Exploring the link between healthcare organizational culture and provider work satisfaction: a systematic review

Abstract

Background

Organizational culture and work satisfaction are fundamental domains important for a good working environment and are closely linked to employees' work performance and well-being in healthcare environments. Although organizational culture is critical, research on how and what domains affect work satisfaction in the healthcare sector remains scattered. By combining the literature, this review will offer significant insights into which factors significantly influence work satisfaction in the healthcare sector. It will also map the literature on this subject, identifying key patterns, gaps, and inconsistencies that can direct future research directions.

Methods

Our review complied with the Systematic Review and Meta-Analysis Statement's Preferred Reporting Items. This review used three databases for the literature search (PubMed, Scopus, and Web of Science). The literature search focused on more recent published studies between 2014 and 2024, and the search was conducted in November 2024. Two authors evaluated the bias of studies using a risk of bias template, a critical appraisal tool for use in JBI Systematic Reviews, to assess the risk of bias and the paper's quality. Studies were analyzed and compiled based on the classification of work satisfaction and the direction of the relationship.

Results

Six themes of value related to organizational culture were formulated among the included studies to synthesize their associations with work satisfaction. The themes tied to organizational culture were 1) continuous communication, 2) organizational leadership, 3) teamwork, 4) employee involvement in decision-making, 5) employee recognition, and 6) autonomy.

Conclusion

Implementing strategies tailored to each theme may increase work satisfaction, foster improved organizational performance, increase retention, and improve the quality of patient care. This may serve as a crucial element in forthcoming healthcare system reforms, aiming to harmonize the requirements of providers and recipients alike.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-025-12973-6.

Background

Organizational culture and work satisfaction are fundamental domains important for a good working environment and are closely linked to employees'work performance and well-being in healthcare environments [1, 2]. Organizational culture is a system of shared meanings held by members that distinguishes the organization from others [3]. This system of shared meaning includes the values, beliefs, and assumptions that characterize the organization. It functions as the social glue of an organization, impacting a wide range of factors, including employee engagement and work satisfaction, communication patterns, and decision-making procedures [3]. The professional environment in healthcare settings and patient outcomes depend much on how the organizational culture is shaped. Conversely, work satisfaction is a pleasurable or positive emotional state resulting from the appraisal of one's work or work experiences [4]. The degree of contentment workers have with their occupations considers factors such as pay, autonomy, work-life balance, appreciation, and social interactions [4].

In current healthcare organizations, work satisfaction is crucial for employee motivation, retention, and performance since professionals deal with significant degrees of stress and emotional expectations [5]. Studies have examined how closely work satisfaction and organizational culture interact. An organization can increase work satisfaction by creating a trusting, supportive, cooperative environment [6]. However, a negative culture characterized by rigid policies, inadequate communication, and a lack of support may lead to high turnover rates, burnout, and work discontent [6]. Work satisfaction in healthcare organizations directly influences the emotional well-being of healthcare professionals and the quality of patient treatment [5]. According to Hulin and Judge, work satisfaction consists of cognitive (evaluative), affective (or emotional), and behavioral reactions to a work [7]. Work satisfaction assessments differ in their degree of cognitive and emotional work sentiment and the overall nature of the work. Although worker satisfaction has been well investigated in many different sectors, healthcare poses unique challenges because of its demanding work environment, diverse workforce, and complicated organizational structures [5]. The diversity of each workforce group, which includes physicians, nurses, health support personnel, and administrative workers, creates a unique yet overlapping culture [8]. For example, nurses prioritize teamwork and support, whereas physicians sometimes emphasize autonomy, leadership, or professional development [9, 10] Culture influences healthcare professionals'daily experiences, impacting their level of engagement, work autonomy, communication, and collaboration [5].

By cultivating a culture of collaboration and transparent communication among departments and healthcare providers, employees may experience heightened engagement and appreciation, hence enhancing work satisfaction. A strict, hierarchical, and compartmentalized culture can diminish work satisfaction by promoting dissatisfaction, isolation, and disengagement [11]. Moreover, a significant cultural factor that influences the entire workplace is leadership. Poor leadership can exacerbate employee stress and dissatisfaction, whereas supportive leadership that fosters well-being, cultivates inclusivity, and honors employee contributions is correlated with increased work satisfaction [12]. Healthcare organizations, on the other hand, have many chances to use organizational culture to increase employee happiness. Research has consistently shown that work satisfaction is linked to various positive outcomes, such as reduced turnover, better teamwork, and improved work performance [13]. Since healthcare workers are more involved and driven to complete their work, satisfied healthcare workers are better suited to delivering the best patient care. Thus, encouraging a good organizational culture might result in a "win–win" situation whereby patients and staff gain simultaneously [14].

