Can Organisational Culture of Teams Be a Lever for Integrating Care? An Exploratory Study.

Maike V Tietschert,Sara J Singer,Federica Angeli,Jonathan Clark,Dirk Ruwaard,Arno J.A Van Raak

doi:10.5334/ijic.4681

Maike V Tietschert, Sara J Singer + Show 4 more

Open Access

https://doi.org/10.5334/ijic.4681

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Abstract

Introduction:Organisational culture is believed to be an important facilitator for better integrated care, yet how organisational culture impacts integrated care remains underspecified. In an exploratory study, we assessed the relationship between organisational culture in primary care centres as perceived by primary care teams and patient-perceived levels of integrated care.Theory and methods:We analysed a sample of 2,911 patient responses and 17 healthcare teams in four primary care centres. We used three-level ordered logistic regression models to account for the nesting of patients within health care teams within primary care centres.Results:Our results suggest a non-linear relationship between organisational culture at the team level and integrated care. A combination of different culture types—including moderate levels of production-oriented, hierarchical and team-oriented cultures and low or high levels of adhocracy cultures—related to higher patient-perceived levels of integrated care.Conclusions and discussion:Organisational culture at the level of healthcare teams has significant associations with patient-perceived integrated care. Our results may be valuable for primary care organisations in their efforts to compose healthcare teams that are predisposed to providing better integrated care.

Highlights

Organisational culture is believed to be an important facilitator for better integrated care, yet how organisational culture impacts integrated care remains underspecified
To respond to a high degree of input uncertainty associated with caring for complex patients, primary care organisations often rely on coordination based on shared values and goals [2, p. 1410, 3, 4] instead of formal coordination mechanisms [4, 5]
We investigate whether organisational culture at the level of healthcare teams relates to patient-perceptions of integrated care

Summary

Introduction

Organisational culture is believed to be an important facilitator for better integrated care, yet how organisational culture impacts integrated care remains underspecified. We assessed the relationship between organisational culture in primary care centres as perceived by primary care teams and patient-perceived levels of integrated care. Conclusions and discussion: Organisational culture at the level of healthcare teams has significant associations with patient-perceived integrated care. To respond to a high degree of input uncertainty associated with caring for complex patients, primary care organisations often rely on coordination based on shared values and goals [2, p. Organisational culture and performance are generally expected to be linearly related [4, 13, 14], assuming that strong cultures within the organisation are associated with better organisational performance [15] In healthcare, this expectation has found little empirical support [for example 13, 14, 16]. Few studies consider the patient’s perspective in defining performance outcomes such as integrated care [16]

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Discussion

Conclusion