Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

1030 — Assessing an Organizational Culture Instrument Based on the Competing Values Framework: Exploratory and Confirmatory Factor Analyses

Helfrich CD (Seattle COE) , Mohr DC (COLMR), Meterko M (COLMR), Li Y (Seattle COE), Sales AE (Seattle COE)

Objectives:
The Competing Values Framework (CVF) has been widely used in health services research, including at the VHA, to assess organizational culture as a predictor of quality improvement implementation, employee and patient satisfaction, and team functioning, among other outcomes. CVF instruments are generally presented as well-validated with reliable aggregated subscales. However, only one study in the health sector has been conducted for the express purpose of validation, and that study population was limited to hospital managers from a single geographic locale.

Methods:
We used exploratory and confirmatory factor analyses to explore the underlying structure of data from a CVF instrument and assessed alternative subscale solutions. We analyzed cross-sectional data from the VHA All Employee Survey on work environment. The study population comprised all employees, including managers and non-managers, and clinical and non-clinical staff. The survey included 14 items adapted from a popular CVF instrument, which measures organizational culture according to four subscales: hierarchical, entrepreneurial, group, and rational.

Results:
Data from102,118 employees (response rate 51%) from 167 VHA facilities were analyzed. Items from the entrepreneurial, group, and rational subscales frequently correlated more highly across scales (r = 0.40 to 0.73) than within scales (r = 0.54 to 0.65), suggesting poor discriminant validity. Alpha coefficients ranged from 0.68 to 0.85 indicating adequate reliability. Exploratory factor analysis revealed two factors, comprising three of four items from the hierarchical subscale loading on one factor, and nine of the ten items from the remaining subscales loading on the other factor. Confirmatory factor analysis indicated the two-subscale solution provides a more parsimonious fit.

Implications:
The CVF instrument did not perform in the VHA population as predicted by the CVF model. A simplified two-subscale model may be more appropriate for scoring organizational culture from this instrument, but more research is needed, particularly to assess criterion validity.

Impacts:
This study suggests caution in drawing inferences from conventional CVF subscales and underscores the importance of assessing the reliability and internal consistency of organizational culture scales in each new context they are used. It further highlights the challenges management scholars face in assessing organizational culture in a reliable, comparable way.