| Most health care providers, consumers, and payers would agree that significant change is needed in the health care delivery system in the United States. There has been increasing interest in the role that organizational culture may play in contributing to achieving and sustaining high levels of quality of patient care. This dissertation explores the construct of relationship-centeredness as an element of organizational culture in health care provider organizations. For the purposes of this study, the term relationship-centered refers to the quality and attributes of clinician-colleague interactions and working relationships in health care provider organizations. A model of relationship-centered organizations proposed by Safran, D. G., Miller, W., and Beckman, H. in a 2006 article in the Journal of General Internal Medicine served as a means of framing, shaping, and guiding this dissertation research.;A qualitative case-study methodology was used to explore the views of patient care providers about what specific relationship qualities with fellow clinicians are important in helping them deliver high quality patient care and what factors contribute to the formation and maintenance of such relationship qualities. The participant sample consisted of three direct patient care delivery organizations: a home health agency, an acute care hospital, and a nursing home. Data collection methods included interviews, direct observation and self-reflection. Data analysis involved identifying patterns, themes, and categories that emerged from the data.;Research results indicated that important qualities of clinician-colleague relationships included were trust, mutual respect, heedful interacting, and mindfulness. Principal contributors to the formation and maintenance of these relationship qualities included supportive social interaction, existence of diversity of mental models, effective information sharing and communication strategies, and leader/manager behavior. Implications of these research findings for the management and operation of health care provider organizations and patient care delivery are discussed and future research opportunities are presented. |