Although organizational culture is critical, research on how and what domains affect work satisfaction in the healthcare sector is still scarce. Moreover, work satisfaction in healthcare is a topic of extensive study; most studies concentrate on discrete elements such as salary, work-life balance, and work demands without considering the more significant cultural setting in which these elements function [15, 16]. Few studies have also examined the complex relationship between organizational culture and work satisfaction, and even fewer have explored the effects of specific cultural components, such as teamwork, communication techniques, leadership styles, or rewards, on work satisfaction in various healthcare contexts [15–17]. The full extent of organizational culture's impact on healthcare workers'satisfaction remains complex and may not be entirely understood. By synthesizing existing literature, this review aims to provide a structured overview of key factors influencing work satisfaction in the healthcare sector. It will also map the literature on this subject, identifying key patterns, gaps, and inconsistencies that can direct future research directions. These insights will assist healthcare managers, and policymakers create interventions promoting work satisfaction and enhancing organizational performance and patient care.

Methods

Our review complied with the Systematic Review and Meta-Analysis Statement's Preferred Reporting Items [18]. This review used three databases for the literature search (PubMed, Scopus, and Web of Science). The literature search focused on more recent published studies between 2014 and 2024, and the search was conducted in November 2024. The search strategy, as shown in Table 1, was based on the PICO framework [19]: 1) population: healthcare provider; 2) intervention: organizational culture; 3) comparator: nil; and 4) outcome: work satisfaction.

Table 1.

Search strategy

Database	Search string
Scopus	TITLE-ABS-KEY(("health organization*" OR "hospital*" OR "health facility*" OR "acute care" OR "primary care" OR "health" OR "healthcare" OR "health care" OR "health-care") AND ("work culture" OR "workplace" OR "work site" OR "worksite" OR "organization* culture" OR "service culture" OR "corporate culture" OR "work climate" OR "organization* climate" OR "service climate" OR "corporate climate" OR "work ethos" OR "organization* ethos" OR "service ethos" OR "corporate ethos" OR "work environment" OR "organization* environment" OR "service environment" OR "corporate environment") AND ("work satisfaction" OR "thriving at work" OR "work achievement" OR "work amusement" OR "work comfort" OR "work contentment" OR "work delight" OR "work enjoyment" OR "work fulfillment" OR "work gratification" OR "work happiness" OR "work joy" OR "work peace of mind" OR "work pleasure" OR "work pride" OR "work relief" OR "work vindication" OR "work well-being"))
Web Of Science	ALL = (("health organization*" OR "hospital*" OR "health facility* "OR "acute care" OR "primary care" OR "health" OR "healthcare" OR "health care" OR "health-care") AND ("work culture" OR "workplace" OR "work site" OR "worksite" OR "organization* culture" OR "service culture" OR "corporate culture" OR "work climate" OR "organization* climate" OR "service climate" OR "corporate climate" OR "work ethos" OR "organization* ethos" OR "service ethos" OR "corporate ethos" OR "work environment" OR "organization* environment" OR "service environment" OR "corporate environment") AND ("work satisfaction" OR "thriving at work" OR "work achievement" OR "work amusement" OR "work comfort" OR "work contentment" OR "work delight" OR "work enjoyment" OR "work fulfillment" OR "work gratification" OR "work happiness" OR "work joy" OR "work peace of mind" OR "work pleasure" OR "work pride" OR "work relief" OR "work vindication" OR "work well-being"))
PubMed	(("health organization*" OR "hospital*" OR "health facility*" OR "acute care" OR "primary care" OR "health" OR "healthcare" OR "health care" OR "health-care") AND ("work culture" OR "workplace" OR "work site" OR "worksite" OR "organization* culture" OR "service culture" OR "corporate culture" OR "work climate" OR "organization* climate" OR "service climate" OR "corporate climate" OR "work ethos" OR "organization* ethos" OR "service ethos" OR "corporate ethos" OR "work environment" OR "organization* environment" OR "service environment" OR "corporate environment") AND ("work satisfaction" OR "thriving at work" OR "work achievement" OR "work amusement" OR "work comfort" OR "work contentment" OR "work delight" OR "work enjoyment" OR "work fulfillment" OR "work gratification" OR "work happiness" OR "work joy" OR "work peace of mind" OR "work pleasure" OR "work pride" OR "work relief" OR "work vindication" OR "work well-being"))

All the published articles acquired from the three databases were downloaded into the citation manager (Endnote Library). Two authors (F.D. and S.A.) examined 5% of the data to ensure that the article retention procedure was uniform. The combined articles from the combined databases were then removed with duplication via two main methods: 1) the Endnote automation tool and 2) manual endnote article list screening by two authors (M.R. and S.A.). The following inclusion criteria were used to evaluate the abstracts: peer-reviewed journal papers written in English that described empirical research performed in medical settings. Broad definitions of healthcare-covered locations include general practices, hospitals, pharmacies, military hospitals, assisted living facilities, mental health centers, and other healthcare settings. Only articles that evaluated the relationship between workplace or organizational culture and work satisfaction were included. Because organizational climate, commitment, and safety culture play significant roles in organizational culture, the measured articles were included if other inclusion criteria were satisfied.

