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DISCUSSION:

Using this week’s readings, continue to analyze your organization’s culture. 

Read the article on 
Defining and assessing culture. 
Pay special attention to the difference between climate and culture, and the methods and instruments used for assessing culture. 

Read Cameron and Quinn’s article, Competing Values 

Cameron and Quinn’s Competing Values:

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  • Defining and Assessing Organizational Culture
  • Jennifer Bellot PhD, RN, MHSA

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    Organizational Culture 1

    As submitted to:

    Nursing Forum

    And later published as:

    Defining and Assessing Organizational Culture

    Volume 46, Issue 1, pages 29–37, January-March 2011

    DOI: 10.1111/j.1744-6198.2010.00207.x

    The target of much debate, organizational culture has occupied a prominent

    position in multidisciplinary publications since the early 1980s. Fraught with

    inconsistencies, the early research and literature addressing organizational culture was

    often conflicting and recursive. As one researcher stated, culture is “one of the two or

    three most complicated words in the English language” (Williams, 1983). Years of

    conceptualization, comparison and assessment have led to an emerging consensus on the

    appropriate definition and role for organizational culture. This manuscript documents the

    historical development of organizational culture as a construct and its ensuing

    assessment, comparing and contrasting prominent theories and methods of understanding

    organizational culture. Subsequently, a brief review of the health care literature

    illustrates the applicability of organizational culture to the health care setting.

    Development

    Organizational Culture 2

    Most researchers agree that the notion of studying work environments first

    emerged with the work of a social psychologist, Kurt Lewin. Lewin, Lippitt and White

    (1939) first coined the term organizational climate in the study “Patterns of Aggressive

    Behavior in Experimentally Created ‘Social Climates.’” This term was used

    inconsistently for the next two decades until the 1960s. By this point, research on

    organizational climate research was flourishing.

    Climate research represented a convergence of psychological and sociological

    epistemologies. During the 1960s and 1970s, climate research generally addressed

    professional socialization and the orientation or integration of the new employee. The

    terms climate and culture were often used interchangeably or within quotation marks, and

    were not well defined conceptually (Reichers & Schneider, 1990). In the mid-1970s the

    emergence of symbolic framing introduced anthropologic epistemology to the study of

    organizational climate. Among climate researchers, the sense that the climate construct

    was not capturing the holism of the work environment led to the development of

    organizational culture. Hence, this represented the beginning of defining culture,

    acknowledging its intangibility and integrating psychologic, sociologic and anthropologic

    methods and philosophies (Ashkanasy, Wilderom, & Peterson, 2000).

    Pettigrew (1979) was the first to introduce formally the term organizational

    culture, incorporating a distinct anthropologic base. Shortly thereafter, an explosion of

    literature was produced regarding organizational culture and its ideal management. Texts

    by Deal and Kennedy (1988), Ouchi (1981) and Peters and Waterman (1982), in

    particular, were responsible for the widespread popularity of this concept. These works,

    however, were prescriptive, solutions-based, largely atheoretical and non-academic. This

    Organizational Culture 3

    early writing was marketed to managers within a typical corporate structure and was

    designed to provide a quick fix and competitive edge.

    Meanwhile, academia struggled to keep up with the commercial sector. The

    central issue behind an academic rise of interest in organizational culture was that “a hard

    ‘scientific’ management of institutions could and should be augmented with, or even

    displaced by, an approach that stressed a softer, more humane understanding of human

    values and culture” (Parker, 2000, p. 1). The organizational culture perspective was the

    “counter culture” of organizational theory, as it challenged much of the contemporary

    organizational behavior theory (Shafritz & Ott, 1987). Until this point, organization

    studies were dominated by a positivist paradigm. The introduction of anthropological

    epistemology propagated the notion that the organizational environment (specifically,

    culture) should be studied using qualitative methods.

    During the 1980s, the conceptual base for organizational culture was developed

    further. As previously mentioned, there was much disagreement among scholars and

    disciplines regarding appropriate definition and assessment. The next sections provide a

    review of the prevailing themes and controversies surrounding the definition of

    organizational culture.

