Organizational culture among levels of health care services in Crete (Greece).

As a concept, organizational culture is multifaceted and it has been studied in fields ranging from social anthropology to industrial-organizational psychology (Schein, 2010) defined as the set of beliefs, values, behavioral patterns, and assumptions shared by members of an organization (Cooke & Rousseau, 1998; Jacobs & Roodt, 2008; Scott, Mannion, Huw, & Marshall, 2003). Researchers in a variety of academic and professional disciplines have studied organizational culture and its possible impact on performance within organizations' services (Brian, Stanley, Armenakis, & Shook, 2009; Davies, Mannion, Jacobs, Powell, & Marshall, 2007; Freund & Drach-Zahavy, 2007; Xenikou & Simosi, 2006; Zheng, Baiyin, & McLean, 2010). In health care, organizational culture has been found to play an important part in ensuring the provision of quality services in sectors including nursing, patient and staff safety, job satisfaction and staff turnover, and in the systematic improvement of management procedures (Boan & Funderburk, 2003; Seyda & Ulku, 2007; Jacobs & Roodt, 2008; Randsley de Moura, Dominic, Retter, Sigridur, & Kaori, 2009; Singer et al., 2009). Furthermore, relationships have also been demonstrated between financial performance and organizational culture (Pelletier, 2005; Sanders & Cooke, 2005). However, establishing the precise relationship between organizational culture type, staff performance and achievement of organization aims was known to be a complex issue and difficult to establish (Marcoulides & Heck, 1993). In addition, it is reasonable to suggest that complex organizationsmight presentmultiple cultures, and the interdependent aspects of each subculture within a large organization might not favour planned changes (Cooke & Rousseau, 1998; Viitanen, Willi-Peltola, Tampsi-Jarvala, & Lehto, 2007; Xenikou & Simosi, 2006). This is most likely to happen in hospital settings, since the subdivision into different departments and wards provides a perfect setting for the development of multiple subcultures (Xenikou & Simosi, 2006).