فرهنگ و اثربخشی سازمانی: مطالعه ارزش ها، نگرش ها و پیامدهای سازمانی

That organizational culture influences firm effectiveness is an assumption implicitly held by many managers and management researchers, although few empirical studies have provided detailed insight into the relationship. This manuscript addresses this dearth of research by examining employee attitudes as a potential mediator of the relationship between organizational culture, as operationalized by the competing values framework [Quinn, R.E., Beyond Rational Management. San Francisco: Josey-Bass; 1988.], and diverse measures of organizational effectiveness. Results of this study, which was conducted in 99 healthcare facilities across the US, provide evidence that suggests that employee attitudes mediate the culture–effectiveness relationship.

3.1. Hospital-level aggregation In order to perform analyses at the hospital level, culture scales were aggregated to the hospital level by averaging individual responses. The amount of variance on each culture scale across informants from each hospital was measured by RWG (James et al., 1984). RWG provides a measure of variance across informants from a particular hospital standardized by the number of response alternatives on the items. An RWG greater than .70 has become an accepted benchmark of an appropriate level of inter-informant agreement, and was thereby used to justify aggregating that variable to the hospital level. Sixty-one hospitals in the sample had an RWG above .70 on all four culture scales (group, developmental, rational, and hierarchical). Additionally, ICC(1) and ICC(2) were calculated to measure each scale's intra-hospital reliability. The scale ICC(1)'s were as follows; .06 for group, .09 for developmental, .10 for rational, and .12 for hierarchical. The scale ICC(2)'s were as follows; .23 for group, .30 for developmental, .34 for rational, and .37 for hierarchical. To ensure inter-informant agreement in the analyses, each analysis included only hospitals with RWG scores above .70 on the independent variables used in that specific analysis. When using balance as an independent variable and during the cluster analysis, hospitals were included only if RWG on all four CVF scales was above .70. The sample size in the hypothesis testing analyses ranged from 61 to 64 depending on the number of hospitals with an acceptable RWG on the independent variable in each analysis. 3.2. Descriptive statistics Table 1 shows the descriptive statistics for all study measures. Coefficient alphas, computed from the individual-level data for each construct are presented on the diagonal. The intercorrelations for all 87 hospitals with 2 or more respondents regardless of the RWG of the independent variables are also shown.3.3. Hypothesis testing Hypothesis 1 predicted that a hospital's group culture score would be positively related to its patient satisfaction and controllable expenses. Group culture showed a positive relationship with patient satisfaction (beta = 1.176, p = .056). The relationship between group culture and controllable expenses was not supported (beta = − 4.264, p = .88). Hypothesis 2 predicted a positive relationship between a balanced culture and patient satisfaction and controllable expenses. This hypothesis was partially supported, as balanced cultures had higher levels of patient satisfaction than unbalanced cultures (balanced M = 83.44, SD = 3.86, unbalanced M = 82.63, SD = 2.69; p = .045), after controlling for previous levels of patient satisfaction. No significant differences in levels of controllable expenses between the balanced and unbalanced group were identified (p = .68). Hypothesis 3 tested the mediating impact of employee attitudes on the culture–effectiveness relationship via a path analysis approach which followed the procedures described in prior research (Mayer and Davis, 1999 and Sapienza and Korsgaard, 1996) that are based on Baron and Kenny's (1986) general principles. This technique compares alternative models (direct, indirect, and saturated) in terms of their fit indices as well as the path coefficients. This analysis was performed for both group culture and balanced culture. The direct model estimated paths from the culture to the attitude variables and to the effectiveness measures while leaving out the paths from the attitude variables to the effectiveness measures. The indirect model (Fig. 1) tested the paths from the culture variables to the attitude variables and from the attitude variables to the effectiveness measures. The saturated model is the same as the indirect except the saturated model also estimates the paths from the culture variables to the effectiveness measure directly.The first comparison was between the chi-square results of the direct and saturated model. For the balance models, the chi-square difference was 13 with 4 degrees of freedom. This difference indicated that the attitude variables mediate balance culture's effects on the effectiveness measures. The chi-square difference between the group models was 10.4 with 4 degrees of freedom. This difference indicated that, like balance, the group domain's impact on effectiveness is mediated by the attitude variables. Next the indirect model was compared to the saturated model. These differences were insignificant for both the group and balance models (balance chi-square difference = 1.2, 2 df; group chi-square difference = 2.5, 2df). These insignificant results suggest that the more complicated saturated models did not improve the fit over the simpler indirect model. All paths in the indirect models were significant and in the hypothesized direction except for the employee satisfaction to patient satisfaction path (see Table 2 and Table 3). These results suggest that employee satisfaction and physician satisfaction fully mediate the culture–effectiveness relationship.