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Culture and quality care perceptions in a Pakistani hospital

Fauziah Rabbani (Aga Khan University Hospital, Karachi, Pakistan)
S.M. Wasim Jafri (Aga Khan University Hospital, Karachi, Pakistan)
Farhat Abbas (Aga Khan University Hospital, Karachi, Pakistan)
Firdous Jahan (Aga Khan University Hospital, Karachi, Pakistan)
Nadir Ali Syed (Aga Khan University Hospital, Karachi, Pakistan)
Gregory Pappas (Aga Khan University Hospital, Karachi, Pakistan)
Syed Iqbal Azam (Aga Khan University Hospital, Karachi, Pakistan)
Mats Brommels (Karolinska Institutet, Stockholm, Sweden)
Göran Tomson (Karolinska Institutet, Stockholm, Sweden)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 17 July 2009

1636

Abstract

Purpose

Organizational culture is a determinant for quality improvement. This paper aims to assess organizational culture in a hospital setting, understand its relationship with perceptions about quality of care and identify areas for improvement.

Design/methodology/approach

The paper is based on a cross‐sectional survey in a large clinical department that used two validated questionnaires. The first contained 20 items addressing perceptions of cultural typology (64 respondents). The second one assessed staff views on quality improvement implementation (48 faculty) in three domains: leadership, information and analysis and human resource utilization (employee satisfaction).

Findings

All four cultural types received scoring, from a mean of 17.5 (group), 13.7 (developmental), 31.2 (rational) to 37.2 (hierarchical). The latter was the dominant cultural type. Group (participatory) and developmental (open) culture types had significant positive correlation with optimistic perceptions about leadership (r=0.48 and 0.55 respectively, p<0.00). Hierarchical (bureaucratic) culture was significantly negatively correlated with domains; leadership (r=−0.61, p<0.00), information and analysis (−0.50, p<0.00) and employee satisfaction (r=−0.55, p<0.00). Responses reveal a need for leadership to better utilize suggestions for improving quality of care, strengthening the process of information analysis and encouraging reward and recognition for employees.

Research limitations/implications

It is likely that, by adopting a participatory and open culture, staff views about organizational leadership will improve and employee satisfaction will be enhanced. This finding has implications for quality care implementation in other hospital settings.

Originality/value

The paper bridges an important gap in the literature by addressing the relationship between culture and quality care perceptions in a Pakistani hospital. As such a new and informative perspective is added.

Keywords

Citation

Rabbani, F., Wasim Jafri, S.M., Abbas, F., Jahan, F., Syed, N.A., Pappas, G., Iqbal Azam, S., Brommels, M. and Tomson, G. (2009), "Culture and quality care perceptions in a Pakistani hospital", International Journal of Health Care Quality Assurance, Vol. 22 No. 5, pp. 498-513. https://doi.org/10.1108/09526860910975607

Publisher

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Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited

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