Hospital Organizational Culture Research Articles

간호사의 워라밸 인식에 대한 내용분석

Purpose : This study aimed to provide foundational insights into various issues related to work-life balance by analyzing interview data on how nurses perceive this concept. Methods : Conducted as a descriptive exploratory research, data were collected from 80 nurses in Seoul and Gyeonggi Province from August 1 to September 20, 2023. Results : Applying content analysis, the study identified four domains, twelve categories, and twenty-two meaningful statements, shedding light on nurses' perceptions of work-life balance. Conclusion : This research contributes to understanding nurses' awareness of work-life balance and can serve as foundational data for improving hospital organizational culture to enhance nurses' work-life balance.

Organizational culture and barriers to change in University of Gondar Comprehensive Specialized Hospital Cardiac Unit

BackgroundCardiovascular disease is a major contributor to high mortality in Ethiopia. Hospital organizational culture affects patient outcomes including mortality rates for patients with cardiovascular disease. Therefore, the purpose of this study was to assess organizational culture and determine barriers to change in the Cardiac Unit of University of Gondar Comprehensive Specialized Hospital.MethodsWe used a mixed methods approach with a sequential explanatory design. We collected data through a survey adapted from a validated instrument measuring organizational culture (n = 78) and in-depth interviews (n = 10) with key informants from different specialty areas. We analyzed the quantitative data using descriptive statistics and the qualitative data through a constant comparative method of thematic analysis. We integrated the data during the interpretation phase to generate a comprehensive understanding of the culture within the Cardiac Unit.ResultsThe quantitative results indicated poor psychological safety and learning and problem solving aspects of culture. On the other hand, there were high levels of organizational commitment and adequate time for improvement. The qualitative results also indicated resistance to change among employees working in the Cardiac Unit as well as other barriers to organizational culture change.ConclusionMost aspects of the Cardiac Unit culture were poor or weak, signaling opportunities to improve culture through identifying culture changing needs, implying the need to be aware of the subcultures within the hospitals that influence performance. Thus, it is important to consider hospital culture in planning health policy, strategies, and guidelines.RecommendationsIt is of paramount importance to strengthen organizational culture through fostering a safe space that enables workers to express divergent views and actively considering such views to improve the quality of care, supporting multidisciplinary teams to think creatively to address problems, and investing in data collection to monitor changes in practice and patient outcomes.

Pengaruh Budaya Organisasi Terhadap Kepuasan Kerja Perawat di Ruang Rawat Inap Rumah Sakit Mitra Medika Tanjung Mulia Kota Medan

Nurse job satisfaction tends to be influenced by the prevailing hospital organizational culture. This study aims to analyze the influence of organizational culture on the job satisfaction of nurses in the inpatient room at Mitra Medika Tanjung Mulia Hospital, Medan City. This type of research is quantitative with a cross sectional study design carried out from September to October 2021. The research population is 84 nurses in the inpatient room. The sampling technique was total sampling with a total sample of 84 people. Data analysis consisted of univariate analysis, bivariate with Chi-Square, multivariate with logistic regression. The results of the univariate analysis showed that most of the respondents were aged 36-45 years 52 (61.9%), female 64 (76.2%), and had a D3 Nursing education level 69 (65.71%). bivariate analysis shows that there is an influence of organizational culture, there is an influence of organizational culture, there is an influence of organizational culture, there is an influence of organizational culture, there is an influence of organizational culture, and there is an influence of organizational culture on the stability aspect of nurses' job satisfaction. multivariate analysis showed that the most influential variable on nurse job satisfaction was the result orientation variable. It is recommended to hospital management to provide nurses with training so that nurses can work according to the targets that have been set.

Recognising the deterioration of patients in acute care wards: a qualitative study.

