Owens Katie, Eggers Jim, Keller Stephanie, McDonald Audrey
HealthStream Engagement Institute, Pensacola, FL.
Analytics, HealthStream, Laurel, MD, USA.
J Healthc Leadersh. 2017 Apr 6;9:25-31. doi: 10.2147/JHL.S126381. eCollection 2017.
Current uncertainty for the future of the health care landscape is placing an increasing amount of pressure on leadership teams to be prepared to steer their organization forward in a number of potential directions. It is commonly recognized among health care leaders that culture will either enable or disable organizational success. However, very few studies empirically link culture to health care-specific performance outcomes. Nearly every health care organization in the US specifies its cultural aspirations through mission and vision statements and values. Ambitions of patient-centeredness, care for the community, workplace of choice, and world-class quality are frequently cited; yet, little definitive research exists to quantify the importance of building high-performing cultures. Our study examined the impact of cultural attributes defined by a culture index (Cronbach's alpha = 0.88) on corresponding performance with key health care measures. We mapped results of the culture index across data sets, compared results, and evaluated variations in performance among key indicators for leaders. Organizations that perform in the top quartile for our culture index statistically significantly outperformed those in the bottom quartile on all but one key performance indicator tested. The culture top quartile organizations outperformed every domain for employee engagement, physician engagement, patient experience, and overall value-based purchasing performance with statistical significance. Culture index top quartile performers also had a 3.4% lower turnover rate than the bottom quartile performers. Finally, culture index top quartile performers earned an additional 1% on value-based purchasing. Our findings demonstrate a meaningful connection between performance in the culture index and organizational performance. To best impact these key performance outcomes, health care leaders should pay attention to culture and actively steer workforce engagement in attributes that represent the culture index, such as treating patients as valued customers, having congruency between employee and organizational values, promoting employee pride, and encouraging the feeling that being a member of the organization is rewarding, in order to leverage culture as a competitive advantage.
当前医疗保健格局未来的不确定性给领导团队带来了越来越大的压力，要求他们做好准备，引领组织朝着多个潜在方向前进。医疗保健领导者普遍认识到，文化将促进或阻碍组织的成功。然而，很少有研究从实证角度将文化与医疗保健特定的绩效结果联系起来。美国几乎每个医疗保健组织都通过使命、愿景声明和价值观来明确其文化抱负。以患者为中心、关爱社区、成为首选工作场所和具备世界级质量等抱负经常被提及；然而，几乎没有确凿的研究来量化建立高绩效文化的重要性。我们的研究考察了由文化指数（克朗巴哈系数α = 0.88）定义的文化属性对关键医疗保健指标相应绩效的影响。我们将文化指数的结果映射到各个数据集上，比较结果，并评估领导者关键指标之间的绩效差异。在我们的文化指数中表现处于前四分之一的组织，在除一项测试的关键绩效指标外的所有指标上，在统计上显著优于处于后四分之一的组织。文化处于前四分之一的组织在员工敬业度、医生敬业度、患者体验和基于价值的整体采购绩效的每个领域都表现出色，具有统计学意义。文化指数处于前四分之一的组织的员工流失率也比处于后四分之一的组织低3.4%。最后，文化指数处于前四分之一的组织在基于价值的采购方面额外多赚了1%。我们的研究结果表明，文化指数的表现与组织绩效之间存在有意义的联系。为了对这些关键绩效结果产生最佳影响，医疗保健领导者应关注文化，并积极引导员工参与体现文化指数的属性，例如将患者视为有价值的客户、员工价值观与组织价值观保持一致、提升员工自豪感以及鼓励员工有身为组织一员是有回报的感觉，以便将文化作为竞争优势加以利用。