    Prevailing Themes

    Drawing from the traditions of three different disciplines, the definition of

    organizational culture is complicated by disagreements regarding what it should and

    should not include and the best to assessment method. Although many theorists in the

    1980s advanced the conceptual understanding of organizational culture, a select group

    has dominated the majority of culture research (Table 1). Further, it is widely accepted

    Organizational Culture 4

    that there is no singular, correct definition of culture. Van Maanen (1985) states, “The

    term ‘culture’ is powerfully evocative, but it does not come from anthropology as an

    intact structural package ready to serve as a paradigmatic foundation on which to build

    the analysis of organizations” (p. 57).

    Through the continued work and conceptual development from such scholars as

    Edgar Schein, Mats Alvesson and Benjamin Schneider, some consistency of thought has

    arisen. This loose consensus of principles has guided much inquiry about organizational

    culture (Siehl & Martin, 1983; Druckman, Singer, & Van Cott, 1997).

    1. Organizational culture exists.

    Although it may seem simplistic, it took years of inquiry and theory to conclude that

    organizational culture exists. This debate is intimately related to the next tenet of culture.

    2. Cultures are inherently fuzzy in that they incorporate contradictions, paradoxes,

    ambiguities and confusion.

    Throughout the development of organizational culture, it has been recognized that

    culture is not a “surface” phenomena. Rather, it is “infused with symbols and

    symbolism” (Druckman, Singer, & Van Cott, 1997, p. 69) and is “undetectable most of

    the time” (Cameron & Quinn, 1999). The lack of tangibility and potential for confusion

    and inconsistency lend to complex assessment of the concept. This thought paradigm is

    more involved than the positivist tradition of business research, thus necessitating greater

    conceptual development.

    3. Organizational culture is socially constructed, the product of groups, not individuals,

    and based on shared experiences.

    Organizational Culture 5

    A core tenet regarding organizational culture is the group nature of the concept.

    Theorists have used this property to distinguish organizational culture from other, similar

    constructs, and to differentiate methods from previous work in organizational climate.

    Culture provides an organization’s members with a framework for understanding and

    making sense of their work environment and

    experiences (

    Siehl & Martin, 1983).

    4. Each organization’s culture is relatively unique, malleable and subject to continual

    change.

    Central to this tenet was the debate over whether culture is something an organization

    has or something that an organization is. Originally, anthropological scholars relied

    on their disciplinary traditions and asserted that organizations were cultures in

    themselves (Rousseau, 1990). Further research, however, has led to relative

    consensus that culture is a property that the organization possesses. Further, since

    culture is a possession, there is the sense that it can be controlled, or at the very least

    influenced and changed, by its members. Culture, therefore, is developed over time

    and is not a static property. The assertion that culture is unique has led to some debate

    over how it is assessed. Generally, academic researchers believe that each

    organization’s culture is distinct, although some instruments have demonstrated the

    ability to group separate cultures into broad categories. The notion that culture was

    malleable was an attractive attribute to corporate managers. Those that subscribed

    to this theory believed that molding organizational culture to an ideal form would thereby

    improve organizational output.

    Organizational Culture 6

    Several accepted definitions of organizational culture are used in the literature, a

    reflection of the epistemologic backgrounds or interests of the researcher. Most recent

    research on culture either cites Schein’s (1987) definition or uses a derivation of his

    work. Schein’s roots as a sociologist and his interests in the integration of new

    employees are apparent in his definition:

    Organizational culture is the pattern of basic assumptions which a given group has

    invented, discovered or developed in learning to cope with its problems of external

    adaptation and internal integration, which have worked well enough to be considered

    valid, and therefore to be taught to new members as the correct way to perceive, think

    and feel in relation to those problems…it is the assumptions which lie behind values

    and which determine the behavior patterns and the visible artifacts such as

    architecture, office layout, dress codes, and so on (1987, p. 383).

    Controversies

    Despite the growing consensus among researchers interested in organizational

    culture, there is also considerable disagreement. This does not necessarily mean that

    organizational culture is a weak or ill-defined concept. Rather, this divergence is

    indicative of a continually developing body of research (Ashkanasy, Wilderom, &

    Peterson, 2000). Several controversies surrounded the definition and operationalization

    of organizational culture. Therefore, this paper will limit discussion to the three most

    frequently cited.

