• Christine Way, Deborah Gregory, Judy Davis, Norma Baker, Sandra LeFort, Brendan Barrett, and Patrick Parfrey.
• School of Nursing and Clinical Epidemiology, Memorial University of Newfoundland, St. John's, NL, Canada. cway@mun.ca
• J Nurs Adm. 2007 May 1; 37 (5): 235-42.

ObjectivesThe 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.BackgroundHealthcare reform has altered the work environment, but few studies have documented the impact of system changes on managers responsible for clinical services.MethodsSurvey 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.ResultsFor 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.ConclusionThe 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.

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