The Relationship Between Organizational Climate and Quality of Chronic Disease Management

The organizational climate of a health care clinic—the perception of policies, procedures and practices—can have an effect on how care is managed and delivered and ultimately, on patient outcomes.

Researchers sought to determine whether two dimensions of climate—task climate and relational climate—were predictive of a primary care team’s performance in managing chronic conditions. A task climate rewards clinical personnel for achieving performance goals. A relational climate promotes trust, supportive collaboration and communication among staff.

This study analyzed 4,539 patients with diabetes who were cared for in 223 primary care clinics of the U.S. Department of Veteran Affairs. Diabetes was chosen as the chronic condition for the study because diabetes care requires control of a number of health indicators and a high degree of coordination among providers. For this study, climate data were drawn from a survey of all employees. Diabetes care was measured by whether or not patients received annual HbA1c testing and foot exams.

The relational climate was positively related to the likelihood of patients receiving their annual diabetes tests. The task climate, however, was not found to be related to clinical outcomes, suggesting that management emphasis on performance goals may not improve care for chronic conditions such as diabetes.