    Singular versus plural

    Is there one, single culture per organization or are there several different cultures

    found within an organization? Early researchers of organizational culture, particularly

    Organizational Culture 7

    those from the anthropologic perspective, posited that in order to be defined as a unique

    culture, each organization possessed a singular, universal culture. More recent research,

    however, has revealed the presence of subcultures, also known as “nested” cultures

    (Parker, 2000). This is an important quality to consider when conceptualizing culture

    management or change. Additionally, recent cultural research has addressed the duality

    of perceived versus actual culture. More research is warranted to determine the

    implications of perceived and actual culture within an organization.

    Consensus versus dissensus

    In the same vein as the preceding controversy, a body of research on

    organizational culture has focused on the consistency of culture throughout an

    organization. This often places administrative perceptions in opposition to the lived

    experience of an organization’s employees. Meyerson’s (1991) research has focused on

    the framing of culture within three paradigms: Integration, ambiguity and fragmentation.

    Meyerson asserts that it is appropriate, when characterizing an organization’s

    culture, to classify it within the bounds of its actual implementation. Based on her

    qualitative study of hospital social workers, she states that an integrated culture is one

    that “shares common and clear understandings and identities” (p. 131). Fragmentation

    and ambiguity, in turn, account for differences in perceptions and experiences among

    organization members. Many researchers, in an attempt to account for these differences,

    have used Meyerson’s classification when assessing culture.

    There is considerable disagreement regarding this method of classification.

    Schein states:

    If there is no consensus or if there is conflict or if things are ambiguous, then, by

    Organizational Culture 8

    definition, that group does not have a culture in regard to those things. It may have

    subcultures, smaller groups that have a shared … consensus about

    something, but the concept of sharing or consensus is core to the definition (1991, p.

    248).

    Meyerson (1991) later argues that ambiguities may be viewed as normal or abnormal

    within an organization’s culture and that most cultural assessments consciously exclude

    ambiguities, since organizational researchers usually study objective and concrete

    phenomena.

    Culture versus climate: The same or different?

    Much research has been devoted to the differentiation of culture from climate. As

    culture was being developed into a separate field of inquiry in the early 1980s, a common

    justification for its study was its unique qualities, separate from organizational climate.

    Many articles, books and chapters have been written on this subject. Rather than present

    this debate in its entirety, this paper will attempt to highlight the major elements of this

    controversy.

    In an early, simplistic attempt to delineate the two concepts, Schwartz & Davis

    (1981) stated, “Whatever culture is, it is not climate” (p. 32). This distinction, although

    not terribly sophisticated, formed the basis of much conceptual development in the 1980s.

    The disciplinary origins of climate and culture overlap, with both sharing common

    sociological threads. Climate research is grounded in Lewin’s Gestalt psychology,

    whereas culture embodies references to anthropology (Schneider, 2000). Traditionally,

    climate has been measured with quantitative measurements and is often compared across

    Organizational Culture 9

    settings. Generally, climate is classified by its purpose (e.g., climate for service, climate

    for productivity).

    The most accepted definition of climate is “the relatively enduring organizational

    environment that a) is experienced by the occupants, b) influences their behavior and c)

    can be described in terms of the values of a particular set of characteristics or attributes of

    the environment” (Tagiuri & Litwin, 1968, p. 25). This definition is quite similar to that

    of organizational culture. In fact, several researchers have propagated the idea that

    climate is a manifestation of culture (e.g., Schein, 1984; Reichers & Schneider, 1990;

    Hatch, 1993) and that the “inadequacies of one approach become the justification for the

    other” (Denison, 1996, p. 6).

    During the emergence of culture as a distinct organizational quality, a central

    issue was differentiating it from organizational climate. As the culture construct was

    further developed, and methods for assessment were determined, these two areas

    approached convergence. Meyerson, in fact, retrospectively asserted that the

    development of culture “represented an ontological rebellion against the dominant

    functionalist or ‘scientific’ paradigm” (1991, p. 256). Is the distinction between climate

    and culture simply a divergence of methods or disciplines?

    Recent research indicates that, while not exactly the same, culture and climate are

    not as different as originally conceptualized. Denison has written in-depth on this

    controversy. He begins a lengthy essay on this topic by stating:

    Although it is clear that culture and climate are, in fact, very different perspectives on

    organizational environments, it is far less clear that they actually examine distinct

    organizational phenomena…or whether they represent closely related phenomena that

    Organizational Culture 10

    are examined from different perspectives (1996, p. 3).

    In fact, it is clear that both culture and climate attempt to address the interplay between

    individuals and their surroundings, but it becomes a circular debate to determine which

    produces and/or affects the other.

