How important is a culture of teamwork and development to hospital performance and patient care?
Organisational culture has long been regarded as an important factor affecting performance in healthcare organisations, yet there is a lack of local information about its effectiveness.
A research study in the UK reported a preferred culture that emphasises a team- and developmental-oriented culture rather than the more traditional hierarchical culture.
This is echoed by other studies suggesting that a culture profile emphasising flexibility allows healthcare organisations to react to their dynamic external environment better. Culture profiles that target flexibility while emphasising goal fulfilment are associated with greater efficiency.
Some research suggests a positive link between a culture that focuses on teamwork and desirable outcomes including patient satisfaction, job satisfaction and higher levels of safety, compared to a culture that emphasises control and compliance through rules and regulations.
University of Otago researchers have been investigating this within the New Zealand healthcare environment, specifically looking at how organisation culture is perceived by District Health Boards' (DHBs) members and their senior executive teams.
Dr. Evelyn Suk Yi Looi (now at Monash University), Dr Richard Greatbanks and Professor André Everett examined the organisational culture profiles and key cultural characteristics of eight New Zealand DHBs, evaluating them against one of the six government-designated critical aspects of healthcare performance – shorter stays in Emergency Departments.
“Given the importance of DHB governance and leadership in shaping the culture of healthcare organisations, we think it is important to better understand how organisational culture is aligned between board members and their respective senior executives alongside healthcare performance,” Dr Looi explained.
The ground-breaking study has just earned the researchers an international accolade, gaining the Outstanding Paper Award in the 2017 Emerald Literati Network Awards for Excellence for the Journal of Health Organization and Management. This prestigious award is presented annually to authors who have contributed the most impressive work published in the previous year.
http://www.emeraldgrouppublishing.com/authors/literati/awards.htm?year=2017&journal=jhom
About the research
Seven of the DHBs emphasised cultures that gave them control and stability rather than focusing on prioritising teamwork and flexibility. This was analysed using an organisational culture framework developed in the field of management - the Competing Values Framework.
Although these findings are not surprising, they confirm that most New Zealand top-tier healthcare organisations are hierarchical. If this represents the health sector generally, it implies that cultural dominance may be constraining healthcare performance, and refocusing on building culture profiles that prioritise teamwork and flexibility may potentially improve healthcare performance.
There are substantial similarities between New Zealand's public healthcare system and the UK's NHS which indicate that the Competing Values Framework should provide a valid benchmark locally. However, the current organisational culture profiles adopted here may not be the most appropriate for producing high performance.
This knowledge will help healthcare organisations to better understand their current operating model, and to recognise the characteristics on which they would like to model the culture of their organisations, particularly for those looking to change their culture.
“The research has helped to establish some benchmarks for both measuring and improving the culture of New Zealand healthcare organisations. While we only focused on one metric of performance of DHBs, it would be interesting to analyse other performance measures to better understand whether there is a link between high performance and the preferred organisational culture profile,” Dr Looi added.