Background: Infrastructure, equipment and staff constraints are often cited as barriers to the recognition and rescue of deteriorating patients in resource-limited settings. The impact of health-system organisation, decision-making and organisational culture on recognition of deterioration is however poorly understood. This study explores how health care providers recognise deterioration of patients in acute care in Sri Lanka. Methods: In-depth interviews exploring decision making and care processes related to recognition of deterioration, were conducted with a purposive sample of 23 health care workers recruited from ten wards at a district hospital in Sri Lanka. Interviews were audio-recorded, transcribed and coded thematically, line-by-line, using a general inductive approach. Results: A legacy of initial assessment on admission and inimical organisational culture undermined recognition of deteriorating patients in hospital. Informal triaging at the time of ward admission resulted in patients presenting with red-flag diagnoses and vital sign derangement requiring resuscitation being categorised as "bad". The legacy of this categorisation was a series of decision-making biases anchored in the initial assessment, which remained with the patient throughout their stay. Management for patients categorised as "bad" was prioritised by healthcare workers coupled with a sense of fatalism regarding adverse outcomes. Health care workers were reluctant to deviate from the original plan of care despite changes in patient condition (continuation bias). Organisational culture - vertical hierarchy, siloed working and a reluctance to accept responsibility- resulted in omissions which undermined recognition of deterioration. Fear of blame was a barrier to learning from adverse events. Conclusions: The legacy of admission assessment and hospital organisational culture undermined recognition of deterioration. Opportunities for improving recognition of deterioration in this setting may include establishing formal triage and medical emergency teams to facilitate timely recognition and escalation.

Development, Pilot Study, and Psychometric Analysis of the AHRQ Surveys on Patient Safety Culture™ (SOPS®) Workplace Safety Supplemental Items for Hospitals.

Workplace safety is critical for advancing patient safety and eliminating harm to both the healthcare workforce and patients. The purpose of this study was to develop and test survey items that can be used in conjunction with the Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey to assess how the organizational culture in hospitals supports workplace safety for providers and staff. After conducting a literature review and background interviews with workplace safety experts, we identified key areas of workplace safety culture (workplace hazards, moving/transferring/lifting patients, workplace aggression, supervisor/management support for workplace safety, workplace safety reporting, and work stress/burnout) and drafted survey items to assess these areas. Survey items were cognitively tested and pilot tested with the SOPS Hospital Survey 2.0 among providers and staff in 28 U.S. hospitals. We conducted psychometric analysis on data from 6684 respondents. Confirmatory factor analysis results (item factor loadings and model fit indices), internal consistency reliability, and site-level reliability were acceptable for the 16 survey items grouped into 6 composite measures. Most composite measures were significantly correlated with each other and with the overall rating on workplace safety, demonstrating conceptual convergence among survey measures. Hospitals and researchers can use the Workplace Safety Supplemental items to assess the dimensions of organizational culture that support provider and staff safety and to identify both strengths and areas for improvement.

Effects of job embeddedness and nursing working environment on turnover intention among trauma centre nurses: A cross-sectional study.

To investigate the effects of job embeddedness and nursing working environment on trauma centre nurses' turnover intention. Trauma centre nurses have higher average turnover intention than hospital nurses. However, factors that increase the turnover intention of trauma centre nurses remain unexplored. This cross-sectional study was conducted from August to October 2019, with 120 trauma centre nurses working at three trauma centres in B, D and U cities using measures of demographic characteristics, job embeddedness, nursing working environment and turnover intention. The mean turnover intention score was 3.60/5 points. There were significant correlations among turnover intention and fit, sacrifice, foundation for quality nursing, ability and leadership of nursing managers, cooperation of nurses and doctors, nurse participation in hospital management and sufficient manpower and material support. Turnover intention was predicted by nurse participation in hospital management, gender, clinical experience and fit, which explained 54%. Factors that influence nurses' turnover intention at trauma centres were gender, clinical experience, job fit and, especially, nurses' participation in hospital management, which had the most effect on the nursing working environment. To expand participation of trauma centre nurses, hospital management systems and organisational culture need improvement.

Recognising the deterioration of patients in acute care wards: a qualitative study

Background: Infrastructure, equipment and staff constraints are often cited as barriers to the recognition and rescue of deteriorating patients in resource-limited settings. The impact of health-system organisation, decision-making and organisational culture on recognition of deterioration is however poorly understood. This study explores how health care providers recognise deterioration of patients in acute care in Sri Lanka. Methods: In-depth interviews exploring decision making and care processes related to recognition of deterioration, were conducted with a purposive sample of 23 health care workers recruited from ten wards at a district hospital in Sri Lanka. Interviews were audio-recorded, transcribed and coded thematically, line-by-line, using a general inductive approach. Results: A legacy of initial assessment on admission and inimical organisational culture undermined recognition of deteriorating patients in hospital. Informal triaging at the time of ward admission resulted in patients presenting with red-flag diagnoses and vital sign derangement requiring resuscitation being categorised as "bad". The legacy of this categorisation was a series of decision-making biases anchored in the initial assessment, which remained with the patient throughout their stay. Management for patients categorised as “bad” was prioritised by healthcare workers coupled with a sense of fatalism regarding adverse outcomes. Health care workers were reluctant to deviate from the original plan of care despite changes in patient condition (continuation bias). Organisational culture - vertical hierarchy, siloed working and a reluctance to accept responsibility- resulted in omissions which undermined recognition of deterioration. Fear of blame was a barrier to learning from adverse events. Conclusions: The legacy of admission assessment and hospital organisational culture undermined recognition of deterioration. Opportunities for improving recognition of deterioration in this setting may include establishing formal triage and medical emergency teams to facilitate timely recognition and escalation.

