(n=37), (1) and (2) combined. We prepared multilevel regression models using scales describing Quality of patient care, Climate to learning, Job satisfaction, and Relations with physicians as dependent variables. As independent variables, we used variables representing local ward conditions. Results. 87 wards,1,137 nurses (55% response rate) provided complete data. The total proportion of variance at ward level ranged from 0.11 (Job satisfaction) to 0.22 (Relations with physicians). The univariate effect of organization models on quality ratings was not statistically significant. Introducing local ward conditions lead to a statistically significant effect of Primary nurse organization on Relations with physicians, and to a substantial proportional reduction in ward level variance, ranging from 32%(Quality of patient care) to 24%(Climate to learning). Conclusion. This study could not show that any of the three organization models were better than the two others in terms of the nurses' perceived quality of patient care or practice environment.
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SUMMARY STATEMENT
What is already known about this topic•Quality improvement is an important responsibility for hospital managers at all levels •The commission of first level nurse managers is to pursue quality for patients, employees, and society•There is little knowledge about the relations between nursing organization in hospital wards and the nurses' perceptions of the quality of patient care and practice environment
What this paper adds•Nurses' ratings of quality is not related to the model of nursing organization•Local conditions other than nursing organization are associated with quality in the eyes of the nurses•Service quality seems to be a weak argument for choosing one model before another 7