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1 – 10 of over 23000Thomas Andersson, Gary Linnéusson, Maria Holmén and Anna Kjellsdotter
Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask…
Abstract
Purpose
Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation.
Design/methodology/approach
Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps.
Findings
The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important.
Practical implications
This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process.
Originality/value
The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.
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Sue S. Feldman, Scott Buchalter, Dawn Zink, Donna J. Slovensky and Leslie Wynn Hayes
The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality…
Abstract
Purpose
The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality improvement and patient safety education program focused on developing leaders to change the future of healthcare quality and safety.
Design/methodology/approach
The safety attitudes questionnaire (SAQ) short-form was used for measuring the culture of quality and safety among healthcare workers who were graduates of an academic medical center’s healthcare quality and safety program. A 53 percent response rate from program alumni resulted in 54 usable responses.
Findings
This study found that 42 (78 percent) of the respondents report that they are currently working in a healthcare quality and safety culture, with 25 (59 percent) reporting promotion into a leadership role after completion of the quality improvement education program. This compares favorably to AHRQ culture of safety survey results obtained by the same academic medical center within the year prior revealing only 63 percent of all inpatient employees surveyed reported working in a quality and safety culture.
Research limitations/implications
The study design precluded knowing to what degree a quality and safety culture, as measured by the SAQ, existed prior to attending the healthcare quality and safety program.
Originality/value
This study has practical value for other organizations considering a quality and safety education program. For organizations seeking to build capacity in quality and safety, training future leaders through a robust curriculum is essential. This may be achieved through development of an internal training program or through attending an outside organization for education.
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The key aim of this narrative literature review, therefore, is to identify the key conceptual categories that inform the construction of positive person-centred culture within…
Abstract
Purpose
The key aim of this narrative literature review, therefore, is to identify the key conceptual categories that inform the construction of positive person-centred culture within hospitals, and how these frameworks are brought to bear upon organisational culture within healthcare systems in Australia.
Design/methodology/approach
This narrative review presents a thematic synthesis of literature identified through a systematic search protocol undertaken across 19 academic databases and Google Scholar as an additional search tool. Thematic qualitative analysis was performed on the research results to determine the common themes within the diverse literature presented within this study.
Findings
Culture change interventions in hospitals attempt to address the problem of widespread unprofessional behaviour within healthcare systems. However, diverse definitions and seemingly fragmented approaches to understanding and enacting organisational culture change present a significant hurdle in achieving cohesive and sustainable healthcare reform. This narrative literature review offers a comprehensive conceptual view of the key approaches that inform positive person-centred culture within hospital settings. In total, three primary dimensions, belonging, behaving and being, aligned against organisational goals, individual behaviours and worker as well as organisational identity were identified. Other individual and group interactional dynamics that give rise to negative organisational culture are further analysed to understand the fault lines along which existing culture change interventions are typically operationalised.
Research limitations/implications
This review is not exhaustive and is limited in its methodological scope. The central values and themes identified within the literature are integral to designing humanised healthcare systems. However, owing to the qualitative nature and contextual variability of these factors, these themes do not lend themselves to replicable quantification.
Social implications
This analysis contributes to foundational research efforts towards transforming healthcare practice to be more aligned with humanised and equitable values within increasingly complex healthcare organisational settings. Designing culture change interventions that align more suitably with the values-driven categories identified in this literature review may increase the effectiveness and sustainability of these interventions and reform efforts at organisational and systemic levels.
Originality/value
This article presents a comprehensive framework to approach healthcare organisational reform through shared and equitable models of operation, management and governance rather than continuing to promote narrowly defined outcomes derived from commodified models of healthcare practice.
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Stanley J. Smits, Dawn E. Bowden and James O. Wells
The healthcare system in the USA is undergoing unprecedented change and its share of unintended consequences. This paper explores the leadership role of the physician in…
Abstract
Purpose
The healthcare system in the USA is undergoing unprecedented change and its share of unintended consequences. This paper explores the leadership role of the physician in transforming the present culture of healthcare to restore, refine and preserve its traditional care components.
Design/methodology/approach
The literature on change, organizational culture and leadership is leveraged to describe the structural interdependencies and dynamic complexity of the present healthcare system and to suggest how physicians can strengthen the care components of the healthcare culture.
Findings
When an organization’s culture does not support internal integration and external adaptation, it is the responsibility of leadership to transform it. Leaders can influence culture to strengthen the care components of the healthcare system. The centrality of professionalism in the delivery of patient services places a moral, societal and ethical responsibility on physicians to lead a revitalization of the care culture.
