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Does organisational culture influence health care performance? A review of the evidence

机译：组织文化是否会影响卫生保健绩效？证据审查

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Objective: To review the evidence for a relationship between organisational culture and health care performance.nMethods: Qualitative comprehensive review: all empirical studies exploring a relationship between organisationalnculture (broadly de. ned) and health care performance (broadly de. ned) were identi. ed by a comprehensive searchnof the literature. Study methods and results were analysed qualitatively to provide a narrative review with integrativendiscussion.nResults: Ten studies met the inclusion criteria. There was considerable variation in the design, study setting, qualitynof reporting and aspects of culture/performance considered. Four of the ten studies reviewed in detail claimed tonhave uncovered supportive evidence for the hypothesis that culture and performance are linked. All the othernstudies failed to . nd a link, though none provided strong evidence against the hypothesis.nConclusions: There is some evidence to suggest that organisational culture may be a relevant factor in health carenperformance, yet articulating the nature of that relationship proves dif. cult. Simple relationships such as ‘strongnculture leads to good performance’ are not supported by this review. Instead, the evidence suggests a morencontingent relationship, in that those aspects of performance valued within different cultures may be enhancednwithin organisations that exhibit those cultural traits. A striking . nding is the dif. culty in de. ning and operationalisingnboth ‘culture’ and ‘performance’ as variables that are conceptually and practically distinct. Considerablyngreater methodological ingenuity will be required to unravel the relationship(s) between organisational culture(s)nand performance(s). Current policy prescriptions, which seek service improvements through cultural transformation,nare in need of a more secure evidential base.
机译：目的：审查有关组织文化与卫生保健绩效之间关系的证据。n方法：定性全面审查：确定所有探索组织文化（广泛定义）与卫生保健绩效（广泛定义）之间关系的实证研究。通过对文献的全面搜索获得。对研究方法和结果进行了定性分析，提供了综合论述的叙述综述。n结果：10项研究符合纳入标准。在设计，研究设置，报告质量以及所考虑的文化/绩效方面存在很大差异。在详细审查的十项研究中，有四项声称已发现支持文化与表演之间联系的假说。所有其他研究都失败了。结论：有一些证据表明组织文化可能是影响健康表现的一个相关因素，但阐明这种关系的性质却很困难。邪教该评论不支持诸如“强壮的文化导致良好的绩效”之类的简单关系。取而代之的是，证据表明存在一种更为偶然的关系，因为在具有这些文化特征的组织中，可以提高在不同文化中有价值的那些方面。惊人的。发现是不同的。德教区宁可将“文化”和“绩效”视为在概念上和实践上截然不同的变量。要弄清组织文化与绩效之间的关系，需要精通方法。当前的政策规定通过文化转型寻求服务改善，因此不需要更可靠的证据基础。

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