The Impact Of Organizational Culture On Performance And Quality Of Care In Healthcare Organizations

Types of Organizational Culture in Healthcare Organizations

Question:

Discuss about the Health Care Organizational Culture.

Health care organization plays an important role in integrating care and making special health service available to ill patients. However, the success of the services and the performance of the staffs is dependent on the culture established in health care organization. Organizational culture is defined as the social phenomenon by which certain language, beliefs and behavior defines organization’s characters and norms (Alvesson M. , 2016). Culture can also be defined as a set of guiding beliefs and thinking shared by all members of the organization (Csikszentmihalyi, 2014). According to Competing Values Framework Model, there are  four cultural types which include:

• clan culture in which members collaborate with one another and organization bound by values of team work, consensus and communication,
• market culture is built on the dynamics of competition and profitability,
• adhocracy culture which is based on value of change and focuses mainly on creativity where employees are encouraged to take risk,
• hierarchy culture which exists when strict institutional procedure is in place for staffs(Siourouni, 2012). 

Irrespective of the type of culture present in health care organization, presence of specific culture is important to drive staff performance and achieve long-term result. Certain competing variables exist in the culture of organization such as patient’s need, providers need, institution and regulators. Despite these needs, organizational culture has an impact on hospital performance as well as quality of care (Valentine, 2015). For example, regardless of individual staff’s capabilities and performance, supportive work culture has impact of staff’s performance as well patient outcome. This essay gives further insight into the health care organizational culture and the benefits of organizational culture on performance and quality of care.

Every organization has its own unique culture which  has a direct impact on its members. It is a system of shared values, beliefs and assumptions that governs activities and performance of staffs in the organization. There are different orientations on the basis of which organizational culture is established in different institute. Some examples of different orientations which defines organizational culture includes risk orientation, precision, achievement orientation, fairness, collaboration, competitive and rule orientation (Alvesson & Sveningsson, 2015). Organization which has a preference for risk orientation encourages staffs to innovate in their job responsibilities. In the case of health care organization, there is more preference for achievement orientation where the focus is to implement strategies to improve outcome of patients.  For example the Gleneagles hospital at Singapore has a commitment towards quality health care and so the staffs have worked together to be internationally recognized as organization for patient and staff safety  (About Us | Gleneagles Hospital, Singapore, 2017).

The core purpose of health care organization culture is to have an impact on performance. A study investigating the relationship between hospital culture and hospital performance has revealed that some hospitals in China have a culture of social responsibility. Hence, they give more preference to the interest of the society instead of individual patients. Such hospitals tend to have shorter length of stay and greater efficiency of inpatient care. In contrast, there are other hospitals with cultures focusing on customer satisfaction. Such hospitals have been found to have longer length of stay. Some hospitals also have a culture of cost control. In such case, the focus of staffs is to work together in a way to minimize errors and enhance patient’s satisfaction with the service (Huang & Xue, 2011). Hence, the above examples give the idea that orientation, consistency, involvement and adaptability are the indicators of organizational performance.

Impact of Organizational Culture on Performance and Quality of Care

There are numerous impact of organizational culture on the organization. Organizations with supportive work culture are likely to achieve stable performance. Such organizations have highly committed staffs who align their goal and objectives with that of the organizational goals. Hence, the commitment of staffs has a positive impact on overall performance of the employees. Developing a safety culture is also a major demand in the health care industry which in turn is associated with positive organizational performance (Stock, Stock, McFadden, & McFadden, 2017). The main purpose of patient safety culture is to minimize adverse events and facilitate better health outcome for patients. In a safety culture, health care staffs are committed to changes and they make meaningful contribution to promote safety of patient. Safety culture provides staff with all necessary resources and support needed to correct and improve the work process. There is also a great focus on identifying risk in organization’s activities and immediately reporting about errors. Such system encourages collaboration across all disciplines to identify the best solution to address safety concerns in the health care environment (Ulrich & Kear, 2014).

An example of a hospital in Singapore which is pioneering patient safety is the Gleneagles Hospital. It is a private regional hospital which offers a variety of medical services. It has been accredited by Joint Commission International for its quality and safety standards for patient safety. As poor standards of work quality and low commitment of staffs are some of the factor resulting in adverse events in hospitals, top performing health care organization move forward with a specific goal to promote safety of patient. Some of the important patient safety goals for hospital include improving the accuracy of patient identification, developing effective communication with inter-professional staffs, improving safety in using and administering medications, reducing the risk of infection and any possible harm or injury to patient (Morello, et al., 2013).

