing staff as in the eyes of outsiders. Market culture, compared to clan culture, is negatively related to quality of care in this sample.
  
  
  CONCLUSIONS
  The results indicate that organizational culture in long-term dementia care is important for organizational performance.
authors.affiliation: Netherlands Institute for Health Services Research, Otterstraat 118-124, PO Box 1568, 3500 BN Utrecht, The Netherlands. s.vanbeek@nivel.nl
authors.forename: A P A
authors.initials: AP
authors.lastname: van Beek
authors.forename: D L
authors.initials: DL
authors.lastname: Gerritsen
mesh_terms: D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D006801:Humans; D009735:Nursing Homes / Q000458:organization & administration* / Q000592:standards; D009740:Nursing Staff; D015279:Organizational Culture; D011787:Quality of Health Care; D011795:Surveys and Questionnaires