A descriptive study of the relationship of interaction disturbance to the organizational health of a metropolitan general hospital

The Theory of Organizational Health was derived from clinical experience and readings in industrial quality management literature. The theory was articulated through King's Interacting Systems Framework. The three concepts important to the Theory of Organizational Health are value symbols, interaction disturbance, and organizational health. A newly defined construct of interaction disturbance was proposed within the Theory of Organizational Health as a form of communication that exists when values are not exchanged. Interaction disturbance as opposed to interaction causes the organization to be inconsistent in goal attainment and subsequently performance. Organizational Health is defined as the ability of the organization to maintain and sustain meaningful value symbols for all participants in the culture including internal and external customers.

The study took place in a 1000 bed teaching hospital in the Southeast. The sample included 175 respondents or 36% of the target population of three groups: staff nurses, nurse administrators, and hospital administrators.

The data were collected using McCoy and Tucker's (1989) Survey of Organizational Culture, a value ranking tool, and a demographic survey. Statistical analyses performed on the data included ANOVA, Principal Component Factor Analysis, Cronbach's Alpha, and Spearman's Correlation.

The top four values for the interpersonal systems and the social system were used for analysis. With regard to value congruency, the three interpersonal systems were largely congruent with values of Patient Satisfaction, High Quality Service to the Community, and Employee Well Being ranking in the top three of the combined interpersonal system values. Value incongruency occurred between the interpersonal systems and the social system on Employee Well Being, Communication, Cost Containment, and Profitability. The top four values of the hospital were perceived to be Patient Satisfaction, High Quality Service to the Community, Cost Containment, and Profitability. The most surprising results were the congruence of values between the interpersonal systems and the congruence between interpersonal systems and social systems on values of Patient Satisfaction and High Quality Service to the Community.

Organizational health was perceived to be lowest in areas of mission, customer focus, management constancy, and reward system by the administrators responding. Staff nurses had significantly higher discrepancy scores on factors relating to employee well being. On all indicators of organizational health the respondents indicated that the "actual" performance was less than "desired." A new definition of organization was proposed for use with King's Interacting Systems Framework. Additionally, King's Interacting Systems Framework was reconceptualized so that the impact of the environment on the interacting systems could be understood for future research.