title: Assessing archetypes of organizational culture based on the Competing Values Framework: the experimental use of the framework in Japanese neonatal intensive care units.
abstract: OBJECTIVE
  To assess organizational culture in neonatal intensive care units (NICUs) in Japan.
  
  
  METHODS
  Cross-sectional survey of organizational culture.
  
  
  METHODS
  Forty NICUs across Japan.
  
  
  METHODS
  Physicians and nurses who worked in NICUs (n = 2006).
  
  
  METHODS
  The Competing Values Framework (CVF) was used to assess the organizational culture of the study population. The 20-item CVF was divided into four culture archetypes: Group, Developmental, Hierarchical and Rational. We calculated geometric means (gmean) and 95% bootstrap confidence intervals of the individual dimensions by unit and occupation. The median number of staff, beds, physicians' work hours and work engagement were also calculated to examine the differences by culture archetypes.
  
  
  RESULTS
  Group (gmean = 34.6) and Hierarchical (gmean = 31.7) culture archetypes were higher than Developmental (gmean = 16.3) and Rational (gmean = 17.4) among physicians as a whole. Hierarchical (gmean = 36.3) was the highest followed by Group (gmean = 25.8), Developmental (gmean = 16.3) and Rational (gmean = 21.7) among nurses as a whole. Units with dominant Hierarchical culture had a slightly higher number of physicians (median = 7) than dominant Group culture (median = 6). Units with dominant Group culture had a higher number of beds (median = 12) than dominant Hierarchical culture (median = 9) among physicians. Nurses from units with a dominant Group culture (median = 2.8) had slightly higher work engagement compared with those in units with a dominant Hierarchical culture (median = 2.6).
  
  
  CONCLUSIONS
  Our findings revealed that organizational culture in NICUs varies depending on occupation and group size. Group and Hierarchical cultures predominated in Japanese NICUs. Assessing organizational culture will provide insights into the perceptions of unit values to improve quality of care.
authors.affiliation: Department of Health Informatics, School of Public Health, Kyoto University, Yoshida Konoe Sakyo, Kyoto 606-8501, Japan.|Department of Health Policy, National Research Institute for Child Health and Development, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo 157-8535, Japan.
authors.forename: Hatoko
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Department of Biostatistics, School of Public Health, Kyoto University, Yoshida Konoe Sakyo, Kyoto 606-8501, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yonemoto
authors.affiliation: Department of Health Policy, National Research Institute for Child Health and Development, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo 157-8535, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Mori
authors.affiliation: Department of Health Policy, National Research Institute for Child Health and Development, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo 157-8535, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Department of Neonatology, Maternal and Perinatal Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Sinjuku, Tokyo 162-8666, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kusuda
authors.affiliation: Department of Health Informatics, School of Public Health, Kyoto University, Yoshida Konoe Sakyo, Kyoto 606-8501, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D007564:Japan; D009726:Nurses / Q000523:psychology; D015279:Organizational Culture; D010820:Physicians / Q000523:psychology; D011795:Surveys and Questionnaires; D000078329:Workforce; D016526:Workload
keywords: intensive care; quality improvement; quality management; setting of care