Organizational Culture Associated With Provider Satisfaction

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Figure 1.
Description of the 4 culture archetypes within the Competing Values Framework for Organizational Culture. Adapted from Cameron and Quinn.¹
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Figure 2.
The organizational culture profiles of the 10 community clinics. Each colored trapezoid represents a single clinic.

Table 1. Mean Provider Satisfaction Scores on Survey Dimensions^*

Provider Satisfaction Dimension		Leadership and Communication (n = 10 items)	Quality of Care (n = 4 items)	Time Spent Working (n = 5 items)	Patient Interaction (n = 4 items)	Administrators (n = 4 items)	Compensation (n = 3 items)	Relationships with Staff (n = 4 items)	Resources (n = 4 items)	Acceptance by Colleagues (n = 5 items)	Paperwork (n = 3 items)	Computers (n = 3 items)	Preauthorization hassle (n = 4 items)
Practice^{^†}	Providers (n)	Leadership and Communication (n = 10 items)	Quality of Care (n = 4 items)	Time Spent Working (n = 5 items)	Patient Interaction (n = 4 items)	Administrators (n = 4 items)	Compensation (n = 3 items)	Relationships with Staff (n = 4 items)	Resources (n = 4 items)	Acceptance by Colleagues (n = 5 items)	Paperwork (n = 3 items)	Computers (n = 3 items)	Preauthorization hassle (n = 4 items)
Clinic 1	<4^{^‡}
Clinic 2	4	3.59	4.35	3.25	4.00	3.63	3.33	3.92	3.69	4.30	4.00	4.67	3.50
Clinic 3	6	3.11	4.15	2.91	4.03	3.13	3.28	4.14	3.80	4.10	3.43	4.56	3.86
Clinic 4	5	3.80	4.12	3.18	4.10	3.80	3.40	3.93	4.05	4.08	3.73	4.93	3.25
Clinic 5	7	4.21	4.25	4.22	4.23	4.21	3.56	4.21	3.87	4.71	3.67	4.95	3.06
Clinic 6	8	3.67	3.82	3.89	4.50	3.71	3.85	3.81	3.47	4.53	3.41	4.31	2.87
Clinic 7	4	3.53	3.55	2.60	4.06	3.69	2.75	3.92	4.19	4.00	2.83	4.58	1.63
Clinic 8	10	3.19	4.43	3.91	4.28	3.17	3.30	4.00	3.91	4.06	3.20	4.80	3.48
Clinic 9	11	3.82	4.33	3.80	3.88	3.88	3.75	3.90	3.82	4.18	3.47	4.64	3.53
Clinic 10	8	3.55	4.28	3.43	3.97	3.72	2.94	3.91	3.63	4.05	3.28	4.68	3.16
Grand means	63	3.61	4.14	3.47	4.12	3.66	3.35	3.97	3.83	4.22	3.45	4.68	3.15

Data are means.
↵* The provider satisfaction survey items were measured on Likert scales from “very dissatisfied” (1) to “very satisfied” (5). We aggregated items into 12 domains by summing responses to all survey items in each dimension then calculating grand means for each dimension. These composite domain scores are presented at the clinic level.
↵† Clinic numbers indicate the same clinics as those in Table 2.
↵‡ Because fewer than 4 providers responded, the data from clinic 1 were not included in our analyses.

Table 2. Culture Archetype Scores Within the Community Clinics

Community Clinics (respondents)	Culture Archetypes				P Value^*
Community Clinics (respondents)	Family/Clan	Entrepreneurial	Market/Rational	Hierarchical	P Value^*
Overall mean (n = 10 clinics)	30.1 (16.3)	15.4 (9.8)	24.2 (13.6)	30.3 (11.9)	.001
Clinic 1 (n = 10)	28.8 (17.2)	11.9 (8.3)	23.5 (15.7)	35.8 (15.5)	.007
Clinic 2 (n = 15)	25.5 (15.7)	18.4 (10.0)	29.4 (17.5)	26.6 (12.4)	.170
Clinic 3 (n = 16)	37.3 (10.0)	14.8 (9.7)	18.4 (7.6)	29.5 (12.6)	<.001
Clinic 4 (n = 13)	44.7 (18.4)	10.1 (11.2)	16.5 (9.9)	28.7 (12.8)	<.001
Clinic 5 (n = 10)	19.2 (10.2)	10.2 (7.8)	33.7 (16.5)	36.9 (10.4)	.002
Clinic 6 (n = 25)	28.8 (15.4)	14.2 (9.2)	22.7 (14.7)	34.2 (12.0)	<.001
Clinic 7 (n = 12)	22.1 (12.1)	15.5 (9.2)	27.5 (10.3)	34.8 (13.5)	.003
Clinic 8 (n = 11)	25.2 (13.9)	14.5 (8.8)	31.1 (15.2)	29.3 (6.2)	.008
Clinic 9 (n = 9)	32.1 (20.9)	15.4 (10.0)	21.5 (11.2)	31.0 (11.4)	.056
Clinic 10 (n = 13)	32.4 (9.5)	17.6 (5.7)	24.3 (11.6)	25.7 (5.0)	.001

Data are mean (SD). Bold values indicate the highest archetype score for each clinic.
↵* Analysis of variance of mean archetype scores across clinics followed by Tukey's pairwise comparison of archetypes within clinic (data not shown).

Table 3. Spearman Correlation of Provider Satisfaction With Clinic Culture Archetypes

Dimension/Survey Items by Provider Satisfaction	Culture Archetypes
Dimension/Survey Items by Provider Satisfaction	Family/Clan	Entrepreneurial	Market/Rational	Hierarchical
Leadership and communication dimension (n = 10 items)
How well your group is facing the economic and strategic challenges confronting the physicians in this country
Coefficient	−0.550	0.067	0.717	0.017
P value	.125	.865	.030^*	.966
Quality of care you are able to provide dimension (n = 4 items)
Coefficient	−0.500	0.283	0.717	−0.083
P value	.171	.460	.030^*	.831
Time spent working dimension (n = 5 items)
Coefficient	−0.300	0.783	0.367	−0.183
P value	.433	.013^*	.332	.637
Degree of control you have over your schedule
Coefficient	0.050	0.812	0.034	−0.385
P value	.898	.008^{^†}	.932	.306
Amount of time you spend with each patient
Coefficient	−0.400	0.833	0.383	−0.017
P value	0.286	0.005^{^†}	0.309	0.966
Relationships with staff dimension (n = 4 items)
Coefficient	0.385	0.310	0.017	−0.736
P value	.306	.418	.966	.0245^*
Resources dimension (n = 4 items)
Coefficient	0.400	−0.217	−0.100	−0.733
P value	.286	.576	.798	.025^*
Acceptance by colleagues dimension (n = 5 items)
My values are consistent with those of my colleagues.
Coefficient	−0.233	0.667	0.200	0.017
P value	.546	.050^*	.606	.966
Paperwork dimension (n = 3 items)
I do not have too much administrative work to do.
Coefficient	−0.733	0.233	0.883	0.150
P value	.025^*	.546	.002^{^†}	.700