Organizational culture and performance in health care for older people: a systematic review

In recent years, there has been a growing understanding that organizational culture is an important characteristic that may influence the effectiveness of health care provision, not least for the growing numbers of older people needing care. The purpose of this paper is to review the literature to uncover any reliable evidence supporting the assertion that organizational culture in health care organizations is related, in terms of activity and outcome, to their performance. Searches identified 20 relevant papers published between 1993 and 2010. A number of studies reviewed claims to have uncovered evidence of a relationship in terms of activity, while others failed to find a clear relationship. None of the studies found much evidence against. In terms of outcomes, none of the studies reviewed found evidence of a relationship between culture and performance. It is clear that any relationship between culture and performance is highly unlikely to be simple: such relationships are more likely to be multiple, complex, contingent and dynamic.