Organizational culture has been shown to be associated with intensive care unit job performance and patient outcomes. These findings have led to recommendations to improve the safety climate in ICUs. While ICUs within a single hospital may be expected to have similar climates, previous research has pointed to variations between ICUs. Also, ICU directors' assessments of their personnel's experiences may not be accurate. The purpose of this thesis was to determine whether variations in organizational culture exist between the ICUs of a single institution and between different types of personnel, as well as to assess the accuracy of ICU directors'perceptions of personnel attitudes.
The personnel of four ICUs within a single hospital were surveyed using the Safety Attitudes Questionnaire - ICU, which was designed to assess organizational culture across six factors: teamwork climate, perceptions of management, safety climate, stress recognition, job satisfaction, and work environment. Mean and percent positive scores (percentage of scores greater than or equal to 75 on a 0-100 point scale) were calculated for each ICU and for each job type across ICUs. Generalized estimating equations were used to model each factor score by job type while accounting for a possible clustering effect due to ICU membership. Directors were asked to estimate their personnel's mean factor scores and differences between director estimates and actual scores were assessed using the Wilcoxon signed rank test.
Scores were found to differ significantly across ICUs for all factors except stress recognition. Scores for job satisfaction, perceptions of management, and working conditions were found to differ significantly between physicians and nurses. ICU directors tended to overestimate the attitudes of their personnel, however the overestimation was not found to be significant.
The results suggest that assessments based on hospital level analysis or director opinion may not be sufficient. It is seemingly important to account for differences between ICUs, as well as between personnel types, when creating policies affecting organizational culture. The public health relevance of this thesis is in determining a unit of analysis for organizational culture assessments to improve job performance of ICU personnel, and subsequently, to hopefully improve patient outcomes.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04132005-190309 |
| Date | 14 June 2005 |
| Creators | Miller, Rachel G |
| Contributors | Derek Angus, Lisa Weissfeld, Lan Kong |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04132005-190309/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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