Article retention disagreements were debated until an agreement was reached, with F.D. serving as an arbiter in situations where the suitability of the study was unclear. A full-text analysis of the included publications was conducted after M.R. and S.A. evaluated the remaining abstracts in light of the inclusion criteria. Papers assessing organizational commitment and climate were included if they included work satisfaction outcomes. Articles discussing metrics such as"workload"and"burnout,"which are context-specific (not related to organizational culture), were disqualified if they failed to gauge work satisfaction. Additionally, articles that used only a qualitative study design to gauge work satisfaction were not included in this review. Only associations that were pertinent to the hypothesis were examined. To avoid duplicating articles and better-comprehending article findings, non-English and conference proceedings papers were excluded from this review.

A data extraction sheet (Additional file 1) was used to summarize the included articles. The nation, data collection period, study type, objectives, data gathering techniques, methodology, findings, and implications were among the essential details noted. M.R. and S.A. evaluated the bias of studies via a risk-of-bias template (Additional file 2), which is a critical appraisal tool for use in JBI Systematic Reviews [20] This tool evaluates the risk of bias and the quality of the paper. Studies were analyzed and compiled based on the classification of work satisfaction and the direction of the relationship.

Results

Initially, 881 articles from three central databases (PubMed, Scopus, and Web of Science) were found, as shown in Fig. 1. For the 5% examination of abstracts, Cohen's kappa revealed a moderate level of agreement (0.76) between the two authors, M.R. and S.A. Duplicate articles (n = 349) from the total articles were removed successfully before the screening process, as in the Systematic Review and Meta-Analysis Statement's Preferred Reporting Items flow diagram of reporting [18]. During the screening process, several of the remaining 532 articles were further removed (n = 473) because of 1) irrelevant titles (n = 304), 2) different contexts (not related to organizational culture (n = 61), 3) different populations (not healthcare providers) (n = 48), 4) qualitative study designs (n = 27), and 5) review articles (n = 33).

Fig. 1.

PRISMA flow diagram [18]

Following the screening procedure, which involved reviewing all the paper titles and abstracts, the remaining 59 abstracts met the inclusion criteria for complete paper retrieval. In the eligibility process, 25 articles were removed because they were 1) conference proceedings (n = 24) and 2) non-English (n = 1). Finally, only 27 studies were included in the final synthesis. All the included studies were charted in the extensive table of the articles (Additional file 3), which was created by M.R. and edited by S.A. and F.D.

Study characteristics

This systematic review included 27 studies examining the relationship between healthcare organizational culture and provider work satisfaction. Among these, 24 studies (88.9%) were cross-sectional, whereas three (11.1%) employed a mixed-methods approach. The healthcare professionals represented in the studies included nurses (59.3%, n = 16), doctors (11.1%, n = 3), pharmacists (7.4%, n = 2), dental staff (7.4%, n = 2), and others, such as midwives, physiotherapists, and administrative staff (14.8%, n = 4). The settings included diverse healthcare environments, including hospitals (66.7%, n = 18), clinics (7.4%, n = 2), public health facilities (11.1%, n = 3), dental facilities (7.4%, n = 2), and nursing homes or primary care settings (7.4%, n = 2). The studies were conducted in various countries, with notable contributions from Brazil (18.5%, n = 5), Canada (11.1%, n = 3), and other nations, such as Ethiopia, Finland, and the USA. These data illustrate the global focus on the impact of organizational culture across various healthcare disciplines and settings, as shown in Table 2.

Table 2.

