So what? The value of reputation in public healthcare organisations.

Abstract

This research investigates the perceptual value of reputation and the underlying relationship between reputation and organisational culture, in a public healthcare organisation in South East Queensland. In doing so, it addresses the following research questions: In what way is the perceptual value of reputation conceptualised about public healthcare organisations? In what way is the perceptual value of reputation formed about public healthcare organisations? How do internal and external stakeholders perceive the value of reputation in public healthcare organisations? Increasing problems associated with chronic disease and an ageing population are significantly impacting the Australian health system as health organisations struggle to keep up with demand and rising community expectations. Despite these challenges, public healthcare organisations are required to deliver on the healthcare objectives of the government and maintain performance, efficiency, quality care delivery and equity of services. Fulfilling the government mandate and community expectations requires healthcare organisations to focus on strategies that improve performance and provide a competitive advantage to the organisation. Organisational reputation radiates strong appeal and provides organisations with a competitive advantage over obtaining skilled employees, customer loyalty, improved performance, funding and philanthropic donations. However, the value of reputation within public healthcare organisations has been largely undefined and under researched. Within private organisations, studies have shown reputation to be a valuable intangible resource that has provided organisations with a competitive advantage within their industry and is also likely to be associated with well-performing organisations. This research draws upon existing theory around resource-based view theory to explore the perceptual value of reputation. Studies that examine reputation tend to focus on measurable outputs. Therefore, empirical research that considers how reputation is conceptualised and formed by key stakeholders is scarce, particularly studies conducted in Australia. In addition, research that focuses on understanding the links between reputation and organisational cultural relationships tend to ignore the value of systems and the quality of the relationships between stakeholders. Therefore, this research draws on existing theory around reputation and organisational culture in order to explore the relationship between these two constructs. Further, this research aims to develop a better understanding of how reputation is defined and formed within public healthcare organisations and provide insights as to how organisations can work towards strategically building and managing their reputations. This study used an ethnographic, multi-phase, sequential, exploratory research design, and adopted a multilevel (organisational, group, individual), and multiple cultural perspective (integration, differentiation and fragmentation) approach. The study was conducted in two phases: Phase 1 explored internal stakeholder’s views of reputation at different hierarchical and professional levels. This included a multi-perspective examination involving diverse hierarchical levels of senior managers and frontline staff. Phase 2 was the external stakeholder group which involved interviews with consumers and potential consumers of healthcare organisations. Findings from the two phases were integrated, compared, and converged, to identify similarities and differences between the two data sets. Overall, findings indicate that reputation is a multi-dimensional construct based on the perceptions of key stakeholders. Reputation is defined by three dominant conceptualisations namely, reputation as consciousness; reputation as resource; and reputation as appraisement. By integrating the three conceptual perspectives of reputation, it defines reputation from public stakeholder perspectives. In addition, findings from this research highlight that the value of reputation for public healthcare organisations is identified by three main dimensions namely, consumer satisfaction; healthcare quality; and organisational culture. Thereby, emphasising that reputation is rooted in stakeholder perceptions of the organisation’s actions and behaviours. This research concludes that the value of reputation in public healthcare organisations is perceived as extremely important by both internal and external stakeholders. Reputation is a multidimensional construct that is stakeholder specific and industry specific. Importantly, the dimensions of reputation identified in this study, provide a basis for measuring reputation within organisations and addresses one of the significant problems identified in the reputation literature, that of an agreed method of reputation measurement. Specifically, reputation measurement should be closely tied to the accepted definition, based on the perceptions of stakeholders, and informed by the dimensions of reputation which are specific to the industry. Therefore, this research supports and extends the literature on reputation and confirms that organisational culture is a dimension of reputation. Hence, reputation management strategies need to be developed in collaboration with all stakeholders to ensure the dimensions of reputation are considered from both internal and external perspectives.