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Teamwork Culture and Patient Satisfaction in Hospitals

Meterko, Mark PhD*†; Mohr, David C. PhD*; Young, Gary J. JD, PhD*†

doi: 10.1097/01.mlr.0000124389.58422.b2
Original Article

Background: A growing line of research indicates a positive relationship between a healthcare organization's culture and various performance measures. In these studies, a key cultural characteristic is the emphasis placed on teamwork. None of the studies, however, have examined teamwork culture relative to patient satisfaction, which is now 1 of the most widely used performance measures for healthcare organizations.

Objectives: This study investigated the relationship between teamwork culture of hospitals and patient reports of their satisfaction with the care they received.

Methods: The study setting was the Veterans Health Administration (VHA), Department of Veterans Affairs. The study sample consisted of 125 VHA hospitals for which independent and valid sources of data for culture and patient satisfaction were obtained. Each hospital's culture was assessed relative to 4 dimensions: teamwork, entrepreneurial, bureaucratic, and rational. Patient satisfaction data were available for both inpatient and outpatient settings.

Results: Results from multivariate regression analyses indicated a significant and positive relation between teamwork culture and patient satisfaction for inpatient care, and a significant and negative relation between bureaucratic culture and patient satisfaction for inpatient care. Additional analyses revealed an almost 1 standard deviation difference in patient satisfaction scores between hospitals in the top third and bottom third of the distribution for the teamwork culture measure.

Conclusion: Study results suggest that hospitals and possibly other healthcare organizations should strive to develop a culture emphasizing teamwork and deemphasizing those aspects of bureaucracy that are not essential to assuring efficiency and quality care.

From the *Management Decision and Research Center, VA Boston Healthcare System, Boston, Massachusetts; and the †Program on Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts.

The authors contributed equally to this paper and are listed alphabetically.

The study was supported by a grant from the Department of Veteran's Affairs, Health Services Research and Development Service (94–085) and by a grant from the National Science Foundation (SBR-952884).

Reprints: Gary J. Young, JD, PhD, Management Decision and Research Center (152M), VA Boston Healthcare System, 150 So. Huntington Ave, Boston, MA 02130. E-mail:

The authors contributed equally to this paper and are listed alphabetically.

© 2004 Lippincott Williams & Wilkins, Inc.