Study characteristics

No	Author (Year)	Country	Study type	Healthcare profession type, number of participants	Healthcare setting
1	Al Hamdan et al. (2019) [21]	Jordan	Cross-Sectional	Nurse, (n = 270)	Hospital
2	Andre et al. (2020) [22]	Norway	Cross-Sectional	Nurse	Nursing Home
3	Asegid et al. (2014) [23]	Ethiopia	Cross-Sectional	Nurse	Public Health Facility
4	Chien & Yick (2016) [24]	Hong Kong	Cross-Sectional	Nurse	Hospital
5	Currey et al. (2019) [25]	Australia	Mixed Method	Nurse	Hospital
6	Dahinten et al. (2016) [26]	Canada	Cross-Sectional	Nurse	Hospital
7	Dalal et al. (2023) [27]	Palestine	Cross-Sectional	Doctor, Nurse	Hospital
8	Dutra & Guirardello 2021 [28]	Brazil	Cross-Sectional	Nurse	Hospital
9	Garcia et al. 2017 [29]	Brazil	Cross-Sectional	Nurse	Hospital
10	Goetz et al. 2016 [30]	Germany	Cross-Sectional	Dental Nurse	Dental Clinic
11	Hansson et al. 2022 [31]	Sweeden	Cross-Sectional	Midwife	Hospital
12	Haruta & Goto 2024 [32]	Japan	Cross-Sectional	Doctor, Nurse, Pharmacist	Public Health Facility
13	Håvold et al. 2021 [33]	Norway	Cross-Sectional	Doctor, Nurse, Administration Staff	Hospital
14	Head et al. 2019 [34]	USA	Cross-Sectional	Hospice and Palliative Nurses	Hospital and Clinic
15	Khan et al. 2021 [35]	Pakistan	Cross-Sectional	Doctor, Nurse	Hospital and Clinic
16	Labban et al. 2020 [36]	Saudi Arabia	Cross-Sectional	Endodontist	Dental Facility
17	Lee et al. 2020 [37]	Canada	Cross-Sectional	Nurse	Hospital
18	Liss et al. 2018 [38]	Sweeden	Cross-Sectional	Dental Hygienist	Dental Facility
19	Meng et al. 2018 [39]	China	Cross-Sectional	Doctor, Nurse	Hospital
20	Muluneh et al. 2022 [40]	Ethiopia	Cross-Sectional	Midwife	Hospital and clinic
21	O'Hara et al. 2019 [41]	USA	Cross-Sectional	Nurse	Hospital
22	Oliveira et al. 2017 [42]	Brazil	Cross-Sectional	Nurse	Hospital
23	Pentilla et al. 2021 [43]	Finland	Cross-Sectional	ENT Surgeons	Hospital
24	Poikkeus et al. 2020 [44]	Finland	Cross-Sectional	Nurse	Primary and private healthcare
25	Sillero et al. 2023 [45]	Spain	Cross-Sectional	Physiotherapy	Hospital
26	Suliman & Aljezawi 2018 [46]	Jordan	Cross-Sectional	Nurse	Hospital
27	Yamassake et al. 2021 [47]	Brazil	Cross-Sectional	Nurse	University Hospital

Risk of bias assessment findings

The risk of bias assessment via the JBI Critical Appraisal Tool [20] revealed robust methodological quality across the included studies, although some limitations were evident, as shown in Table 3. Among the 27 studies, a significant proportion (48.1%, n = 13) achieved a perfect score of 8/8, indicating adherence to all criteria for minimizing bias. These studies demonstrated clear inclusion criteria, reliable exposure measurements, and robust statistical analyses while effectively addressing confounding factors. However, 29.6% (n = 8) scored 7/8, often due to the absence of strategies to handle confounding factors (Q6) or unclear criteria for confounding identification. The remaining 22.2% (n = 6) scored 6/8, primarily owing to unclear exposure measurement methods (Q3) or confounding factor strategies. This highlights the variability in methodological rigor, particularly in controlling for potentially confounding influences. Specifically, strategies to address confounding factors (Q6) and clarity in exposure measurements (Q3) were recurrent issues, affecting nearly one-third of the studies. This highlights the need for future research to adopt more rigorous frameworks for controlling for confounding factors and measuring validity. Despite these limitations, the studies collectively provide credible evidence, with over 70% meeting high methodological standards (scores ≥ 7). This consistency strengthens confidence in the synthesized findings on the relationship between organizational culture and healthcare provider work satisfaction.

Table 3.

Risk of bias assessment (JBI systematic reviews) [20]