    Denison (1996) noted that the development of culture wreaked havoc with climate

    researchers, introducing new methods and allowing for variation of assessment.

    Although many acknowledge that climate is a more superficial manifestation of culture, it

    is less clear if this overlap is indicative of different concepts or simply two aspects of the

    same construct. With the introduction of quantitative and mixed methods for study of

    organizational culture in the 1990s, this distinction became even more blurred. As the

    conceptualization and assessment of culture have advanced, it is increasingly apparent to

    many organizational researchers that the two concepts differ more in interpretation rather

    than within the phenomena themselves (Denison 1996).

    Assessment Methods

    Qualitative Approach

    It can be concluded from the literature on organizational culture that most

    conceptualizations are of deep, intangible phenomena not easily objectified. For these

    reasons, and because culture was initially differentiated from climate by its

    anthropological influence, initial scholarly inquiry about culture employed qualitative

    methods. Early studies of organizational culture largely used ethnography or participant

    observation to describe cultures, one institution at a time (Druckman, Singer, & Van Cott,

    1997). The development of cultural study, as distinct from climate study, used the

    applicability of qualitative methods as justification for differentiation. Additionally, early

    Organizational Culture 11

    researchers believed that standardized, quantitative instruments were inappropriate for

    cultural assessment because they would be unable to capture the subjective and unique

    aspects of each culture. Opponents of a strictly qualitative approach, however, asserted

    that comparison between cultures is not possible using this technique.

    Quantitative Tools

    Frustration with the limited generalizability and time intensiveness of qualitative

    methods led to the development of quantitative tools to assess culture. Rousseau (1990)

    advocates for quantitative instruments, stating that cultural assessment would benefit in

    strength and validity from the testing of psychometric properties in these instruments. In

    order to support quantitative methods, however, the underlying conception of culture

    must be that it is something an organization possesses, rather than embodies,

    contradictory to some anthropological theory.

    Cameron & Quinn (1999) argue that it is crucial, if using quantitative instruments,

    that these be validated to ensure the reporting of underlying values and assumptions,

    rather than climate. Further, many theorists argue that questionnaires or survey

    instruments are inappropriate for measuring culture in that they “measure the dimensions

    of culture determined in advance by the researcher, thus potentially missing or distorting

    the actual dimensions of cultures existing a priori in the organization itself” (Druckman,

    Singer, & Van Cott, 1997, p. 72). Taken together, the weaknesses of using qualitative or

    quantitative methods alone leave potential for omission of crucial elements of culture.

    Mixed Methods

    In 1983, Siehl and Martin attempted to bridge this gap by using mixed methods.

    Since then, mixed methods have emerged as the preferred method for assessing

    Organizational Culture 12

    organizational culture. Most recent studies involve some combination of participant

    observation, interview, focus group, survey and/or questionnaire. It is believed that

    mixed methods allow the most explanation of error variance, greater depth in elaboration

    of culture as a construct (Alvesson & Berg, 1992) and more opportunity for data analysis

    (Fleeger, 1993). A great deal of writing has been devoted to promoting and employing

    mixed methods (Siehl & Martin, 1990; Rousseau, 1990; Ashkanasy, Wilderom, &

    Peterson, 2000; Alvesson & Berg, 1992; Smith, Francovich, & Gieselman, 2000;

    Hofstede, Neuijen, Ohayv, & Sanders, 1990; Fleeger, 1993; Goodridge & Hack, 1996;

    Siehl & Martin, 1983).

    Assessment Tools

    As the assessment of organizational culture evolved and quantitative methods

    gained popularity and acceptance, various questionnaires and surveys were developed. It

    is important to note that some of these tools were developed in order to be marketed to

    managers and were therefore not subject to theoretical development by academic

    researchers. Discussion in this paper will be limited to those tools developed by trained

    researchers.

    Unfortunately, most tools assessing organizational culture were never subjected to

    psychometric evaluation. It is recognized that there is no ideal instrument as each tool

    has limitations for use or scope (Scott, Mannion, Davies, & Marshall, 2003). That being

    said, the two most cited and scientifically rigorous instruments are the Organizational

    Culture Assessment Instrument (OCAI; Cameron & Quinn, 1999) and the Organizational

    Culture Inventory (OCI; Cooke & Lafferty, 1986).

