SAĞLIK HİZMETİ ÖRGÜTLERİNDE ÖRGÜT KÜLTÜRÜ: BİR SİSTEMATİK TARAMA

Abstract

Organizational culture is important in understanding people's behavior in organizations when managing external demands and internal social changes. There has been an increasing drive to understand and address the organizational culture and try to change it where optimal health performance is hindered.  Insufficient attention has been given to the environment of health care and how it can influence individual and organizational results. Before trying to implement any new healthcare redesign or reform, it is essential to be aware of what characterizes their organizational culture.This study aimed to assess to which extent the organizational culture domain has been mentioned in the healthcare settings. The search was performed in the Emerald, Ebsco-host, Google Scholar, PubMed and Science-Direct databases for the time period 2008–2018. The research question that guided this review was posed as: “How it is important to study organizational culture in healthcare settings”. Studies that did not meet the predetermined criteria were excluded, while those that complied with the inclusion criteria were listed and further reviewed. Twenty one articles were included in the final analysis of this study. Excellence in healthcare delivery is linked to positive value systems delivered through a multidisciplinary team approach and the use of strategic involvement, the most important cultural organizational influences for optimum efficiency in the delivery of quality care. The future use of this organizational culture assessment in healthcare studies that seek to understand healthcare systems deeply and its influence on clinical performance, will play an essential role in achieving their planned targets.

Keywords

• Organizational culture,healthcare organizations,hospital

ORGANIZATIONAL CULTURE IN HEALTHCARE ORGANIZATIONS: A SYSTEMATIC REVIEW

Abstract

Background and Objectives: Organizational culture is important in understanding people's behavior in organizations when managing external demands and internal social changes. There has been an increasing drive to understand and address the organizational culture and try to change it where optimal health performance is hindered. Insufficient attention has been given to the environment of health care and how it can influence individual and organizational results. Before trying to implement any new health care redesign or reform, it is essential to be aware of what characterizes their organizational culture. This study aimed to assess to which extent the organizational culture domain has been mentioned in the health care settings. Method: The search was performed in the Emerald, Ebsco-Host, Google Scholar, PubMed and Science-Direct databases for the time period 2008–2018. The research question that guided this review was posed as: “How it is important to study organizational culture in health care settings”. Studies that did not meet the predetermined criteria were excluded, while those that complied with the inclusion criteria were listed and further reviewed. Twenty-one articles were included in the final analysis of this study. Results: Diverse health care settings were represented in the studies. Twenty-one articles were included in the final analysis of this study. Among the relevant studies, 17 were research articles; 12 were quantitative studies, 2 were qualitative, one mixed method study and 2 were Organizational culture measurement tools design articles. Conclusion: Excellence in health care delivery is linked to positive value systems delivered through a multidisciplinary team approach and the use of strategic involvement, the most important cultural organizational influences for optimum efficiency in the delivery of quality care. The future use of this organizational culture assessment in health care studies that seek to understand health care systems deeply and its influence on clinical performance, will play an essential role in achieving their planned targets.

Keywords

• Organizational culture,health care organizations,hospitals

References

1. Acar, A. Z., & Acar, P. (2012). The effects of organizational culture and innovativeness on business performance in healthcare industry. Procedia-Social and Behavioral Sciences, 58, 683-692.
2. Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M. & Tishelman, C. (2012). Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. Bmj, 344, e1717.
3. Alharbi, T. S. J., Ekman, I., Olsson, L. E., Dudas, K., & Carlström, E. (2012). Organizational Culture and the implementation of person centered care: results from a change process in Swedish hospital care. Health policy, 108(2-3), 294-301.
4. Ambrecht, F. M. R., Jr., Chapas, R. B., Chappelow, C. C., & Farris, G. F. (2001). Knowledge management in research and development. Research Technology Management, 44(4), 28–48.
5. Bate, S. P. (2010). Strategies for cultural change. Routledge.
6. Bell DeTienne, K., & Jackson, L. A. (2001). Knowledge management: understanding theory and developing strategy. Competitiveness Review: An International Business Journal, 11(1), 1-11.
7. Belohlav, J. A., Cook, L. S., Olson, J. R., & Drehmer, D. E. (2010). Core values in hospitals: a comparative study. Quality Management Journal, 17(4), 36-50.
8. Benders, J., & Van Hootegem, G. (1999). Teams and their context: moving the team discussion beyond existing dichotomies. Journal of Management Studies, 36(5), 609-628.

