Healthcare organizations in Singapore are mainly governed by the Ministry of Health of Singapore Government. Singapore healthcare organizations are specifically aimed at providing affordable healthcare services. These affordable healthcare services are provided through essential savings, subsidies and price control. In Singapore, not a single medical service is provided free of cost irrespective of the type of subsidy for a particular medical condition. Main agenda behind this strategy is to avoid over-utilizations of the medical services. Level of subsidy varies with varied medical conditions. Healthcare system in Singapore provides its population healthcare services in terms of primary healthcare, hospital care, long – term care for complex diseases and medical education. About 80 % of the primary healthcare services are provided by the widely spread private outpatient clinics and remaining are provided by government polyclinics. In contrast to primary care, hospital care is provided by the hospitals and remaining by the private clinics. Hospitals in the Singapore mainly provide inpatient, outpatient and emergency services to the patients (Tucci, 2010).
The term Organizational Culture was quoted by Jacques in 1951. Organizational Culture is the integrated way of working of the all the stakeholders of the organization. In this integrated approach of working all the members of the organization share their views or thinking and behave accordingly on particular issue. Organizational culture comprises of appropriate use symbols, language, assumptions and behavior. Specifically in the healthcare organization organizational culture is very important aspect because healthcare service is the integrated efforts of the people from different discipline like doctors, pharmacist, nurses and social activists. Healthcare organization should have its own rules and regulations to govern the behavior, activities and performance of each of these people from different discipline (Scott, 2003). People from different disciplines should work effectively. This produces synergistic effect on the outcome of the group because each stakeholder performs to their strengths and expertise to provide holistic care to the patients. If people of all these discipline started working independently without communicating with each other or without understanding work of each other, there would be possibility of inconsistent outcome in the patient care and spread of wrong message about the organization.
Primary and foremost important objective of the healthcare organization is patient safety and to achieve and maintain it consistent, healthcare organizations should maintain proper organizational culture. Organizational culture helps to exchange knowledge and experience among the experienced members of the organization and also helps to teach to the new members of the organization (Peck, 2004). Organizational culture always reminds its employees about the important aspects for the success of the organization and seeks to change their behavior for achieving success for the organization. On the other hand, organizational culture also explains the how negative behavior of the members of the organization lead to the failure of the organization. Culture of health care organization effectively manages the proper utilization of the all levels of human resource and as a result there is valuable control over the economic loss. Not only team work but humanistic values of the employees are very important aspect of the organizational culture. Organizational culture implements these humanistic values in each aspect of the employees like recruitment, training and socialization of the team members. Organizational culture identifies employees with consistent values with organization rather than qualification during recruitment process (Braithwaite et al., 2009). Training should be provided to the healthcare staff considering both interest of the staff member and requirement of the organization. This type training would be more productive both for job satisfaction of the healthcare professional and success of the organization. Socialization of the healthcare professional in healthcare organization is very important specifically in the first year of the employment. This is because new employees should be acclimatized to the new work environment. Molding of the employee into the good team player is completely dependent on the team leader. Regular meetings of all the team members would help to improve the socialization of the employee and also understanding the operating system and culture of the organization. In these meetings experiences and stories by the senior members of the group should be shared. Organizational culture facilitates the employees with awards so that there would be encouragement to the employee for the better performance. This constructive aspect of the organizational culture helps to improve the patient centered care and attainment of the organizational goal.
Positive interpersonal communication and approach are the important components of the organizational culture. These components help to give satisfaction to both healthcare professionals and patients in the healthcare organizations. As a result there is successful holistic care of the patient and achievement of the organizational goal. Organizational culture put people first and this gives great sense of satisfaction to the employees to perform in more positive way. Organizational culture is the driving force for the empowerment of the employees, implementation of the effective patient care philosophy and improvement in the value of the organization. Organizational culture helps to bring constructive communication and relationship between patient and healthcare professionals. This can be helpful in implementing caring culture in the healthcare organization. As a result, there can be more patient satisfaction with less number of healthcare staff and improvement in the economic status of the healthcare organization. This gives competitive advantage to the organization. Organizational culture empowers healthcare professionals to implement their own strategies for patient care with respect to the needs of the patients. Organizational culture brings optimal balance between the employee related activities and the organization goal. This produces win-win situation for all the stakeholders (Wooten & Crane, 2003).
Implementation of the organizational culture in the healthcare organization is not the straightforward task. Most important requirement is strong mission statement from the management. Mission statement should consider emotional aspects of the employees. Also, this mission statement should be focused towards the wellbeing of the society. Internal communication is the one most important factor which affects organizational culture. Main theme of organizational culture is the integrated way of working. For integrated approach of working there should be positive interpersonal relationships among all the employees and these employees should be courteous and respectful to each other. As healthcare service is an integrated work of doctors, nurses, pharmacist and pathologist and positive relations among them directs organization in positive way. Organizational structure is also one of the internal factors which affect organizational culture. In a healthcare organization, every department should be well structured comprising of specialist doctors and with well established hierarchy. This type of structure in the healthcare organization have better control on the work. On the other hand, healthcare organization comprising of contractual workers with less compensation, may save money for the organization but control over the work of the team would be less. Due to this, there would be negative impact on the organizational culture of the organization (Hamidi et al., 2017; Davis et al., 2016).
Economics and financial states of the healthcare organization can be considered as both external and internal factor impacting organizational culture in healthcare organization. Satisfactory compensation to the employees in the healthcare organization gives positive energy for the employees for working towards wellbeing of the patients and achieving goal of the healthcare organization. Competitive nature of the healthcare organizations affects the cost of treatment in healthcare organizations. This decline in the cost of treatment which is external factor of economy affects organizational culture of the healthcare organization. This decline in the cost of treatment would have negative impact on the financial status of the organization. As a result, there would be disturbance in the work of the employees in taking care of patients. This ultimately results in the change in the organizational culture and act as hindrance in achieving goal for the organization (Kernick, 2004).
