title: Organizational culture associated with provider satisfaction.
abstract: BACKGROUND
  Organizational culture is key to the successful implementation of major improvement strategies. Transformation to a patient-centered medical home (PCHM) is such an improvement strategy, requiring a shift from provider-centric care to team-based care. Because this shift may impact provider satisfaction, it is important to understand the relationship between provider satisfaction and organizational culture, specifically in the context of practices that have transformed to a PCMH model.
  
  
  METHODS
  This was a cross-sectional study of surveys conducted in 2011 among providers and staff in 10 primary care clinics implementing their version of a PCMH: Care by Design. Measures included the Organizational Culture Assessment Instrument and the American Medical Group Association provider satisfaction survey.
  
  
  RESULTS
  Providers were most satisfied with quality of care (mean, 4.14; scale of 1-5) and interactions with patients (mean, 4.12) and were least satisfied with time spent working (mean, 3.47), paperwork (mean, 3.45), and compensation (mean, 3.35). Culture profiles differed across clinics, with family/clan and hierarchical cultures the most common. Significant correlations (P ≤ .05) between provider satisfaction and clinic culture archetypes included family/clan culture negatively correlated with administrative work; entrepreneurial culture positively correlated with the Time Spent Working dimension; market/rational culture positively correlated with how practices were facing economic and strategic challenges; and hierarchical culture negatively correlated with the Relationships with Staff and Resource dimensions.
  
  
  CONCLUSIONS
  Provider satisfaction is an important metric for assessing experiences with features of a PCMH model. Identification of clinic-specific culture archetypes and archetype associations with provider satisfaction can help inform practice redesign. Attention to effective methods for changing organizational culture is recommended.
authors.affiliation: the Department of Marketing, David Eccles School of Business; the Department of Family and Preventive Medicine, School of Medicine; the Department of Sociology; the Division of Geriatrics; and the Department of Economics, College of Social and Behavioral Science, University of Utah, Salt Lake City; the Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England; Community Clinics, University of Utah Hospitals and Clinics; VA Salt Lake City Geriatric Research, Education, and Clinical Center, Salt Lake City, UT; and University of Utah HealthPlans, Murray, UT.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Scammon
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tabler
authors.forename: Kimberly
authors.initials: K
authors.lastname: Brunisholz
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Gren
authors.forename: Jaewhan
authors.initials: J
authors.lastname: Kim
authors.forename: Andrada
authors.initials: A
authors.lastname: Tomoaia-Cotisel
authors.forename: Julie
authors.initials: J
authors.lastname: Day
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Farrell
authors.forename: Norman J
authors.initials: NJ
authors.lastname: Waitzman
authors.forename: Michael K
authors.initials: MK
authors.lastname: Magill
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006801:Humans; D007588:Job Satisfaction; D015279:Organizational Culture; D018802:Patient-Centered Care / Q000458:organization & administration*; D011216:Practice Management, Medical / Q000458:organization & administration*; D014589:Utah
keywords: Cross-Sectional Studies; Medical Home; Organizational Culture; Patient-Centered Care; Practice Management; Problem Solving