Date of Award

4-1994

Degree Name

Doctor of Philosophy

Department

Sociology

First Advisor

Dr. Thomas van Valey

Second Advisor

Dr. James Petersen

Third Advisor

Dr. Neil Kent

Fourth Advisor

Dr. Subhash Sonnad

Keywords

organizational culture, veteran's health care

Abstract

The organizational culture in a Veteran's Administration Medical Center (VAMC) was described using triangulated methods which included both secondary quantitative survey data, and internal documentary data sources. The initial survey data collected, from staff and elder veterans revealed an overall positive perception from both samples regarding the quality of life for elder veterans living on extended care wards. The study investigated the extent to which the VAMC's organizational culture affected these perceptions of quality of life.

Documentary data were collected from a variety of VAMC sources regarding behaviors, ideologies, leadership trends, mechanisms of control, and the formal organizational structure. A content analysis determined the artifacts and ideologies which defined the VAMC's organizational culture. The results from these data suggest that the depth of the vertical, bureaucratic, organizational structure within the VAMC imposes strict adherence to quality of life standards as a cultural norm. Moreover, admission standards, patient profiles and staffing patterns all positively affect quality of life compliance. Finally, standards for the provision of quality medical care were found to be both an espoused value, and a formal regulation within the VAMC's organizational culture.

To determine the effects of the organizational culture on the perceptions of quality of life, the survey data were re-analyzed. A secondary analysis collapsed the original indicators into nine themes which had emerged from the content analyses of the VAMC documents. The nine themes were then cross-tabulated using the chisquare test of independence. common relationships among the themes, and, between the two samples were thought to demonstrate a similar acculturation process. The results indicated that while positive relationships were found among the quality of life themes for both audiences, the exact thematic relationships were somewhat different. These results suggest that while both staff and veterans were successfully acculturated into the VAMC organizational culture, the process differed.

Overall, these results indicated that the organizational culture does affect the perceptions of quality of life for staff and veterans respondents on the extended care wards. Moreover, the process of acculturation within the VAMC organization differs depending upon one's role within the organizational hierarchy.

Access Setting

Dissertation-Open Access

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