Practical implications
This paper focuses on cultural issues in healthcare and provides options and guidance for physicians as they attempt to lead and manage the context in which services are delivered.
Originality/value
The Competing Values Framework, the major interdependent domains and five principal mechanisms for leaders to embed and fine tune culture serve as the main tenets for describing the ongoing changes in healthcare and defining the role of the physician as leaders and advocates for the Patient Care Culture.
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Marc Dorval and Marie-Hélène Jobin
This work seeks to offer a greater understanding of Lean healthcare implementation challenges conceptually taking a situated cultural organizational change perspective.
Abstract
Purpose
This work seeks to offer a greater understanding of Lean healthcare implementation challenges conceptually taking a situated cultural organizational change perspective.
Design/methodology/approach
A descriptive model of healthcare organizations’ Lean adoption trajectories is built using ripple and bridging modelization strategies from elements of three classic organizational change theories and knowledge from Lean, organizational culture, healthcare and operations management literature.
Findings
The “contingent Lean culture adoption” (CLCA) model suggests five theoretical trajectories the healthcare organizations may experience when conducting a Lean transformation. These trajectories evolve from a new concept of Lean cultural friction (LCF) which represents cultural friction that a healthcare organization encounters toward an ultimate Lean culture proficiency state through time. From high to low initial LCF, a healthcare organization may in its Lean proficiency course end up in three states: lower, similar or higher LCF situation.
Research limitations/implications
The CLCA model demonstrates the potential to be developed into a framework and possibly a Lean cultural friction theory pending further qualitative and quantitative validation.
Practical implications
The CLCA model may help healthcare managers to use more appropriate cultural change strategies during their organization’s Lean journey.
Originality/value
This work enriches the concept of Lean cultural change which may apply not only to healthcare organizations but also to other ones. It suggests the existence of a healthcare organization Lean culture proficiency archetype and introduces the notion of Lean cultural friction.
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Gary Linnéusson, Thomas Andersson, Anna Kjellsdotter and Maria Holmén
This paper applies systems thinking modelling to enhance the dynamic understanding of how to nurture an innovative culture in healthcare organisations to develop the innovation…
Abstract
Purpose
This paper applies systems thinking modelling to enhance the dynamic understanding of how to nurture an innovative culture in healthcare organisations to develop the innovation system in practice and speed up the innovative work. The model aims to provide a holistic view of a studied healthcare organisation's innovation processes, ranging from managerial values to its manifestation in improved results.
Design/methodology/approach
The study is based on empirical material from a healthcare unit that, within a few years, changed from having no innovations to repeatedly generating innovations. The study uses the modelling language of causal loop diagrams (CLDs) in the system dynamics methodology to identify the key important aspects found in the empirical material.
Findings
The proposed model, based on the stories of the interviewees, explores the dynamics of inertia when nurturing an innovative culture, identifying delays attributed to the internal change processes and system relationships. These findings underscored the need for perseverance when developing an innovative culture in the entrepreneurial phases.
Practical implications
The approach of using systems thinking to make empirical healthcare research results more tangible through the visual notations of CLDs and mental simulations is believed to support exploring complex phenomena to induce and nurture both individual and organisational learning.
Originality/value
The results from this approach provide deepened analysis and provoke the systems view to explain how the nurturing of the culture can accelerate the innovation processes, which helps practitioners and researchers to further expand their understanding of their healthcare contexts.
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This paper aims to explore the influence of dimensions of organizational culture, namely, development culture, group culture, rational culture and hierarchical culture, on…
Abstract
Purpose
This paper aims to explore the influence of dimensions of organizational culture, namely, development culture, group culture, rational culture and hierarchical culture, on healthcare supply chain resilience (HCRES). Further, the study explored the moderating role of technology orientation on organizational culture dimensions and healthcare resilience linkages.
Design/methodology/approach
The study adopted a multi-unit study of different hospital supply chains (SCs). Consequently, perceptual data were gathered from seven dominant entities in a typical medical/hospital SC: hospitals, hotels, chemistry and pharmaceutical, marketing/public relations/promotion, medical equipment manufacturers and surgical suppliers, food and beverage providers (i.e. restaurants) and insurance providers. The responses were gathered using online survey and were analyzed using structural equation modeling.
Findings
Based on 276 completed responses, positive influences were found for development, group and rational cultures on HCRES. As expected, a negative influence of hierarchical culture was found on HCRES. Further, technological orientation was found to enhance the positive effects of development, group and rational cultures on HCRES. However, no prominent moderation was noted for hierarchical culture’s influence on HCRES. The findings suggested managers to focus more on developing competing values framework (CVF)-based dimensions of organizational culture dimensions for effective risk mitigation so as to provide healthcare services in a timely manner to patients.