No	Author(s)	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	SCORE
1	Al-Hamdan	Y	Y	Y	Y	Y	N	Y	Y	7/8
2	André	U	Y	Y	Y	Y	N	Y	Y	6/8
3	Asegid	Y	Y	Y	Y	Y	Y	Y	Y	8/8
4	Chien	Y	Y	Y	Y	Y	N	Y	Y	7/8
5	Currey	Y	Y	Y	Y	U	N	Y	Y	6/8
6	Dahinten	Y	Y	Y	Y	U	N	Y	Y	6/8
7	Dalal	Y	Y	Y	Y	U	N	Y	Y	6/8
8	Dutra	Y	Y	Y	Y	Y	Y	Y	Y	8/8
9	Garcia	Y	Y	Y	Y	Y	U	Y	Y	7/8
10	Goetz	Y	Y	Y	Y	Y	U	Y	Y	7/8
11	Hansson	Y	Y	Y	Y	Y	Y	Y	Y	8/8
12	Haruta	Y	Y	Y	Y	Y	Y	Y	Y	8/8
13	Håvold	Y	Y	Y	Y	Y	Y	Y	Y	8/8
14	Head	Y	Y	Y	Y	Y	Y	Y	Y	8/8
15	Khan	Y	Y	Y	Y	Y	Y	Y	Y	8/8
16	Labban	N	Y	Y	Y	Y	Y	Y	Y	7/8
17	Lee	Y	Y	Y	Y	Y	Y	Y	Y	8/8
18	Liss	N	N	Y	Y	Y	Y	Y	Y	6/8
19	Meng	Y	Y	Y	Y	Y	Y	Y	Y	8/8
20	Muluneh	Y	Y	Y	Y	Y	Y	Y	Y	8/8
21	O'Hara	N	Y	Y	Y	Y	Y	Y	Y	7/8
22	Oliveira	Y	Y	Y	Y	Y	N	Y	Y	7/8
23	Penttilä	N	Y	Y	Y	Y	N	Y	Y	6/8
24	Poikkeus	Y	Y	Y	Y	Y	Y	Y	Y	8/8
25	Sillero Sillero	Y	Y	Y	Y	Y	Y	Y	Y	8/8
26	Suliman	N	Y	Y	Y	Y	Y	Y	Y	7/8
27	Yamassake	Y	Y	Y	Y	Y	Y	Y	Y	8/8

Y: yes, N: no, U: unclear, Q1: Were the sample inclusion criteria clearly defined? Q2: Were the study subjects and the setting described in detail? Q3: Was the exposure measured validly and reliably? Q4: Were objective, standard criteria used for measurement of the condition? Q5: Were confounding factors identified? Q6: Were strategies to address confounding factors stated? Q7: Were the outcomes measured validly and reliably? Q8: Was appropriate statistical analysis used?

Overall findings

Six themes of value related to organizational culture were formulated among the included studies to synthesize their associations with work satisfaction, as shown in Fig. 2. The themes tied to organizational culture were as follows: 1) continuous communication, 2) organizational leadership, 3) teamwork, 4) employee involvement in decision-making, 5) employee recognition, and 6) autonomy. The positive associations between the themes and work satisfaction are summarized in Table 4.

Fig. 2.

Thematic synthesis of healthcare organizational culture and provider work satisfaction

Table 4.

Organizational culture themes toward work satisfaction (positive association)

No	Author	Organizational culture components*
		Continuous Communication#	Organizational Leadership#	Teamwork#	Employee Involvement in Decision-Making#	Employee Recognition#	Autonomy#
1	Al-Hamdan	√	√	√	√
2	André			√	√
3	Asegid		√	√		√	√
4	Chien						√
5	Currey	√	√	√
6	Dahinten		√		√
7	Dalal	√	√
8	Dutra	√	√
9	Garcia		√	√		√
10	Goetz			√		√	√
11	Hansson		√			√
12	Haruta	√	√
13	Håvold		√			√
14	Head		√	√			√
15	Khan	√
16	Labban		√	√		√
17	Lee			√
18	Liss			√
19	Meng		√			√
20	Muluneh	√	√			√	√
21	O'Hara		√	√			√
22	Oliveira		√	√			√
23	Penttilä					√
24	Poikkeus	√	√	√
25	Sillero Sillero	√	√	√	√
26	Suliman		√	√
27	Yamasaki		√	√			√

^*Outcome measured with different instruments; all associations were only positive

^#Organizational culture with a p-value < 0.05 indicates a significant positive association with work satisfaction

Theme 1: continuous communication

We found that nine of the 27 studies included in our review were positively associated with organizational practices by providing continuous information and good communication among colleagues with high work satisfaction. Studies by [21, 25] focusing on nurses revealed that having sufficient time and opportunity to engage in discussions regarding patient care issues with fellow nurses and doctors results in a notable positive correlation (r = 0.392, df = 229, P < 0.05) and an association with a median of 3.0 (3.0, 3.2), P value = 0.006. Another study in Palestine [27] involving doctors and nurses also revealed that a positive communication culture in an organization led to high work satisfaction (β = 0.20, p = 0.03). In Brazil, a study conducted by [28] reported that work satisfaction was related to good communication and information exchange between the nurse and the physician (r = 0.34, p < 0.001). Moreover, a similar positive association was also observed in the other five studies [28, 32, 35, 40, 44, 45].

