Hospital Mission: Content and Transmission Mechanisms as Factors Related to Patient Satisfaction in Selected U.S. Hospitals

Date of Submission


Document Type


Degree Name

Doctor of Science in Management Systems (Sc.D.)




Judith A. Neal

Committee Member

Gordon R. Simerson

Committee Member

Louis Mottola

LC Subject Headings

Hospitals--United States--Administration, Corporate culture--United States, Patient satisfaction--United States

Call No. at the Univ. of New Haven Library

AS 36 N290 Mgmt. Syst. 1995 no. 1


The purpose of this research was to explore mission from the perspective of a total organizational vision (TOV), transmission mechanisms, and strength of transmission as explanatory factors related to patient satisfaction. TOV was defined as including all documents related to the organization's mission, vision, ethics, values, beliefs, purpose, direction, and so on. In addition, attributes of organizations were investigated, including religious affiliation, to determine if there were associated differences in the dependent variables. The study used two questionnaires and content analysis of organizational mission-related documents as sources of data. The sample consisted of 338 hospitals that were known to have used the Press, Ganey patient satisfaction instrument.

The current study appears to have been the first attempt at research on the relationships among components of the mission institutionalization system. The four key mission content types searched for in the various organizational mission documents were: spiritual content, social content, ethical content, and organizational content. The summation (range of 0 to 4) of the types of content present for each organization resulted in the strength of total organizational vision (STOV) variable. Organizations identified specific transmission mechanisms used, noted the length of time used, and assigned a weight based on the strength of their use in the organization. The product of these three factors (number of mechanisms x average weight given x average time used) created a variable called the strength of transmission (SOT).

Six hypotheses were included in the research. The study found that there were relationships among TOV content, strength of transmission, and patient satisfaction when other organizational factors were held constant. The research indicated that there was a significant positive relationship between spiritual content (independent variable) in hospital mission documents and strength of transmission (dependent variable) of the TOV. There was also a significant positive relationship between religious affiliation (independent variable) and the inclusion of spiritual content (dependent variable) in the TOV. Additionally, the study found a significant positive relationship between strength of TOV (independent variable), and strength of transmission (dependent variable). Direct significant results with overall patient satisfaction were only found for religious hospitals and organizations that have spiritual content in their mission. The study also provided an analysis of the transmission mechanisms employed by the organizations.

The results of this research will assist hospital institutions in more fully understanding organization vision, transmission, and outcomes, thus providing insights by which they can improve the effectiveness of the strategic management and planning process. In addition, it will provide impetus for more specific strategy formulation and implementation dealing with organizational effectiveness and patient satisfaction. The expectation is that with such improvements an organization would be more successful and competitive in the changing health care environment.