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The Relationship Between Organizational Culture and Practice Systems in Primary Care

Dugan, Donna Pillittere PhD; Mick, Stephen S. PhD, FACHE; Scholle, Sarah Hudson MPH, DrPH; Steidle, Ernie F. PhD; Goldberg, Debora Goetz PhD, MHA, MBA

Journal of Ambulatory Care Management:
doi: 10.1097/JAC.0b013e3181ff6ef2
Issue on the Medical Home: Original Article
Abstract

The patient-centered medical home is an approach to comprehensive primary care relying on well-developed systems. Research has shown that for practices to meet patient-centered medical home requirements, care models may need to be redesigned. However, there is a dearth of information about what factors are important to achieve this goal. Self-report surveys from 293 staff across 42 practices in Minnesota showed variation in use of systems and dimensions of organizational culture. Organizational cultures that emphasize collegiality and quality but not autonomy were significantly related to the use of clinician reminders, clinical quality evaluation and improvement, and clinical information systems.

Author Information

Dr Dugan is Independent Consultant, Arlington, Virginia. Department of Health Administration (Drs Mick and Goldberg); School of Allied Health Professions, Virginia Commonwealth University, Richmond, Virginia (Dr Steidle); and National Committee for Quality Assurance, Washington, District of Columbia (Dr Scholle).

Correspondence: Donna Pillittere Dugan, PhD, Independent Consultant, Arlington, VA (DonnaPDugan@gmail.com).

We are thankful to the Health Partners Research Foundation and the National Committee for Quality Assurance for use of and consultation on aspects of the dataset. We are grateful to the medical directors and their organizations for completing the Physician Practice Connections-Readiness Survey. These medical groups were Affiliated Community Medical Centers, Allina Medical Clinic, Altru Health System, Aspen Medical Group, Brainerd Medical Center, PA, Buffalo Clinic, PA, Camden Physicians, CentraCare Health System, Columbia Park Medical Group, Dakota Clinic, Ltd, Fairview Health Services, Fairview Red Wing Health Services, Family Health Services of Minnesota, Fergus Falls Medical Group, PA, HealthEast Clinics, HealthPartners Central Minnesota Clinics, HealthPartners Medical Group, Hennepin Faculty Associates, Hutchinson Medical Center, Lakeview Clinic, Ltd, Mankato Clinic, Ltd, Mayo Clinic, MeritCare Health System, Multicare Associates, North Clinic, North Memorial Health Care Clinic Services, Northstar Physicians, Northwest Family Physicians, Olmsted Medical Center, Park Nicollet Health Services, Ridgeview Care System, St. Cloud Medical Group, PA, St. Luke's Clinics, St. Mary's/Duluth Clinic Health System, Stillwater Medical Group, SuperiorHealth Medical Group, University of Minnesota Physicians Family Medicine Clinics, Western Wisconsin Medical Associates, SC, and Winona Clinic, Ltd.

Funding Disclosure: Data collection was supported by funding from The Robert Wood Johnson Foundation.

© 2011 Lippincott Williams & Wilkins, Inc.