Organizational culture & unique challenges in healthcare
Padma Puppala
Luis L. MartinsAssociate ProfessorUniversity of Texas at Austin
Dr Jonathan PintoAssistant ProfessorImperial CollegeLondon
Culture is the sum of total of the learned behaviour of a group of people that are generally considered to be the tradition of that people and
are transmitted from generation to generation
Culture
Values
Beliefs
Attitudes
Customs
Attitude is a settled way of thinking or feeling about something that
governs people’s behaviour
Japanese culture
What is the culture in your university?
Culture is the sum of total of the learned behaviour of a group of people that are generally considered to be the tradition of that people and
are transmitted from generation to generation
“The specific collection of values and norms that are shared by people and groups in an organization and that control the way they interact with each other and with stakeholders outside the organization.”
(Hill & Jones, 2001)
“A pattern of shared basic assumptions that the group learned as it solved its problems of external adaptation and internal integration, that has worked well enough to be considered valid, and therefore, to be taught to new members as the correct way you perceive, think, and feel in relation to those problems.”
(Schein, 1985)
Organizational culture
Strategy
Org. Structure
Management practices
Policies
Processes
Employee behaviour
Edgar Schein’s classification
Levels of Organizational Culture
• Symbols, stories, texts
• Ceremonies, rituals, facilities, awards
Artifacts
(observable products)
• Norms about what is right/wrong, un/important
• Slogans, mission statements
Values
(Rules of behavior )
• Taken-for-granted shared beliefs
• Hidden, must be inferredAssumptions
Values
• Espoused Values (“talk”):
– concepts or beliefs
– pertain to desirable end-states or behaviours
– transcend situations
– guide selection or evaluation of behaviour
– are ordered by relative importance.
• Enacted Values (“walk”):
– what is actually exhibited by employees
• Core Values:
– The primary values (which may or may not be included in the “espoused values”) that are accepted throughout the organization, which trump all other decision-making criteria.
Norms
Legitimate, socially shared standards against which the appropriateness of behaviour can be evaluated.
Categories of norms:
• Performance norms
• Appearance norms
• Social arrangement norms
• Allocation of resources norms
Culture• Dominant culture:
Expresses the core values that are shared by a majority of the organization’s members.
• Subcultures:Mini-cultures within an organization, typically defined by departmental and geographical boundaries.
• Strong Culture:A culture in which core values are intensely held and widely shared. Strong cultures facilitate performance by – Energizing people, by appealing to a higher ideals, values,
and goals – Shaping and coordinating behaviours by communicating
organizational prioritiesGoogle culture
The culture of a health care organization can powerfully influence its ability to manage human resources and serve patients, and ultimately has a
strong impact on its economic performance (Kotter & Heskett, 1992).
Patient satisfaction
Employee satisfaction
Creating & maintaining culture
Define culture in mission statement
Recruit individuals whose values are consistent with the organization's culture
Reinforce such values through training and socialization
Rewards are a powerful tool in constructive cultures
Staff empowerment to use their own means to achieve patient satisfaction
The Taj way
Universal HealthcareDecommercialized Healthcare]
Human Values in HealthcareSpiritualisation of Healthcare
Work
Demanding work environment
Stress
High emotional turmoil
24/7 service
Difficult to strike a work life balance
Support system
No social support systems in India
Government Private
Power distance Hierarchial Hierarchial
Individualism Collective Individualistic
Uncertainity avoidance Scores low Expected to be high
Masculinity Feminine MasculinePerformance drivenCompetitive & Assertive
Long term Long term Changing strategy
Reward systems Time bound Pay-for-performance reward structures
No hospital or healthcare delivery system can be successful unless there is a seamless interface between
departments, teams and individuals.
Thank you