Do senior management cultures affect performance? Evidence from Italian public healthcare organizations

Healthcare organizations are often characterized by diffuse power, ambiguous goals and a plurality of actors. In this complex and pluralistic context, senior managers are expected to make strategic directions and lead healthcare organizations toward their goals and performance targets. The present work explores the relationship between senior management team culture and performance by investigating Italian public healthcare organizations in the Tuscany Region. Our assessment of senior management culture was accomplished through the use of an established framework and a corresponding tool, the Competing Values Framework (CVF), which supports the idea that specific aspects of performance are related to a dominant management culture. Organizational performance was assessed using a wide range of measures collected by a multidimensional Performance Evaluation System (PES), which was developed in Tuscany to measure the performance of its 12 local health authorities (LHAs) and 4 teaching hospitals. Usable responses were received from 80 senior managers of 11 different healthcare organizations (2 teaching hospitals and 9 LHAs). Our findings show that Tuscan healthcare organizations are characterized by various dominant cultures: developmental, clan, rational and hierarchical. These variations in dominant culture were associated with performance measures. The implications for management theory, professional practice and public policy are discussed.