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The association between organizational cultural competence and teamwork climate in a network of primary care practices

Kumra, Tina; Hsu, Yea-Jen; Cheng, Tina L.; Marsteller, Jill A.; McGuire, Maura; Cooper, Lisa A.

doi: 10.1097/HMR.0000000000000205
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Background: A health system's commitment to delivering culturally competent care is essential in creating a culture of respect for patients, clinicians, and administrative staff. As the diversity of the health care workforce grows, gaining an understanding of the perspectives among different health care personnel and the value that they place on organizational cultural competence is a first step in developing more effective team environments.

Purpose: The aim of the study was to determine whether an association exists between perceptions of organizational cultural competence and teamwork climate among employees in a health system.

Methodology/Approach: One thousand eighty employees in a primary care network consisting of 49 ambulatory practices were surveyed on their perceptions of senior management's efforts in organizational cultural competence and teamwork climate in their own work setting using 5-point Likert scales. Linear regression models were used to evaluate the association between organizational cultural competence and teamwork climate.

Results: The overall organizational response rate for the survey was 84%. Higher perception of organizational cultural competence was associated with better teamwork climate (coef. = 0.4, P <0.001) after adjusting for gender, age, years in specialty, race, and position type. The association was stronger in magnitude for support staff compared to administrators and clinicians and stronger for younger compared to older age groups.

Conclusions: Higher employee perceptions of organizational cultural competence are associated with better self-reported teamwork climate, and this relationship is magnified for support staff and younger employees.

Practice Implications: Senior leaders of health systems should consider investment in cultural competence as a contributor toward team effectiveness. Specifically, organizations may help support cultural competence by committing resources to the following: developing a comprehensive plan that addresses patients' cultural needs, recruiting and retaining a diverse staff and leadership, collaborating with the community, recognizing and rewarding care that meets patients' cultural needs, and providing adequate diversity training.

Tina Kumra, MD, MPH, is Assistant Professor, Department of Pediatrics, Johns Hopkins University School of Medicine, and Johns Hopkins Community Physicians, Baltimore, Maryland. E-mail: tkumra1@jhmi.edu.

Yea-Jen Hsu, PhD, MHA, is Assistant Scientist, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Tina L. Cheng, MD, MPH, is Professor, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Jill Marsteller, PhD, MPP, is Associate Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Maura McGuire, MD, is Assistant Professor, Division of General Internal Medicine, Johns Hopkins University School of Medicine, and Johns Hopkins Community Physicians, Baltimore, Maryland.

Lisa A. Cooper, MD, MPH, is Professor, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

This work was supported, in part, by grants from the National Heart, Lung, and Blood Institute (P50 HL0105187 and K24 HL083113).

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