Organizational culture associated with provider satisfaction

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.