Health care organizations also use certain tools to improve and develop safety culture in hospitals. For example, falls among patient was a major issue in National University Hospital. They then focused on monitoring clinical performance by means of clinical quality indicators. In the area of hand hygiene, tool has been implemented to measure hand hygiene compliance. They have also adopted WHO’s guidelines on five moment of hand hygiene to prevent infection. In addition, fall prevention tools protocol has been established in the hospital for post fall review, footwear advice, patient and family education, structured rounding, supervised toileting, medication review and staff awareness regarding fall prevention practices (Hospital Wide Indicators::National University Hospital. , 2017). Hence, these processes are reflective of effective safety culture and aligning organizational processed for quality improvement.

Tools and Techniques for Improving Organizational Culture in Healthcare Organizations

The health care organization is influenced not only by its culture, but also by many internal and external factors present in the organization. Health care leaders play a crucial role in managing different issues in dynamic health care environment. However, their role in developing effective work culture is challenging because internal and external factors also influence the work process in hospital setting. The internal factors of organization include organizational structure, health care design, health care organization’s mission and goals, availability of staffs, competence and motivation of staffs. The motivation and job satisfaction of employees are influences by good pay, working environment, security in the job, chance of recognition and promotion and organizational policies. Availability of resource and facilities is also a critical factor that determines the quality of services provided to patients. Evidence has proved that the above mentioned points are important internal factors that have an impact of the quality of care. Supportive leaders play a critical role in work process planning, level of workload fulfilling education and training needs and effectively managing resources, employees and process. Certain evidence based tools and technique also enable managers to enhance the quality of care (Mosadeghrad, 2014).

External factors in health care organization include the patients, the relationship with care providers and the policy makers who have an impact on key work processes. Both internal and external factors also play a role in the creation and perpetuation of safety culture (Flottorp, et al., 2013).   This can be illustrated with the example of creating a patient safety culture in hospital setting.  It is necessary for a hospital who wish to create a patient safety culture, to develop a high quality and clear patient safety protocol. The next important element to establish such culture is making all necessary resource and tools available to all staffs so that they can do work with efficiency and cause no harm or risk to patient. In addition, the attitude and motivation of health care staffs towards patient safety also determines their compliance to protocols. Clinical managers must also ensure that they provide adequate work hours and education to nursing staffs and other health care staffs so that they do not regard safety protocol as a burden, but regard it as an advantage in doing their job in the most efficient manner. Hence, as internal and external factors has an impact on developing safety culture, clinical managers can guarantee patient safety by identifying factors that could have an impact on safety, developing effective clinical standard for safety, educating about the clinical standards for patient safety and continuously evaluating patient safety issues (Kim, Park, Park, Yoo, & Choi, 2013).

Influences of Internal and External Factors on Organizational Culture

The above discussion has given example about different types of organizational culture such as supportive culture, clan culture, adhocracy culture and market culture. However, apart from all this, another important culture is the value based culture which is defined by a clear set of values and guiding principles that drives action of people. In such organization, employees align their personal values with organizational value to create a unified workforce. Leaders play a role in setting specific value for the organization and staff can handle changes based on those values (Guiso, Sapienza, & Zingales, 2015). Value based culture is considered effective because such culture facilitates productivity and they remain stable for longer time.

Value based culture is regarded as useful because it helps in building a culture that promotes fulfillment and driving shareholder values too. For instance, strong adaptive culture with shared values in top business organization, helps them to overcome competitive challenges in business. Value based culture is also useful in a culturally diverse workplace such as healthcare organization. A value base culture gives special emphasis to patient outcomes and engaging in effective therapeutic relationship with patient (Denison, Nieminen, & Kotrba, 2014). Such culture provides a roadmap to clinical managers and staffs to promote patient engagement in care, coordinate care and measure patient outcome. 

The performance of a value based organization can be measured by outcome oriented indicators and value based indicators. As values based culture has more committed and satisfied staffs, the assessment of staff performance and their satisfaction with the job can give an idea about how patient’s or staffs values are preserved in health care organization. Job satisfaction is a crucial variable to measure as it determines the commitment of staffs to participate in different care programs. For example, in many hospitals, nursing residency programs are designed to increase competence and skills of staff. However, the participation in such programs is dependent on job satisfaction parameters. Some of the important domains of nurse’s job satisfaction include extrinsic reward, opportunity of professional growth, work environment, hospital system and praise and recognition (Lin, Viscardi, & McHugh, 2014). Hence, measuring job satisfaction will be reflective of effectiveness of values based culture in promoting excellent clinical performance within health care organization.

Conclusion

In conclusion, the discussion on function and different types of organizational culture provides an idea regarding how health care organization’s vision and leadership style affects quality of care and clinical performance of staffs. Apart from leader’s role in creating an effective organization culture, many internal and external factors have been found to promote creating unique culture for the health care organization. It is also mentioned that values based culture is important for health care organization because of its role in promoting patient engagement and staff fulfillment. To work in a dynamic health care environment, health care organizations must adapt different tools to assess the effectiveness of their culture in improving performance of staffs.

Value-Based Culture in Healthcare Organizations

References

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