Theme 2: organizational leadership

Our review revealed that 20 studies were positively associated with work satisfaction. Interestingly, this theme also had the greatest positive association with work satisfaction. This can be observed in a study conducted among healthcare providers, whereby hospital management, which provides a good practice environment and good relationships with subordinates, is positively associated with work satisfaction and strongly predicts it (r = 0.196, p < 0.001) [39]. Similarly, a study by [47] reported similar findings, with good organizational support by policies and leadership being found to be a strong predictor leading toward high work satisfaction aOR = 0.486 (0.326, 0.646), p < 0.001. Another study in Japan by [32] reported that healthcare providers will have greater satisfaction if their organization has a leader-centered practice. The leader is notably highly credible in managing healthcare facilities aOR = 0.955 (0.922, 0.989), p = 0.01. The other 17 studies included in our review also revealed similar positive associations between this value of organizational culture and increased work satisfaction among healthcare providers.

Theme 3: teamwork

Good team cohesion and positive teamwork behavior in healthcare settings are essential organizational cultures influencing work satisfaction. In our review, 16 of the included studies showed a positive association with increased work satisfaction. A study by [29] revealed that good team cohesion with high cooperative values in the workplace is significantly associated with high work satisfaction outcomes (rs = 0.42, p < 0.01). Another study conducted in Germany among dental nurses also revealed a strong positive association between strong teamwork and high work satisfaction (mean 4.00 (0.86), p = 0.03) [30]. Similarly, a recent Canadian study among nurses revealed a positive association between them (r = 0.41, p < 0.01) [48]. Moreover, a study by [49] revealed that good teamwork between nurses and other groups of workers, such as physicians in the same organization, is positively associated with greater work satisfaction (r = 0.509, p < 0.001).

Theme 4: employee involvement in decision-making

Our review also revealed that four of the 27 articles specifically studied the association between employee involvement in decision-making and company growth. A study by [21] revealed that control of nursing practices through decision-making freedom is positively associated with high work satisfaction (r = 0.392, df = 229, P < 0.05). Furthermore, another study by [50] among nurses at nursing homes reported that nurses'involvement in the organization's growth led to high work satisfaction (mean = 2.86, p < 0.05). A study by [26] in Canada also revealed a positive association between nurses'involvement in healthcare facility growth and high work satisfaction (β = 0.37 (0.52, 0.76), p < 0.001). Finally, in our review, a study in Spain among hospital physiotherapists revealed a positive association between their involvement in organizational decision-making and high work satisfaction (r = 0.79, p < 0.05) [45].

Theme 5: employee recognition

The rewards the organization gave the employee through career growth, recognition, and rewards are positively associated with work satisfaction and are displayed in 9 articles in our review. A study by [31] revealed that the possibility of development is associated with work satisfaction (β = 0.23 (0.19, 0.27), p < 0.001). Another study by [36] reported a positive association between professional development support among endodontists (84.0%, p < 0.001) for improvement and work satisfaction. In Finland, a study by [43] reported a positive association between professional training opportunities and work satisfaction among ENT surgeons (85%, p = 0.001). Moreover, a study conducted by [23] reported that recognition at work was positively associated with work satisfaction (r = 0.59, p < 0.01). Similarly, the remaining five studies also revealed a positive association among different healthcare provider professions. [29, 30, 33, 39, 40].

Theme 6: autonomy

Healthcare providers will have a positive association with work satisfaction if they have autonomy at work, as found in 8 articles of our review. A study by [34] also revealed a positive association between hospice and palliative care (r = 0.398, p < 0.001). Another study by [41] reported a significant positive association between autonomy and work satisfaction (r = 0.843, df = 1, p < 0.001). In Brazil, a study conducted among nurses in critical units revealed a significant positive association between work autonomy and the work satisfaction index (r = −0.40, p < 0.001) [42]. Furthermore, the study by [40] revealed a significant association between work autonomy and work satisfaction (mean = 8.5 (3.50), p < 0.05). The remaining four studies also revealed a significant association between work autonomy and work satisfaction [23, 24, 30, 47].