A multidisciplinary exploration of patients' and their relative' experiences of food and nutritional care: baseline data from an action research study

Hospital organisational culture is a major contributing factor to lapses in healthcare delivery, critically affecting all aspects of patient care [1]. Providing optimum food, hydration and nutritional care is a fundamental aspect of patient care that facilitates recovery and reduces complications associated with the adverse consequences of malnutrition (undernutrition), such as prolonged hospital stays and increased mortality, aside from significant cost implications [2]. Evidence on organisational culture in health care institutions has demonstrated a significant association with staff actions and behaviours that stem from shared ways of thinking, which has implications for patients’ experiences and service delivery [3].

ANALYSIS OF EMPLOYEE TURNOVER FACTORS IN GUIZHOU PUBLIC HOSPITALS UNDER ORGANIZATIONAL CULTURE

Many existing studies have shown that organizational culture has an impact on employee turnover behavior, but the types of organizations are different, and the culture within different organizations is also quite different. The influence of organizational culture on employee turnover should be classified and analyzed across different types of organizations. Using the example of a public hospital in Guizhou, this paper carries out an empirical analysis of the relationship between hospital’s organizational culture and employee turnover rate. In this particular case, organizational culture is divided into four dimensions: perceived trust, collectivism, adventurousness and openness. The conclusion shows that there is a significant negative correlation between hospital organizational culture and turnover intention. Perceived trust has the greatest effect on employee turnover rate, which is greater than collectivism, adventurousness and openness. The conclusions and suggestions of this paper will provide some reference for hospitals’ human resource management, promoting reform and development of public hospital management in Guizhou.

병원 조직문화가 남자간호사의 직무만족도에 미치는 영향

Purpose : This study was conducted to investigate the effects of hospital organizational cultures and job satisfaction of male nurses and to identify the relations between these two factors. Mathod : 110 males were involved in the study who worked at 7 university hospitals in Seoul and 2 university hospitals in Gyeonggi area. This survey-based study was analyzed using the SPSS 17.0 statistical program to carry out frequency analysis, t-test, ANOVA, pearson's correlation and multiple linear regression analysis. Results : The mean score of hospital organizational culture was 3.13 points out of 5 points and the mean score of job satisfaction as 2.92 points. the factors that gave significant impacts on job satisfaction were age, education and higher job satisfaction in high, and have faith in the job satisfaction significantly affected. Task-centered organization culture showed appeared to have significant effects on job satisfaction. Conclusion : It is expected to develop programs which can encourage male nurses to fulfill their own goals and to search the way can change the roles and awareness of male nurses and can understand diverse hospital organizations and their organizational cultures.

Factors Influencing Nurses' Willingness to Speak Up Regarding Patient Safety in East Asia: A Systematic Review.

Speaking up for patient safety among health care professionals is important because it can contribute to the prevention of adverse patient events, such as medication errors, infections, wrong-site surgical procedures, and other sentinel events. This systematic review identified factors that facilitate or inhibit nurses’ willingness to speak up regarding patient safety in East Asian hospitals. Following the steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, four databases, including PubMed, CINAHL, PsycInfo, and Web of Science, were searched. Nine studies were analyzed in this review, including five qualitative and four quantitative studies published between 2014 and 2019. Quality of included studies were evaluated using the Mixed-Method Appraisal Tool. Data synthesis was based upon qualitative-led synthesis adopting two existing multilevel frameworks on safety voice and employee voice signals. Four studies were conducted in Japan, three in South Korea, one in Hong Kong, and one in Taiwan. We organized factors influencing East Asian nurses’ willingness to speak up regarding patient safety according to the following four contexts: individual (motivation toward patient safety, organizational commitment, perceived effectiveness and importance of speaking up, and assertive personality), team (positive relationship and team trust, team culture, and mentoring), organizational (hospital administrative support and organizational culture) and sociocultural (hierarchy and power differential and collectivistic culture). However, due to the limited number of studies conducted in East Asian hospitals, further studies with larger cohort samples of nurses in various East Asian countries should be conducted to deepen our understanding of nurses’ willingness to voice their concerns for patient safety.

