The Relationship Between Organizational Culture and Practice Systems in Primary Care

Dugan, Donna Pillittere; Mick, Stephen S.; Scholle, Sarah Hudson; Steidle, Ernie F.; Goldberg, Debora Goetz

doi:10.1097/jac.0b013e3181ff6ef2

Cited by 22 publications

(11 citation statements)

References 20 publications

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“…Organizations should create infrastructures to promote NP-physician relations such as clear guidelines for NP and physician teamwork with the goal to provide best care to patients. The primary care settings with supportive organizational attributes such as collegiality are more likely to provide better patient care (Dugan, Mick, Scholle, Steidle, & Goldberg, 2011). Understanding the physician and NP relationship is crucial to understanding the organizational climate and improving primary care delivery.…”

Section: Discussionmentioning

confidence: 99%

Organizational climate in primary care settings: Implications for nurse practitioner practice

Poghosyan

Nannini

Clarke

2012

Journal of the American Academy of Nurse Practitioners

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NPs should be encouraged to assess organizational climate in their workplace and choose organizations that promote autonomy, collegiality between NPs and physicians, and encourage professional visibility. Organizational and NP awareness of qualities that foster NP practice will be a first step for developing strategies to creating an optimal organizational climate for NPs to deliver high-quality care. More research is needed to develop a comprehensive conceptual framework for organizational climate and develop new instruments to accurately measure organizational climate and link it to NP and patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Organizational climate in primary care settings: Implications for nurse practitioner practice

Poghosyan

Nannini

Clarke

2012

Journal of the American Academy of Nurse Practitioners

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“…Earlier research also established that an organizational culture that emphasizes quality is related to the existence of practice improvement activities (Dugan et al. ). Our case study research supports this finding and provides additional evidence that leadership priorities and support greatly influenced practice improvement efforts.…”

Section: Discussion and Conceptual Frameworkmentioning

confidence: 99%

Why Do Some Primary Care Practices Engage in Practice Improvement Efforts Whereas Others Do Not?

Goldberg

Mick

Kuzel

et al. 2012

Health Services Research

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Objective.To understand what motivates primary care practices to engage in practice improvement, identify external and internal facilitators and barriers, and refine a conceptual framework. Data Sources. In-depth interviews and structured telephone surveys with clinicians and practice staff (n = 51), observations, and document reviews. Study Design. Comparative case study of primary care practices (n = 8) to examine aspects of the practice and environment that influence engagement in improvement activities. Data Collection Methods. Three on-site visits, telephone interviews, and two surveys. Principal Findings. Pressures from multiple sources create conflicting forces on primary care practices' improvement efforts. Pressures include incentives and requirements, organizational relationships, and access to resources. Culture, leadership priorities, values set by the physician(s), and other factors influence whether primary care practices engage in improvement efforts. Conclusions. Most primary care practices are caught in a cross fire between two groups of pressures: a set of forces that push practices to remain with the status quo, the "15-minute per patient" approach, and another set of forces that press for major transformations. Our study illuminates the elements involved in the decision to stay with the status quo or to engage in practice improvement efforts needed for transformation. Key Words. Primary care, practice transformation, quality improvement, qualitative research Why do some primary care practices manage to transform themselves into new models of health care delivery whereas others do not? This is the central question of our research because the quality of care received by many Americans is often suboptimal (Schoen et al. 2007;Anderson and Marcovich 2010). Quality issues plaguing primary care include patients' lack of access to

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“…When considering the patients side there are studies showing that patient satisfaction and quality of care is the same or better if nurses take over certain tasks from physicians autonomously [28–30]. On the other hand, one recent U.S. study found that those organizational cultures that emphasized collegiality and quality but not autonomy were related to quality evaluation and improvement [31]. …”

Section: Discussionmentioning

confidence: 99%

No common understanding of profession terms utilized in health services research

Hoffmann

Wojczewski

Aarendonk³

et al. 2016

Wien Klin Wochenschr

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SummaryBackgroundHealth services research, especially in primary care, is challenging because the systems differ widely between countries. This study aimed to explore the different understanding of the terminology used, particularly, regarding the professions nursing and medical secretaries.MethodsThe study was an add-on study to the Quality and Costs in Primary Care (QUALICOPC) project in Austria and designed as qualitative research. The qualitative phase was conducted by using semi-structured telephone interviews with general practitioners (GP). and17 GPs participated in the study.ResultsNo uniform meaning of the terms commonly utilized for the abovementioned health professions could be found among Austrian GPs. For example, under the profession term practice assistants, nurses as well as literal medical secretaries with and without special education and related work competencies and responsibilities were subsumed.ConclusionsOur study results show that no uniform meaning of the terms commonly utilized for above described health profession could be found even within one country by GPs. These findings are highly relevant, especially, when trying to compare results with similar data from other countries or negotiating about workforce issues. Our findings implicate several action points for health services research and health policy. We propose the development of a harmonized terminology in Europe for the health profession based on standards of undergraduate and postgraduate education, competencies and continuous education commitments. This would not only benefit comparative health system research but also patient safety across Europe.

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The Relationship Between Organizational Culture and Practice Systems in Primary Care

Cited by 22 publications

References 20 publications

Organizational climate in primary care settings: Implications for nurse practitioner practice

Organizational climate in primary care settings: Implications for nurse practitioner practice

Why Do Some Primary Care Practices Engage in Practice Improvement Efforts Whereas Others Do Not?

No common understanding of profession terms utilized in health services research

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