Discussion

The current healthcare system faces challenges that are not just passing concerns but are enduring issues that affect the well-being of their operations, their employees, and, above all, patient care. Issues such as staffing shortages, aging populations, and the workforce, as well as high patient demand, complicated policies, and the emergence of the latest treatments, frequently contribute to staff burnout and work discontent. Healthcare workers, such as physicians, nurses, and support staff, deal with difficulties that can significantly impact their general well-being and productivity. Cultivating a healthy organizational culture that is associated with work satisfaction is crucial to ensure work momentum, engagement, and retention, thus resulting in the best patient care and outcome [51]. Employees'work satisfaction is always fundamental in the healthcare system, as it affects general productivity and devotion at work. Content workers are more likely to deliver high-quality care, remain involved in their positions, and lower absenteeism and turnover [5]. On the other hand, low work satisfaction can result in disengagement, low morale, and even errors in patient care, all of which compromise the standards and safety of medical care [5]. Overwork, unappreciated, and sometimes underpaid healthcare workers are less likely to perform at their best, and higher turnover rates can exacerbate staffing shortages and other issues facing healthcare organizations [52]. This review's findings emphasize positive cultural themes, including continuous information and communication, leadership styles and policies, teamwork, employee involvement, recognition, and autonomy. All these themes are equally essential for creating a supportive and collaborative atmosphere that alleviates stress, encourages effective workload management, and makes employees feel valued. The intertwined relationship of all the themes from this review will generate a better prospect of work satisfaction. Additionally, since satisfied and invested healthcare professionals are more dedicated to providing compassionate, high-quality treatment, a positive culture may indirectly impact patient outcomes [14].

Connecting themes in the competing values framework

The competing values framework (CVF) is one of the most influential and extensively used models in organizational culture research. It can act as a viewpoint on work satisfaction [53]. The impact of the six themes derived from this review on healthcare provider satisfaction can be better understood by comprehending how healthcare providers interact within the underlying culture. The manifestations of clan culture include teamwork, comprehensive employee engagement, and advancing employee competencies and growth [54]. The internal and integration paradigms of the competing value framework establish the basis for clan culture. For example, teamwork flourishes in clan cultures because of the cooperative, familial environment they create, which results in solid interpersonal bonds and higher levels of work satisfaction. However, bureaucratization and the family climate in public organizations, especially in government hospitals, are usually ordinary [55]. This laid the foundation for the acceptance of power distance between superiors and subordinates, much like a hierarchal clan. This is reflected in this systematic review, in which most hospital-based or government-related studies tend to focus on this culture. Importantly, both cultures still foster highly consistent products, services, and efficiency, with a stable environment that leads to the uniformity of services and maintenance [54].

In these environments, healthcare professionals frequently experience peer support, which lowers burnout and increases work satisfaction. Autonomy is usually disregarded in clan and culture hierarchal cultures. However, decision-making is typically decentralized, and employees are encouraged to contribute to developing organizational procedures, increasing employee involvement and opportunity [53]. Employees who feel that their efforts are valued have a stronger sense of ownership and are more satisfied with their works. In achieving the best organizational performance, one should know which organizational culture suits their personality. Employees who are place in the right position, coupled with positive personality and work culture, tends to accomplish higher productivity, including teamwork, employee engagement, growth, and recognition [56]. Another study foresees the importance of mentoring and personal growth to facilitate organizational commitment and culture [57]. The generation of a positive feedback loop that promotes work happiness and work satisfaction further enhances employees’ optimism and commitment. Focusing on internal growth and acknowledgement makes providers feel appreciated, inspired, and willing to stick with their company [2].

In contrast, market culture offers a different organizational dynamic that can have more complicated consequences for healthcare provider satisfaction because it prioritizes control, competitiveness, and efficiency. Market culture is more focused on the external environment, with customers as their central theme. Employees value communication, competence, and competition. However, they may overlook some facets of worker happiness and well-being, particularly leadership and autonomy. A study by Maike et al. suggested that a modest orientation toward market culture results in higher patient ratings than does weak or strong market emphasis [58]. In another study, it was recommended that a production-oriented market culture would only create a lower safety climate and health workers’ satisfaction [59]. Healthcare organizations may depend on directed leadership in these settings, which is primarily concerned with efficiency and hitting goals. Healthcare providers may feel alienated or disengaged if they perceive their leadership as distant or too focused on outcomes at the expense of their personal development. On the other hand, adhocracy emphasizes innovation, creativity, and risk-taking. Employees value personal growth, variety, stimulation, and autonomy. In this review, although autonomy is an essential theme in organizational culture, it does not interconnect with another adhocracy theme that leads to work satisfaction. A study by Zazzali et al. revealed that this culture was not significantly associated with any satisfaction measures [59].