Organizational culture: A key factor to improve nurse performance

This study aims to analyze the impact of organizational culture on Quality of Nursing Work Life (QNWL) and nurse performance, the impact of QNWL on nurse performance, and the role of QNWL in mediating the influence of organizational culture on nurse performance in Baptist Batu Hospital. This research used a cross-sectional approach. Data were gathered using the census method from March to April 2019. A total of 58 nurses participated in this study. The data were analyzed using descriptive statistics and Structural Equation Modeling Partial Least Square. The results showed that organizational culture has a significant and positive impact on nurse performance and QNWL. However, QNWL does not have a significant impact on nurse performance. Thus, QNWL does not mediate the influence of organizational culture on nurse performance. To enhance nurse performance and QNWL, hospital managers should focus on strengthening the hospital's organizational culture.

Management Consulting Intervention Case Study in a Complex and Toxic Hospital Organizational Culture

Abstract Healthcare organizations in turmoil often turn to management consultants to collect data, engage in analysis, evaluate processes, and make recommendations. This is a case study of an actual hospital with complex issues around organizational culture, organizational conflict, diversity, and talent management. The paper explores the intervention approaches used to address the toxic organizational cultural problems through the lens of organizational development, change management, and corporate behavioral theory.

Changing hospital organisational culture for improved patient outcomes: developing and implementing the leadership saves lives intervention.

BackgroundLeadership Saves Lives (LSL) was a prospective, mixed methods intervention to promote positive change in organisational culture across 10 diverse hospitals in the USA and reduce mortality for patients with acute myocardial infarction (AMI). Despite the potential impact of complex interventions such as LSL, descriptions in the peer-reviewed literature often lack the detail required to allow adoption and adaptation of interventions or synthesis of evidence across studies. Accordingly, here we present the underlying design principles, overall approach to intervention design and core content of the intervention.Methods of intervention developmentHospitals were selected for participation from the membership of the Mayo Clinic Care Network using random sampling with a purposeful component. The intervention was designed based on the Assess, Innovate, Develop, Engage, Devolve model for diffusion of innovation, with attention to pressure testing of the intervention with user groups, creation of a think tank to develop a comprehensive assessment of the landscape, and early and continued engagement with strategically identified stakeholders in multiple arenas.ResultsWe provide in-depth descriptions of the design and delivery of the three intervention components (three annual meetings of all hospitals, four rounds of in-hospital workshops and an online community), designed to equip a guiding coalition within each site to identify and address root causes of AMI mortality and improve organisational culture.ConclusionsThis detailed practical description of the intervention may be useful for healthcare practitioners seeking to promote organisational culture change in their own contexts, researchers seeking to compare the results of the intervention with other leadership development and organisational culture change efforts, and healthcare professionals committed to understanding complex interventions across healthcare settings.

The Moderating Effect of Organization Culture on Competition Intensity and Hospital Quality

This study empirically tests the relationship between hospital competition intensity and its quality, and the moderating impact of hospital culture on this relationship. An emailed questionnaire collected data from 239 American hospital CEO's to validate the measures and test the hypothesized relationships. The results corroborated the importance of competition intensity as determinant of hospital quality and the positive moderating impact of hospital organization culture as measured here. Future research should expand this model to include other potential determinants of hospital quality such as economic conditions and hospital size. Also, future research should explore other potential moderators and mediators for inclusion in a more elaborate model. While hospitals administrators cannot control the intensity of their competition, and are forced to do everything they can to improve hospital quality (including establishing a helpful organization culture), understanding how to measure these constructs and manage their relationships should be very useful.

Building for Change: Comparative Case Study of Hospital Architecture.

Objective:This study assesses how architectural design strategies impact the flexibility of hospitals to change over time.Background:Most hospitals are designed for highly specialized medical functions, which is often in conflict with the need to design the hospital facility to accommodate evolvement and change of functions over time. Architectural design strategies provide different approaches to the need to design for a specific medical program while planning for its future change.Methods:The study compares two hospital buildings with a very similar configuration and medical program but with significantly different architectural design strategies: One was designed for an unknown future medical function, and the second was designed for a specific medical function. The study analyses the two hospital buildings by their design strategy, planning, design process, and construction by phases and compares their change in practice over the last twelve years.Results:The design strategy to fit a specific function limited the hospital affordance to make changes during the design process, construction, and occupancy phases. Systematic design of system separation for an unknown function, in contradiction to a “tailor-made” approach in the design for a specific function, was found to support a variety of changing medical programs.Conclusions:Architectural design strategies developed in an early stage of the design process has a major impact on the future evolution of the hospital facility. The different results between the two projects also demonstrate the greater influence of healthcare policies, hospital organization culture, and infrastructure funding models on the architecture and flexibility of hospitals.

