Organizational culture, quality of care and leadership style in government general hospitals in Kuwait: a multimethod study

Purpose To investigate the organizational culture, assess the quality of care, and measure their association with a transformational/transactional leadership style in six hospitals. Materials and methods We used cross-sectional and retrospective quantitative approaches in government-sponsored secondary-care hospitals. A sample of 1,626 was drawn from a frame of 9,863 healthcare workers in six hospitals. Followers were surveyed using the Multifactor Leadership Questionnaire and the Organizational Description Questionnaire. We reviewed and analyzed one year (2012) of quarterly and annual quality indicators from the hospitals. Data were analyzed using suitable statistical analyses. Results We collected 1,626 responses from six hospitals. 66.4% to 87.1% of participants in each hospital identified their hospital’s organizational culture as transformational, whereas 41 out of 48 departments were identified as having a transformational culture. The percentage of participants at each hospital rating their leader and organizational culture as transformational ranged from 60.5% to 80.4%. The differences between leadership style and organizational culture were statistically significant for four of the hospitals. For most of the quality indicators, there was a positive, but nonsignificant, correlation with leadership style. Conclusion Leaders define and influence organizational culture. The prevailing transformational leadership style creates and maintains a transformational organizational culture. The effect of transformational leadership on the quality of care delivered by the organization was measured in this study, and showed a positive and nonsignificant relationship between generic quality indicators and the transformational style.