9. Bloor, G., & Dawson, P. (1994). Understanding professional culture in organizational context. Organization studies, 15(2), 275-295.
10. Braithwaite, J., Herkes, J., Ludlow, K., Testa, L., & Lamprell, G. (2017). Association between organisational and workplace cultures, and patient outcomes: systematic review. BMJ open, 7(11), e017708.
11. Cabana, M. D., & Kim, C. (2003). Physician adherence to preventive cardiology guidelines for women. Women's Health Issues, 13(4), 142-149.
12. Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abboud, P. A. C., & Rubin, H. R. (1999). Why don't physicians follow clinical practice guidelines?: A framework for improvement. Jama, 282(15), 1458-1465.
13. Daft, R. L., & Weick, K. E. (1984). Toward a model of organizations as interpretation systems. Academy of management review, 9(2), 284-295.
14. Davenport, T. & Prusak, L. (1998). Working knowledge: How organizations manage what they know. Boston: Harvard Business School Press.
15. Davies, H. T., Nutley, S. M., & Mannion, R. (2000). Organisational culture and quality of health care. BMJ Quality & Safety, 9(2), 111-119.
16. De Bono, S., Heling, G., & Borg, M. A. (2014). Organizational culture and its implications for infection prevention and control in healthcare institutions. Journal of Hospital Infection, 86(1), 1-6.
17. De Kraker, M. E., Wolkewitz, M., Davey, P. G., Grundmann, H., & BURDEN Study Group. (2011). The clinical impact of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay related to methicillin resistant Staphylococcus aureus bloodstream infections. Antimicrobial agents and chemotherapy infections. Antimicrobial agents and chemotherapy.
18. Denison, D. R. (1996). What is the difference between organizational culture and organizational climate? A native's point of view on a decade of paradigm wars. Academy of management review, 21(3), 619-654.
19. Edmondson, A. C. (2003). Speaking up in the operating room: How team leaders promote learning in interdisciplinary action teams. Journal of management studies, 40(6), 1419-1452.
20. Elving, W. J. (2005). The role of communication in organisational change. Corporate communications: an international journal, 10(2), 129-138.
21. Carlström, E. D., & Ekman, I. (2012). Organisational culture and change: implementing person-centred care. Journal of health organization and management, 26(2), 175-191.
22. Fedorowsky, R., Peles-Bortz, A., Masarwa, S., Liberman, D., Rubinovitch, B., & Lipkin, V. (2015). Carbapenem-resistant Enterobacteriaceae carriers in acute care hospitals and postacute-care facilities: The effect of organizational culture on staff attitudes, knowledge, practices, and infection acquisition rates. American journal of infection control, 43(9), 935-939.
23. Firth-Cozens, J. (1995). Sources of stress in junior doctors and general practitioners. Yorkshire Medicine, 7(3), 10-13.
24. Firth-Cozens, J., & Greenhalgh, J. (1997). Doctors' perceptions of the links between stress and lowered clinical care. Social science & medicine, 44(7), 1017-1022.
25. Fischer, R., Ferreira, M. C., Assmar, E. M. L., Redford, P., & Harb, C. (2005). Organizational behaviour across cultures: Theoretical and methodological issues for developing multi-level frameworks involving culture. International Journal of Cross Cultural Management, 5(1), 27-48.
26. Giannitsioti, E., Athanasia, S., Antoniadou, A., Fytrou, H., Athanassiou, K., Bourvani, P. & Giamarellou, H. (2009). Does a bed rail system of alcohol-based handrub antiseptic improve compliance of health care workers with hand hygiene? Results from a pilot study. American journal of infection control, 37(2), 160-163.
27. Gold, A. H., Malhotra, A., & Segars, A. H. (2001). Knowledge management, an organizational capabilities perspective. Journal of Management Information Systems, 18(1), 185-214.
28. Gould, D. J., Hewitt-Taylor, J., Drey, N. S., Gammon, J., Chudleigh, J., & Weinberg, J. R. (2007). The CleanYourHandsCampaign: critiquing policy and evidence base. Journal of Hospital Infection, 65(2), 95-101.
29. Hemmelgarn A.L., Glisson, C. and James, L.R. (2006). Organisational culture and climate: implications for services and interventions research. Clinical Psychology: Science and Practice, 13(1):73-89.
30. Hemmelgarn, A. L., Glisson, C., & James, L. R. (2006). Organizational culture and climate: Implications for services and interventions research. Clinical Psychology: Science and Practice, 13(1), 73-89.
