culture. Population This study was conducted in a hospital health system in the southeastern part of the United States. The hospital health system was founded in 1998 and provides efficient, responsive care. The hospital health system offers a full network of health services and encompasses three highly regarded hospitals within its network. It is a world-class healthcare network dedicated to providing outstanding patient care, educating tomorrow’s healthcare leaders, and discovering new and better ways to treat disease through biomedical research. According to the Medical Center and Health System Facts and Statistics (2013) in the U.S. News & World Report, the hospital health system has approximately 16,318 full-time employees, while the academic university medical center has 9,963 full-time employees. The sample for this study was taken from the total population of departments/ areas at the hospital health system. It consisted of five departments within the hospital health system with 60 staff members. Subjects for the study included staff members who were employed with the departments/areas during the researcher’s initial work with the unit. A single-stage sampling procedure was utilized to determine departments/areas that were included in the study. Creswell (2014) stated, “a single-stage sampling procedure is one in which the researcher has access to names in the population and can sample the people directly” (p. 158). The five departments/areas were selected using two criteria that included (1) the researcher having worked with the departments/areas between 2011-2015 and (2) the department/area increased its work culture Tier score during a 1- to 2-year period