    Organizational Culture Assessment Instrument (OCAI)

    Organizational Culture 13

    The OCAI uses ipsative scoring scales to categorize organizational culture. In

    ipsative scoring, respondents assign points to their answers and all answers must sum to a

    predetermined total. The OCAI is based upon the Competing Values Framework,

    originally conceptualized by Campbell in 1974. Derived from this framework, the OCAI

    has undergone several revisions and, through factor analysis, has a well developed

    classification system. Quinn refined Campbell’s work in 1983 to create four

    organizational “types”: Clan, Adhocracy, Hierarchy and Market. Ultimately, these types

    became the basis for the OCAI. Cameron and Quinn (1999) emphasize that there is no

    one “correct” typology for an organization. The OCAI assesses the degree of each type

    represented in an organization and presents an individualized assessment of

    appropriateness of that typology, given the organization’s goals.

    The OCAI was deliberately designed to be simple, so as to facilitate maximum

    participation at all levels of an organization. Additionally, it contains generalized

    questions, in order to appeal to many different kinds of organizations. The OCAI, or

    versions of it also based on the Competing Values Framework, have been used in several

    studies of organizational culture (e. g., Denison, 1990; Cameron & Freeman, 1991; Jones,

    DeBaca, & Yarbrough, 1997). Its reliability and validity were established in a series of

    studies (Quinn & Spreitzer 1991; Yeung, Brockbank, & Ulrich, 1991; Zammuto &

    Krakower, 1991).

    Critics of the OCAI maintain that it does not precisely measure culture, instead

    “pigeon holing” organizations into a priori diagnostic categories created by researchers

    (Druckman, Singer, & Van Cott, 1997). Strict qualitative methodologists object on the

    grounds that this does not reveal the unique aspects of an organization’s culture, instead

    Organizational Culture 14

    lumping results into generic categories. Cameron and Quinn, however, readily admit that

    the OCAI is intended to be both diagnostic and prescriptive in function. Further, ipsative

    scoring inherently creates a situation where respondents’ answers are dependent upon

    each other, since they must sum to a pre-determined total. This can obscure the

    interpretation and clarity of results. Proponents of the OCAI point to its ease in

    implementation and its low cost.

    Organizational Culture Inventory (OCI)

    Similarly, the Organizational Culture Inventory (OCI; Cooke & Lafferty, 1986)

    classifies organizations into three general types of cultures: Constructive,

    Passive/Defensive and Aggressive/Defensive. Additionally, it evaluates twelve sets of

    behavioral norms within an organization. The OCI has been used for many purposes and

    is the most widely used industry tool for assessing organizational culture, completed by

    over 2 million respondents worldwide as of the year 2000 (Cooke & Szumal, 2000).

    Since this tool has been used so widely, a large information base exists on the behavior of

    cultures.

    The conceptual framework for the OCI was developed by Cooke and colleagues

    and is based upon distinguishing between an organization’s concern for people versus its

    concern for task. The OCI tool is built upon the Human Synergistics circumplex

    conceptual framework, derived via factor analysis from many cultural studies. Sub-

    constructs of the OCI have been empirically supported and validated by numerous

    sources (Cooke & Rousseau, 1988; Cooke & Szumal, 1993; Xenikou & Furnham, 1996).

    Similar to the OCAI, organizations are typed and classified into three predetermined

    categories based on the degree of strength to which they represent each category. In

    Organizational Culture 15

    addition to assessing the current culture of an organization, the OCI has the capacity to

    determine the ideal culture for an organization, allowing for comparison between actual

    and ideal cultures. This feature has led to the use of the OCI as the basis for planning

    culture change.

    A quantitative instrument with similar predetermined categories, the OCI shares

    the same criticisms as the OCAI. Additionally, it is not as user-friendly and simple as the

    OCAI. The OCI is a lengthier survey and is subject to proprietary analysis, eliminating

    the possibility of internal organizational evaluation. Its widespread use and extensive

    psychometric testing make it an attractive option for researchers. Cooke and Szumal

    (2000) list more international testing (Asia, Africa, Latin America) as a next step in the

    development of the OCI.

    Applicability to Health Care

    Most work on organizational culture concerns the traditional corporation.

