Buy this Article for $10.95

Have a coupon or promotional code? Enter it here:

When you buy this you'll get access to the ePub version, a downloadable PDF, and the ability to print the full article.


  1. Way, Christine PhD, RN
  2. Gregory, Deborah MSc, RN
  3. Davis, Judy MN, RN
  4. Baker, Norma MN, RN
  5. LeFort, Sandra PhD, RN
  6. Barrett, Brendan MD
  7. Parfrey, Patrick MD


Objectives: The purpose was to investigate managers' perceptions of organizational culture and attitudinal and behavioral reactions during and after restructuring, and to test a model linking culture to outcome.


Background: Healthcare reform has altered the work environment, but few studies have documented the impact of system changes on managers responsible for clinical services.


Methods: Survey data were collected from clinical managers (N = 104; 99) employed by 3 institutional boards in Newfoundland and Labrador in 2000 and 2002. Response rates were 57.6% and 47.7%, respectively.


Results: For both periods, most variable ratings were in the low range and depicted moderately, positive intercorrelations. Select culture variables, trust, and job satisfaction emerged as significant predictors of commitment. Although culture and trust exerted inconsistent effects on intent, satisfaction remained a predictor over time.


Conclusion: The findings support the negative impact of reform on clinical managers, and the strong link between positive ratings of culture, trust, and satisfaction, and greater commitment and intent to stay. Greater attention should focus on promoting more positive cultures and work-related attitudes, and less turnover intentions.