The Effects of Appreciative Inquiry Versus Problem Solving on Organizational Culture

The nursing profession has exhibited a significant interest in studying organizational culture as it relates to implementing new models of care for improving efficiency, nursing practices, and outcomes. None of the reported studies to date have investigated the effects of interventions to strengthen culture and facilitate change. The primary purpose of this study was to gain understanding of existing hospital unit based culture styles and determine if they could be strengthened over time. The second purpose of the study was to determine if using appreciative inquiry versus problem solving interventions would produce quantifiable results related to change in culture styles and specific performance measures (staff satisfaction, patient satisfaction, and turnover).;The site for this research was a 310-bed community-based hospital located outside of a large Midwest city in the United States. Five inpatient nursing care units were selected to participate; three of the units received an appreciative inquiry intervention and one unit received a problem solving intervention while undergoing a model change. A control unit was selected that did not receive an intervention or a model change.;A mixed methodology, sequential exploratory strategy was used, including quantitative and qualitative methods. Through a field study, subunits were investigated using multiple data collection procedures over a 12-month period of time. The Organizational Culture Inventory RTM was used to measure the strength of behavioral norms both pre and post intervention. Data obtained from structured work group sessions led to the design and delivery of interventions that provided a deeper understanding of the shared values that the units possessed. These interventions were then used to create a future vision and strategies to improve their culture. Performance metrics were analyzed to assess the relationship between the interventions and outcomes.