    Therefore, some adaptation to the central goals and focus of a human services

    organization are necessary before application to a health care setting. Although not

    always explicit, it appears that Schein’s conceptual work and theory have most

    influenced the study of organizational culture in health care. Schein is frequently cited as

    the conceptual reference for this inquiry. Sovie (1993) emphasizes that health care

    organizations should be particularly concerned with organizational culture because “the

    shared beliefs, values, and feelings that exist within an institution direct the perception of

    and the approach to the work that is to be done” (p. 72).

    Two teams of researchers (Gershon, Stone, Bakken, & Larson, 2004; Scott,

    Mannion, Davies & Marshall, 2003) have completed in-depth searches and evaluated

    Organizational Culture 16

    tools used to measure organizational culture in the health care setting. Both teams

    reviewed biomedical literature via online databases and consulted with experts in the

    behavioral research field. Although most instruments were developed and published in

    the mid-1980s, Gershon and colleagues (2004) found that their application to health care

    was largely limited to the previous five years. Additionally, most studies were completed

    in hospitals and targeted nurses in their evaluations. They surmise that this could be in

    response to a 1999 Institute of Medicine report, To Err is Human: Building a Safer

    Health Care System, which advocated culture change in order to decrease medical error

    rates.

    Gershon and colleagues also found, predictably, that terminology differed across

    instruments. Potentially, this contributes to the further confounding of assessment of

    organizational culture. Reflecting frustration with the inconsistency of terms, the team

    stated:

    If aspects of the organizational culture are ill-defined, frequently shifting, poorly

    communicated, not reinforced, and/or poorly supported administratively, both the

    employees’ collective perceptions and their behaviors (i.e., delivery of care, safe work

    practices, and teamwork) will be inconsistent (2004, p. 37, emphasis in original).

    Gershon and team conclude, on the basis of reliability and validity, that the

    Organizational Culture Inventory (Cooke & Lafferty, 1986) is most appropriate for use in

    the health care setting.

    A year previous to Gershon’s article, Scott and colleagues (2003) performed a

    similar analysis of organizational culture instruments in health care. They identified

    thirteen tools designed specifically to measure culture only (without reference to climate).

    Organizational Culture 17

    Nine of these thirteen were used in studies of health care environments. Schein’s

    conceptualization of organizational culture was used when analyzing each tool, only

    quantitative measures were evaluated.

    Rather than choosing one “best” instrument for cultural assessment, the team

    concluded that “the choice of instrument should be determined by how organizational

    culture is conceptualized by the research team, the purpose of the investigation, intended

    use of the results and availability of resources” (Scott, Mannion, Davies, & Marshall,

    2003, p. 923). In this way, the team’s recommendations are appropriate to a wider set of

    applications for cultural assessment. Overall, however, Scott and colleagues devote a

    large portion of their concluding thoughts to advocating mixed methods. Citing their

    earlier work, Scott’s team deemed it appropriate to study surface manifestations of

    culture with quantitative methods and follow up with assessment of underlying

    assumptions with qualitative techniques. The team then provides examples of studies

    using mixed methods in different order (e.g., Qual-quant, Quant-qual). They determined

    that either order could be appropriate, depending on the goals of the study.

    Conclusion

    After 25 years of development, the construct of organizational culture has finally

    reached some consensus. Although research does not universally subscribe to one

    definition of organizational culture, there is relative agreement on major elements of its

    definition. Organizational culture exists. It can be ambiguous, but it is unique to each

    institution and malleable. Organizational culture is socially constructed, arising from

    group interactions.

    Organizational Culture 18

    As the construct has developed, so have methods for assessing it. Beginning with

    the assertion that organizational culture can be evaluated using qualitative techniques,

    researchers have moved on to consider broader methods. Quantitative measurement tools

    have been developed and psychometrically tested, and, most recently, mixed methods

    have been employed to provide a richer assessment of organizational culture. Although

    most of the conceptual and measurement work regarding organizational culture has been

    based upon the traditional corporate structure, research has shown that it is adaptable to

    the health care sector. The recognition and assessment of organizational culture is

    particularly valuable in health care, as it addresses the therapeutic milieu, thereby

    creating the potential to maximize service, quality and outcomes for both health care

    providers and recipients of care.

    Organizational Culture 19

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    Organizational Culture 25

      Thomas Jefferson University
      Jefferson Digital Commons
      2-10-2011
      Defining and Assessing Organizational Culture
      Jennifer Bellot PhD, RN, MHSA
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