title: The relationship between organizational climate and quality of chronic disease management.
abstract: OBJECTIVE
  To test the utility of a two-dimensional model of organizational climate for explaining variation in diabetes care between primary care clinics.
  
  
  METHODS
  Secondary data were obtained from 223 primary care clinics in the Department of Veterans Affairs health care system.
  
  
  METHODS
  Organizational climate was defined using the dimensions of task and relational climate. The association between primary care organizational climate and diabetes processes and intermediate outcomes were estimated for 4,539 patients in a cross-sectional study.
  
  
  METHODS
  All data were collected from administrative datasets. The climate data were drawn from the 2007 VA All Employee Survey, and the outcomes data were collected as part of the VA External Peer Review Program. Climate data were aggregated to the facility level of analysis and merged with patient-level data.
  
  
  RESULTS
  Relational climate was related to an increased likelihood of diabetes care process adherence, with significant but small effects for adherence to intermediate outcomes. Task climate was generally not shown to be related to adherence.
  
  
  CONCLUSIONS
  The role of relational climate in predicting the quality of chronic care was supported. Future research should examine the mediators and moderators of relational climate and further investigate task climate.
authors.affiliation: Center for Organization, Leadership, and Management Research, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130, USA. justin.benzer@va.gov
authors.forename: Justin K
authors.initials: JK
authors.lastname: Benzer
authors.forename: Gary
authors.initials: G
authors.lastname: Young
authors.forename: Kelly
authors.initials: K
authors.lastname: Stolzmann
authors.forename: Katerine
authors.initials: K
authors.lastname: Osatuke
authors.forename: Mark
authors.initials: M
authors.lastname: Meterko
authors.forename: Allison
authors.initials: A
authors.lastname: Caso
authors.forename: Bert
authors.initials: B
authors.lastname: White
authors.forename: David C
authors.initials: DC
authors.lastname: Mohr
mesh_terms: D002908:Chronic Disease / Q000628:therapy; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D015999:Multivariate Analysis; D015279:Organizational Culture; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States; D014728:Veterans