Meterko Mark, Mohr David C, Young Gary J
Management Decision and Research Center, VA Boston Healthcare System, Boston, Massachusetts, USA.
Med Care. 2004 May;42(5):492-8. doi: 10.1097/01.mlr.0000124389.58422.b2.
A growing line of research indicates a positive relationship between a healthcare organization's culture and various performance measures. In these studies, a key cultural characteristic is the emphasis placed on teamwork. None of the studies, however, have examined teamwork culture relative to patient satisfaction, which is now 1 of the most widely used performance measures for healthcare organizations.
This study investigated the relationship between teamwork culture of hospitals and patient reports of their satisfaction with the care they received.
The study setting was the Veterans Health Administration (VHA), Department of Veterans Affairs. The study sample consisted of 125 VHA hospitals for which independent and valid sources of data for culture and patient satisfaction were obtained. Each hospital's culture was assessed relative to 4 dimensions: teamwork, entrepreneurial, bureaucratic, and rational. Patient satisfaction data were available for both inpatient and outpatient settings.
Results from multivariate regression analyses indicated a significant and positive relation between teamwork culture and patient satisfaction for inpatient care, and a significant and negative relation between bureaucratic culture and patient satisfaction for inpatient care. Additional analyses revealed an almost 1 standard deviation difference in patient satisfaction scores between hospitals in the top third and bottom third of the distribution for the teamwork culture measure.
Study results suggest that hospitals and possibly other healthcare organizations should strive to develop a culture emphasizing teamwork and deemphasizing those aspects of bureaucracy that are not essential to assuring efficiency and quality care.
越来越多的研究表明,医疗保健机构的文化与各种绩效指标之间存在正相关关系。在这些研究中,一个关键的文化特征是对团队合作的重视。然而,没有一项研究考察过团队合作文化与患者满意度之间的关系,而患者满意度现在是医疗保健机构最广泛使用的绩效指标之一。
本研究调查了医院的团队合作文化与患者对所接受护理的满意度报告之间的关系。
研究背景为退伍军人事务部的退伍军人健康管理局(VHA)。研究样本包括125家VHA医院,这些医院拥有独立且有效的文化和患者满意度数据来源。每家医院的文化从四个维度进行评估:团队合作、创业、官僚和理性。患者满意度数据在住院和门诊环境中均可用。
多元回归分析结果表明,团队合作文化与住院护理患者满意度之间存在显著正相关,官僚文化与住院护理患者满意度之间存在显著负相关。进一步分析显示,在团队合作文化指标分布处于前三分之一和后三分之一的医院之间,患者满意度得分相差近1个标准差。
研究结果表明,医院以及其他可能的医疗保健机构应努力营造一种强调团队合作、淡化那些对确保效率和优质护理并非必不可少的官僚主义方面的文化。