基于竞争价值观框架评估组织文化原型：该框架在日本新生儿重症监护病房的实验性应用
Assessing archetypes of organizational culture based on the Competing Values Framework: the experimental use of the framework in Japanese neonatal intensive care units.
作者信息
Sasaki Hatoko, Yonemoto Naohiro, Mori Rintaro, Nishida Toshihiko, Kusuda Satoshi, Nakayama Takeo
机构信息
Department of Health Informatics, School of Public Health, Kyoto University, Yoshida Konoe Sakyo, Kyoto 606-8501, Japan.
Department of Health Policy, National Research Institute for Child Health and Development, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo 157-8535, Japan.
出版信息
Int J Qual Health Care. 2017 Jun 1;29(3):384-391. doi: 10.1093/intqhc/mzx038.
OBJECTIVE
To assess organizational culture in neonatal intensive care units (NICUs) in Japan.
DESIGN
Cross-sectional survey of organizational culture.
SETTING
Forty NICUs across Japan.
PARTICIPANTS
Physicians and nurses who worked in NICUs (n = 2006).
MAIN OUTCOME MEASURES
The Competing Values Framework (CVF) was used to assess the organizational culture of the study population. The 20-item CVF was divided into four culture archetypes: Group, Developmental, Hierarchical and Rational. We calculated geometric means (gmean) and 95% bootstrap confidence intervals of the individual dimensions by unit and occupation. The median number of staff, beds, physicians' work hours and work engagement were also calculated to examine the differences by culture archetypes.
RESULTS
Group (gmean = 34.6) and Hierarchical (gmean = 31.7) culture archetypes were higher than Developmental (gmean = 16.3) and Rational (gmean = 17.4) among physicians as a whole. Hierarchical (gmean = 36.3) was the highest followed by Group (gmean = 25.8), Developmental (gmean = 16.3) and Rational (gmean = 21.7) among nurses as a whole. Units with dominant Hierarchical culture had a slightly higher number of physicians (median = 7) than dominant Group culture (median = 6). Units with dominant Group culture had a higher number of beds (median = 12) than dominant Hierarchical culture (median = 9) among physicians. Nurses from units with a dominant Group culture (median = 2.8) had slightly higher work engagement compared with those in units with a dominant Hierarchical culture (median = 2.6).
CONCLUSIONS
Our findings revealed that organizational culture in NICUs varies depending on occupation and group size. Group and Hierarchical cultures predominated in Japanese NICUs. Assessing organizational culture will provide insights into the perceptions of unit values to improve quality of care.
目的
评估日本新生儿重症监护病房（NICU）的组织文化。
设计
组织文化的横断面调查。
地点
日本各地的40个NICU。
参与者
在NICU工作的医生和护士（n = 2006）。
主要观察指标
采用竞争价值观框架（CVF）评估研究人群的组织文化。20项CVF分为四种文化原型：团体型、发展型、层级型和理性型。我们按单位和职业计算了各维度的几何平均数（gmean）和95%自抽样置信区间。还计算了员工中位数、床位、医生工作时长和工作投入度，以考察不同文化原型之间的差异。
结果
总体而言，在医生中，团体型（gmean = 34.6）和层级型（gmean = 31.7）文化原型高于发展型（gmean = 16.3）和理性型（gmean = 17.4）。总体而言，在护士中，层级型（gmean = 36.3）最高，其次是团体型（gmean = 25.8）、发展型（gmean = 16.3）和理性型（gmean = 21.7）。主导文化为层级型的单位，医生数量（中位数 = 7）略多于主导文化为团体型的单位（中位数 = 6）。在医生中，主导文化为团体型的单位床位数量（中位数 = 12）多于主导文化为层级型的单位（中位数 = 9）。主导文化为团体型的单位的护士（中位数 = 2.8）工作投入度略高于主导文化为层级型的单位的护士（中位数 = 2.6）。
结论
我们的研究结果显示，NICU的组织文化因职业和团队规模而异。团体型和层级型文化在日本NICU中占主导地位。评估组织文化将有助于深入了解单位价值观认知，以提高护理质量。
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