Implications for the healthcare workplace

Embracing a positive organizational culture in healthcare improves work productivity and satisfaction, which always correlate with patient management. Open communication channels that allow team members to express concerns and exchange ideas without fear of retaliation are a top priority for healthcare organizations. This involves transparency and inclusiveness between superiors and subordinates, thus creating sustainable trust and diminished uncertainty. Effective communication is vital during crises or pandemics, as it indirectly reduces conflicts [60]. Harmony in the organization must be balanced with leadership style and policy. A qualitative study in Iran revealed that issues such as centralized systems, human resources, empowerment, and leaders who frequently struggle with skills, expertise, and time management in a demanding, team-oriented healthcare environment are among the leadership challenges in the healthcare sector [61]. Finding a solution that fits the current workplace culture in healthcare management should be a primary priority to ensure that it does not jeopardize essential patient care. It is necessary to foster a strong sense of teamwork from the top down. Team-oriented or interdisciplinary collaboration is needed, especially in hospital-based areas dealing with patients on multidisciplinary issues. Providing growth chances such as professional development programs inspire employees and improves their abilities. The Thriving at Work model can be embedded to foster vitality and learning in the workplace, which can be achieved by increasing autonomy, encouraging continuous learning, and creating an environment where employees feel energized and valued [62]. A sense of ownership and accountability is fostered by increasing autonomy and empowering healthcare workers to make knowledgeable decisions. Employee engagement and retention improve when they are included in the decision-making process, continuous education pathways, and appreciation of accomplishments. Employee motivation and morale can also significantly increase by formally and informally recognizing and praising their accomplishments. Healthcare organizations may increase employee well-being, lower burnout, and ultimately improve patient care by implementing these techniques and creating a more meaningful work environment. All these goals can be achieved through policy adjustment, strong leadership, and a willingness to change among healthcare workers. For example, transitioning from so-called mechanistic models to relational, dialogue-oriented techniques facilitates more flexible and human-centered organizational change [63]. Braithwaite et al. assert that sustainable systems change must account for complexity, context, and local adaptability instead of depending on linear implementation models [64]. Additionally, fostering a professional culture that aligns with healthcare worker well-being and purpose is crucial for facilitating transformation [65]. Collectively, readiness for change must be bolstered by inclusive, contextually aware, and values-oriented organizational strategies.

Strengths and limitations

This systematic review contributes to the existing literature by elucidating the relationship between organizational culture and work satisfaction. We used a comprehensive search strategy and a systematic, widely used method for synthesizing quantitative data. Nevertheless, it is essential to acknowledge the limitations of this systematic review. The exclusion of pre-2014 studies and three databases might have limited the scope of the articles. Exclusion of non-English studies might lead to missing or overlooking relevant, valuable insights, particularly from diverse cultural contexts or healthcare systems in different regions. Only quantitative study findings were included in this study, which may limit the ability to capture healthcare workers'whole or broader experience in this organizational culture. Qualitative research could offer richer insights into capturing the components that lead to work satisfaction, especially perceptions, live experiences, and behavior. Even though this systematic review summarizes the body of research on the relationship between organizational culture and provider work satisfaction, we acknowledge that our findings largely align with prior literature and do not introduce entirely new theoretical insights. Given these limitations, however, our use of a systematic approach offers a more structured and transparent analysis, reinforcing existing knowledge and identifying potential gaps for future research.

Conclusions

The culture within an organization holds significant importance, influencing the overall atmosphere and determining whether it is a conducive and fulfilling environment for employees, which in turn correlates with work satisfaction. This systematic review suggests that themes such as continuous information and communication, leadership styles and policies, teamwork, employee involvement, recognition, and autonomy are crucial in forming a strong organizational culture that provides better work satisfaction among healthcare professionals. Our study revealed that leadership, communication, teamwork, and recognition are the main factors in building a positive culture in the diverse structure of organizations, involving all the positions of healthcare professionals. The findings offer significant insights for healthcare organizations aiming to foster a constructive culture and promote employee cohesion. It also provides a platform for policymakers and healthcare administrators to cultivate environments where healthcare providers are engaged and satisfied in their professional roles. The implementation of strategies tailored to each theme may increase work satisfaction, foster improved organizational performance, increase retention, and increase the quality of patient care. This may serve as a crucial element in forthcoming healthcare system reforms, aiming to harmonize the requirements of providers and recipients alike. As healthcare systems globally experience profound transformations—such as the implementation of universal healthcare, initiatives toward privatization, or reorganization to rectify inefficiencies—these alterations invariably influence the cultural dynamics within healthcare organizations.

Authors’ contributions

M.R.R conceptualized the study, performed the systematic literature search, extracted data, contributed to the analysis, and drafted significant portions of the manuscript. S. A.M.H conducted the risk of bias assessment, supervised the methodology implementation, critically reviewed the findings, and contributed to refining the manuscript’s structure and content. F.B.D provided oversight throughout the research process, resolved discrepancies during data synthesis, contributed to the interpretation of results, and revised the manuscript for intellectual content and clarity.

Funding

This work received funding from FRGS/1/2024/SS02/UKM/02/1 and Faculty of Medicine UKM.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.