Organizational climate in primary care settings: implications for nurse practitioner practice.
OBJECTIVE
The purpose of this review is to investigate literature related to organizational climate, define organizational climate, and identify its domains for nurse practitioner (NP) practice in primary care settings.


METHODS
A search was conducted using MEDLINE, PubMed, HealthSTAR/Ovid, ISI Web of Science, and several other health policy and nursingy databases.


CONCLUSIONS
In primary care settings, organizational climate for NPs is a set of organizational attributes, which are perceived by NPs about their practice setting, emerge from the way the organization interacts with NPs, and affect NP behaviors and outcomes. Autonomy, NP-physician relations, and professional visibility were identified as organizational climate domains.


CONCLUSIONS
NPs should be encouraged to assess organizational climate in their workplace and choose organizations that promote autonomy, collegiality between NPs and physicians, and encourage professional visibility. Organizational and NP awareness of qualities that foster NP practice will be a first step for developing strategies to creating an optimal organizational climate for NPs to deliver high-quality care. More research is needed to develop a comprehensive conceptual framework for organizational climate and develop new instruments to accurately measure organizational climate and link it to NP and patient outcomes.
Columbia University School of Nursing, New York, New York.
Lusine
L
Poghosyan
Angela
A
Nannini
Sean
S
Clarke
D006801:Humans; D009722:Nurse Practitioners; D024802:Nurse's Role; D015279:Organizational Culture; D019555:Physician-Nurse Relations; D011320:Primary Health Care; D017009:Professional Autonomy
Work environments; nurse practitioners; organizational change; organizational climate; organizational culture; primary care