31. Horwitch, M., & Armacost, R. (2002). Be all it can be: Helping knowledge management. Journal of Business Strategy, 26–31.
32. Institute of Medicine (1999). To Err Is Human. Building a Safer Health System. National Academy Press, Washington DC.
33. Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century.
34. Jafree, S. R., Zakar, R., Zakar, M. Z., & Fischer, F. (2015). Nurse perceptions of organizational culture and its association with the culture of error reporting: a case of public sector hospitals in Pakistan. BMC health services research, 16(1), 3.
35. Khatri, N., Halbesleben, J. R., Petroski, G. F., & Meyer, W. (2007). Relationship between management philosophy and clinical outcomes. Health Care Management Review, 32(2), 128-139.
36. Kwak, C., Chung, B. Y., Xu, Y., & Eun-Jung, C. (2010). Relationship of job satisfaction with perceived organizational support and quality of care among South Korean nurses: A questionnaire survey. International journal of nursing studies, 47(10), 1292-1298.
37. Lawson, S. (2003). Examining the relationship between Organizational Culture and knowledge management (Doctoral dissertation, Nova southeastern university).Leonte´v A.N. (1978). Activity, Consciousness, and Personality. Englewood Cliffs, NJ:Prentice Hall.
38. MacDavitt, K., Chou, S. S., & Stone, P. W. (2007). Organizational climate and health care outcomes. The Joint Commission Journal on Quality and Patient Safety, 33(11), 45-56.
39. Martin, J., & Siehl, C. (1983). Organizational culture and counterculture: An uneasy symbiosis. Organizational dynamics, 12(2), 52-64.
40. Michie, S., & Williams, S. (2003). Reducing work related psychological ill health and sickness absence: a systematic literature review. Occupational and environmental medicine, 60(1), 3-9.
41. Miettinen R. and Virkunnen J. (2005).Epistemic objects, artefacts and organizational change. Organization, 12(3), 437-56.
42. Montgomery, A., Panagopoulou, E., Kehoe, I., & Valkanos, E. (2011). Connecting organisational culture and quality of care in the hospital: is job burnout the missing link?. Journal of health organization and management, 25(1), 108-123.
43. Olofsson, P., Gellerstedt, M., & Carlström, E. D. (2009). Manchester triage in Sweden–interrater reliability and accuracy. International emergency nursing, 17(3), 143-148.
44. O'Reilly, C. A., & Chatman, J. A. (1996). Culture as social control: Corporations, cults, and commitment.
45. Palmquist, I., & Lindell, G. (2000). Emergency Departments in Sweden—Today and in the Future. Vård i norden, 20(4), 28-31.
46. Parikh, M. (2001). Knowledge management framework for high-tech research and development. Engineering Management Journal,13(3), 27–33.
47. Parmelli, E., Flodgren, G., Beyer, F., Baillie, N., Schaafsma, M. E., & Eccles, M. P. (2011). The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review. Implementation Science, 6(1), 33.
48. Rider, E. A., Gilligan, M. C., Osterberg, L. G., Litzelman, D. K., Plews-Ogan, M., Weil, A. B.,& Frankel, R. M. (2018). Healthcare at the Crossroads: The Need to Shape an organizational culture of Humanistic Teaching and Practice. Journal of general internal medicine, 1-8.
49. Rundall, T. G., Shortell, S. M., Wang, M. C., Casalino, L., Bodenheimer, T., Gillies, R. R., & Robinson, J. C. (2002). As good as it gets? Chronic care management in nine leading US physician organisations. BMJ: British Medical Journal, 325(7370), 958.
50. Saillour-Glénisson, F., Domecq, S., Kret, M., Sibe, M., Dumond, J. P., & Michel, P. (2016). Design and validation of a questionnaire to assess organizational culture in French hospital wards. BMC health services research, 16(1), 491.
51. Schein E. (1985). Organizational Culture and leadership. 1st edition. San Fransisco: Jossey-Bass. ISBN 0875896391.
52. Schlenker, B. R., & Weigold, M. F. (1992). Interpersonal processes involving impression regulation and management. Annual review of psychology, 43(1), 133-168.
53. Scott, T., Mannion, R., Davies, H., & Marshall, M. (2003a). The quantitative measurement of organizational culture in health care: a review of the available instruments. Health services research, 38(3), 923-945.
54. Scott, T. I. M., Mannion, R., Davies, H. T., & Marshall, M. N. (2003b). Implementing culture change in health care: theory and practice. International journal for quality in health care, 15(2), 111-118.