Originality/value
The study is the first to investigate the effects of organizational culture’s dimensions on resilience. The study has empirically established the association between CVF view and dynamic capabilities. The study underlined the importance of resilience in healthcare SCs. Resilience is an important dynamic capability in healthcare SCs to provide uninterrupted treatments and services to patients. Any failure in such a service can be fatal. Further, the study developed the measures of development, group, rational and hierarchical culture for further investigation in healthcare. This study is also the first to develop a measure for resilience in the healthcare sector.
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Patrick A. Palmieri, Lori T. Peterson, Bryan J. Pesta, Michel A. Flit and David M. Saettone
Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes…
Abstract
Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established through modification in employee safety perspective and work behavior, human resource (HR) professionals need to contribute to this developing organizational domain. The IOM indicates individual employee behaviors cumulatively provide the primary antecedent for organizational safety and quality outcomes. Yet, many safety culture scholars indicate the concept is neither theoretically defined nor consistently applied and researched as the terms safety culture, safety climate, and safety attitude are interchangeably used to represent the same concept. As such, this paper examines the intersection of organizational culture and healthcare safety by analyzing the theoretical underpinnings of safety culture, exploring the constructs for measurement, and assessing the current state of safety culture research. Safety culture draws from the theoretical perspectives of sociology (represented by normal accident theory), organizational psychology (represented by high reliability theory), and human factors (represented by the aviation framework). By understanding not only the origins but also the empirical safety culture research and the associated intervention initiatives, healthcare professionals can design appropriate HR strategies to address the system characteristics that adversely affect patient outcomes. Increased emphasis on human resource management research is particularly important to the development of safety cultures. This paper contributes to the existing healthcare literature by providing the first comprehensive critical analysis of the theory, research, and practice that comprise contemporary safety culture science.
Patrick A. Palmieri and Lori T. Peterson
The Institute of Medicine's seminal report, To err is human: Building a safer health system, established the national patient safety framework and initiated interest in changing…
Abstract
The Institute of Medicine's seminal report, To err is human: Building a safer health system, established the national patient safety framework and initiated interest in changing the traditionally punitive healthcare culture. This paper reviews a multidisciplinary literature and offers an attribution framework to explicate the organizational processes that contribute to an industry-wide culture where clinicians are routinely blamed for adverse patient events. Attribution theory is concerned with the manner in which people explain the behaviors of others or themselves by assigning causality for events. To date, attribution theory, though well established in the management literature, has yet to be translated to healthcare. In this paper, we first describe the historical evolution of attribution theory in relation to human behavior in clinical practice and healthcare management and then discuss the work environments in contemporary healthcare organizations. Next, we demonstrate the applicability of attribution theory to healthcare by providing two adverse event exemplar cases. Then, the Healthcare Attribution Error Model is offered to demonstrate how concepts from attribution theory serve as antecedents to the employee cynicism, learned helplessness, organizational inertia, and the emerging Just Culture perspective. We conclude by suggesting attribution theory offers an important theoretical framework that warrants further conceptual development and empirical research. In the quest to produce exceptional healthcare environments where safety and quality are fundamental employee concerns, healthcare managers and clinical professionals need theoretically supported knowledge and evidence-based insights.
Albi Thomas and M. Suresh
Using total interpretive structural modelling (TISM), this paper aims to “identify”, “analyse” and “categorise” the sustainable-resilience readiness factors for healthcare during…
Abstract
Purpose
Using total interpretive structural modelling (TISM), this paper aims to “identify”, “analyse” and “categorise” the sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic.
Design/methodology/approach
To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview with each respondent. To identify how the factors interact, the TISM approach was employed and the cross-impact matrix multiplication applied to a classification method was used to rank and categorise the sustainable-resilience readiness factors.
Findings
This study identified ten sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic. The study states that the major factors are environmental scanning, awareness and preparedness, team empowerment and working, transparent communication system, learning culture, ability to respond and monitor, organisational culture, resilience engineering, personal and professional resources and technology capability.
Research limitations/implications
The study focused primarily on sustainable-resilience readiness characteristics for the healthcare sector.
Practical implications
This research will aid key stakeholders and academics in better understanding the factors that contribute to sustainable-resilience in healthcare.
Originality/value
This study proposes the TISM technique for healthcare, which is a novel attempt in the subject of readiness for sustainable-resilience in this sector. The paper proposes a framework including a mixture of factors for sustainability and resilience in the healthcare sector for operations.
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