There is possibility of influence of the external medical profession on the employees of the organization. This external medical profession can be national or international medical policies. In such cases, it would be difficult to match with organizational culture and external medical profession culture. External bodies like specialty societies, patient interest group and media also can become hurdles for the implementation of the organizational culture in the healthcare organization. Management and medical professionals working in the healthcare organization are form different professional background. There is possibility of disagreement and conflict between these two professionals. This can be considered as one of the crucial internal hurdle for implementing organization culture in healthcare organization.
Healthcare organization is a social place to provide care to the diverse type of patients. In such place shared language should be utilized very effectively. Organization culture of the healthcare organization effectively implements this shared language in healthcare organization. Knowledge is very important factor in healthcare organization for holistic care of the patients. Organizational culture is helpful in sharing knowledge from the senior member of the team and also among the team members. Organizational culture brings work from team with effective dialogue with team members and not by controlling the team members. Different stakeholders of the healthcare organization like management, doctors, nurse and pharmacist have different interests and level of knowledge. Organizational culture helps to bring together all these interests and knowledge which are helpful in achieving goal for the organization. Organizational culture helps these different stakeholders to look at things both in similar and different way. Organizational culture also helps employees to understand, judge, and value different types of patients and provide care to them accordingly. Organizational culture helps employees to see at the work in more conscious and visible way. Organizational culture helps to incorporate value in the work of the employees and try to eradicate assumptions and artifacts from the work place (Nasirpour et al., 2010).
Organizational culture helps employees to think in the direction to place patient care above the economic and corporate benefits of the organization. This gives more clinical freedom to the healthcare professionals. Organizational culture encourages employees to apply new methods and techniques, also it rewards employees based on the performance. Organizational culture helps to bring stability in the existing employees, instead of frequent recruiting of the new employees. In healthcare organization people with different beliefs, values and culture work together. This can lead to the subculture, misunderstanding and conflict within the employees. Organizational culture helps to resolve all these conflicts among the employees. There is also the possibility of rivalry among different subcultures of the organization. Organizational culture helps to integrate all the subcultures together and try to resolve rivalry. There is possibility of establishing medical autonomy by both doctors and management. However, organization culture set an agenda and goal for the organization and eradicates possibility of establishing autonomy. Organizational culture is a very useful parameter for understanding ability of the organization to provide holistic care to the patients. Organizational fitness can also be improved by establishing organizational culture. Establishment of the organizational culture in healthcare organization is one of the routes for improving healthcare services. Organizational culture addresses multiple aspects like organizational structure, economic status, work accountability, strategy implementation and human recourse management. Thus, organizational culture can manage almost all the aspects of the organization and helps organization to achieve the goal. Organizational culture helps to bring the synergy to the work of organization. Organizational culture helps organizations to accommodate different types of professionals together. It helps to bring complete change in the organization and not on the edges only (Zhou et al., 2011; Wooten & Crane, 2003).
Conclusion:
Improvement in the productivity of the healthcare organization can be achieved by bringing overall change in the organization. This can be achieved by implementing firm changes with substance in the organization. Organizational culture is one of the strategies which can be implemented for improving overall performance of the organization. For the implementation of the organizational culture attributes of the culture of the organization should be identified, this culture should have positive impact on the clinical outcome of the hospital and it should align with management goals. Organizational culture should be adopted consciously over the time for benefit of the organization. Organization culture is the connecting link among the employees and connecting link between the employees and management. Organizational culture brings harmony among all the stakeholders of the healthcare organization and brings benefit for the organization. External and internal factors should be considered while implementing organizational culture in the organization. In summary, cultural transformation in healthcare organization by implementing organizational culture is an effective strategy for providing holistic care to the patients and achieving goal of the organization.
References:
Braithwaite, J., Hyde, P., & Pope, C.. (2009). Culture and Climate in Health Care Organizations. Springer.
Davis, K., White, S., & Stephenson, M. (2016). The influence of workplace culture on nurses’ learning experiences: a systematic review of qualitative evidence. JBI Database of Systematic Reviews and Implementation Reports, 14(6), 274-346.
Hamidi, Y., Mohammadibakhsh, R., Soltanian, A., & Behzadifar, M. (2017). Relationship between organizational culture and commitment of employees in health care centers in west of Iran. Electron Physician, 9(1), 3646-3652.
Kernick, D. (2004). Complexity and Healthcare Organization: A View from the Street. Radcliffe Publishing.
Nasirpur, A.A., Gohari, M.R., & Moradi, S. (2010). The relationship of centralization, organizational culture and performance indexes in teaching hospitals affiliated to Tehran University of Medical Sciences. Acta Medica Iranica, 48(5), 326-31.
Peck, E. (2004). Organisational Development in Healthcare: Approaches, Innovations, Achievements. Radcliffe Publishing.
Scott, T. (2003). Healthcare Performance and Organisational Culture. Radcliffe Publishing.
Tucci, J. (2010). The Singapore health system – achieving positive health outcomes with low expenditure. Watson Wyatt Healthcare Market Review. Retrieved from https://www.towerswatson.com/ on 17.03.2017.
Wooten, L. P. & Crane, P. (2003). Nurses as Implementers of Organizational Culture
Nursing Economics, 21(6).
Zhou, P., Bundorf, K., Chang, Ji., & Xin Huang, J. (2011). Organizational Culture and Its Relationship with Hospital Performance in Public Hospitals in China. Health Services Research, 46(6), 2139–2160.
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