55. Scott, T., Mannion, R., Marshall, M., & Davies, H. (2003). Does organizational culture influence health care performance? A review of the evidence. Journal of health services research & policy, 8(2), 105-117.
56. Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002). Burnout and self-reported patient care in an internal medicine residency program. Annals of internal medicine, 136(5), 358-367.
57. Shortell, S. M., O'Brien, J. L., Carman, J. M., Foster, R. W., Hughes, E. F., Boerstler, H., & O'Connor, E. J. (1995). Assessing the impact of continuous quality improvement/total quality management: concept versus implementation. Health services research, 30(2), 377.
58. Sinkowitz-Cochran, R. L., Burkitt, K. H., Cuerdon, T., Harrison, C., Gao, S., Obrosky, D. S., & Jernigan, J. A. (2012). The associations between organizational culture and knowledge, attitudes, and practices in a multicenter Veterans Affairs quality improvement initiative to prevent methicillin-resistant Staphylococcus aureus. American journal of infection control, 40(2), 138-143.
59. Sorra, J. S., & Dyer, N. (2010). Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC health services research, 10(1), 199.Sow, M. (2017). The Relationship between Leadership Style, Organizational Culture, and Job Satisfaction in the US Healthcare Industry. Management and Economics Research Journal, 3(2017), 1332.
60. Spataro, S. E. (2005). Diversity in context: how organizational culture shapes reactions to workers with disabilities and others who are demographically different. Behavioral sciences & the Law, 23(1), 21-38.
61. Stock, G. N., McFadden, K. L., & Gowen III, C. R. (2007). Organizational culture, critical success factors, and the reduction of hospital errors. International Journal of Production Economics, 106(2), 368-392.
62. Street, A., & Blackford, J. (2001). Communication issues for the interdisciplinary community palliative care team. Journal of clinical nursing, 10(5), 643-650.
63. ThomaS, C., Ward, M., Chorba, C., & Kumiega, A. (1990). Measuring and interpreting organizational culture. The Journal of nursing administration, 20(6), 17-24.
64. Thompson, D. S., Workman, R., & Strutt, M. (2009). Decline in the rates of meticillin-resistant Staphylococcus aureus acquisition and bacteraemia in a general intensive care unit between 1996 and 2008. Journal of Hospital Infection, 71(4), 314-319.
65. Tyagi, R. K., Cook, L., Olson, J., & Belohlav, J. (2013). Healthcare technologies, quality improvement programs and hospital organizational culture in Canadian hospitals. BMC health services research, 13(1), 413.
66. Valler W. (2003). It’s culture all the way down. Journal of Economic Issues, 37(1), 35-45.
67. Vittal, S. A., & Shivraj, K. 2010. Modeling enablers for successful KM implementation. Journal of Knowledge Management, 14(1), 100-113.
68. Vygotsky, L. S. (1980). Mind in society: The development of higher psychological processes. Harvard university press.
69. Wakefield, B. J., Blegen, M. A., Uden-Holman, T., Vaughn, T., Chrischilles, E., & Wakefield, D. S. (2001). Organizational culture, continuous quality improvement, and medication administration error reporting. American Journal of Medical Quality, 16(4), 128-134.
70. Wiig, K. M. (1997). Knowledge management: where did it come from and where will it go?. Expert systems with applications, 13(1), 1-14.
71. Williams, E. S., Manwell, L. B., Konrad, T. R., & Linzer, M. (2007). The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health care management review, 32(3), 203-212.
72. Williams, M. V. (2007). Improving patient safety in radiotherapy by learning from near misses, incidents and errors. The British journal of radiology, 80(953), 297-301.
73. Xie, S., Helfert, M., Lugmayr, A., Heimgärtner, R., & Holzinger, A. (2013, July). Influence of organizational culture and communication on the successful implementation of information technology in hospitals. In International Conference on Cross-Cultural Design (pp. 165-174). Springer, Berlin, Heidelberg.
74. Zachariadou, T., Zannetos, S., & Pavlakis, A. (2013). OCin the primary healthcare setting of Cyprus. BMC health services research, 13(1), 112.
75. Zazzali, J. L., Alexander, J. A., Shortell, S. M., & Burns, L. R. (2007). Organizational culture and physician satisfaction with dimensions of group practice. Health services research, 42(3p1), 1150-1176.