Family Practice Advance Access published online on June 24, 2007
Family Practice, doi:10.1093/fampra/cmm020
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The association between culture, climate and quality of care in primary health care teams
a National Primary Care Research and Development Centre, 5th Floor - Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL
b Department of Health, Richmond House, 79 Whitehall, London SW1A 2NS, UK. Correspondence to Peter Bower
Email: peter.bower{at}manchester.ac.uk
Received 10 May 2006; Revised 4 April 2007; Accepted 24 April 2007.
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Abstract |
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Background. Culture and climate represent shared beliefs and values that may influence quality of care in health care teams, and which could be manipulated for quality improvement. However, there is a lack of agreement on the theoretical and empirical relationships between climate and culture, and their relative power as predictors of quality of care. This study sought to examine the association between self-report measures of climate and culture in primary care teams and comprehensive measures of quality of care.
Methods. The data were derived from a cross-sectional survey of 492 professionals in 42 general practices in England. Self-report measures of culture (the Competing Values Framework) and climate (the Team Climate Inventory) were used, together with validated measures of quality of care from medical records and self-report.
Results. The majority of practices could be characterized as ‘clan’ culture type. Practices with a dominant clan culture scored higher on climate for participation and teamwork. There were no associations between culture and quality of care, and only limited evidence of associations between climate and quality.
Conclusions. The current analysis would not support the hypothesis that culture and climate are important predictors of quality of care in primary care. Although larger studies are required to provide a definitive test, the results may suggest the need for a more complex model of the associations between culture, climate and outcomes, and further research may be required into the interaction between culture and climate with other determinants of behaviour such as internal and external incentives.
Keywords. Culture, team climate, quality of care, health care teams, quality improvement.
Hann M, Bower P, Campbell S, Marshall M and Reeves D. The association between culture, climate and quality of care in primary health care teams. Family Practice 2007; Pages 1–7 of 7.