The Influence of Organizational Culture on Planning as Perceived by Employees in The Hospital

Planning is essential to healthcare institutions. The first important factor that indicates the effectiveness and efficiency of an organization is planning and the realization of how the vision and mission that have been set up are implemented. However, organizational culture plays a key role in setting a plan for hospitals. It is upon this premises that this study seeks to find the impact of organizational culture on planning as professed by employees in the hospital and the significant difference between sex and age when planning was considered. This was quantitative research which was designed as descriptive-correlational. The self-constructed instrument was conveniently administered to 108 hospital employees within Laguna in the Philippines to measure their hospital organizational culture and planning. The statistical study treatment was based on SPSS version 23, where Mean and Standard Deviation and Pearson Correlation and t-test were used to analyze the data. The results revealed that hospital planning was very high, and they strongly agree with the influence of their organizational culture. Furthermore, the study resulted that there is a high correlation between organizational culture and planning. There was a significant difference in sex, however, there was no significant difference in age. The implication is that hospitals must make sure that their firms’ culture supports planning so that they can meet their objectives. The study recommends that hospitals must make sure that their cultural practices support planning. This is among the various ways to achieve hospitals success and make them effective and efficient.

CARING THEORY IN CORRELATION TO HOSPITAL ORGANIZATIONAL CULTURE TOWARDS A SUSTAINABLE HOLISTIC PROGRAM FOR NURSES

The study determined the significant correlation between the extent of attainment of the Caring Theory and extent of practice of characteristic of hospital organizational culture - Leadership Style, Managerial Values and Characteristics of Members, amongst 491 nurses from 5 government-funded hospitals in Metro Manila. It also showed: a very high extent of Caring attained by the nurses in terms of all the Caritas processes except the third; a very high extent of the Characteristics of the Hospital Organizational Culture Being Practiced as to Characteristics of its Members; and a high extent as to Leadership Style, and Managerial Values. It was recommended that nurses: must be more sensitive to their needs and of others; sustain their caring attitude and observe well characterization of others; lastly to enhance their leadership style and managerial values; Hospital administrators must arrange for ideal nurse-patient ratio and give nurses the appropriate load that they can accomplish for the shift; They also have to create a culture of success and positive environment for their nurses and lastly they should use the Sustainable Holistic Program for Nurses to sustain their very high extent of practice of caring attitudes and enhance those that were not.

The influence of hospital accreditation: a longitudinal assessment of organisational culture

BackgroundA growing body of evidence supports the link between hospital organisational culture and health outcomes. Organisational culture is thus an essential consideration for hospital accreditation, a practice of systematically assessing the quality of hospital care against accepted standards. This study assesses the interplay between accreditation and hospital professional staff perception of organisational culture.MethodsA prospective cohort study design was used to explore the influence of accreditation on organisational culture within a large, publicly-funded, university teaching hospital in Hong Kong. All full-time hospital and academic physicians, nurses and allied health professionals were invited to participate. Organisational culture was evaluated using the Competing Values Framework through the Quality Improvement Implementation Survey. Organisational culture was assessed longitudinally at 9 months prior to accreditation, 3 months following and 15 months after accreditation. To capture potential shifts in staff perception of organisational culture through the accreditation process, we conducted a between time-point comparison using a linear trend model.Results545 clinical staff completed the organisational culture survey pre-accreditation, 378 three- months post-accreditation and 141 15-months post-accreditation. Hierarchical culture was the dominant organisational culture domain pre-accreditation, followed by rational, developmental and group culture, respectively. Following accreditation, hierarchical culture declined but remained dominant, while group and developmental culture increased. However, the decline in hierarchical culture was U-shaped with scores increasing at 15-months post-accreditation, though not to pre-accreditation levels. When stratified by professional group, hierarchical culture declined following accreditation with corresponding increases in group culture and developmental culture among physicians and nurses, respectively. While allied health professionals did not perceive any significant cultural differences directly following accreditation, a significant increase in hierarchical culture and corresponding decrease in group culture was found 15-months post-accreditation.ConclusionsThis study suggests the hospital accreditation process may contribute to shifts in staff perception of organisational culture. Our findings also indicate differential views of organisational culture across professional groups. Finally, we note the striking dominance of hierarchical culture in this Hong Kong hospital across all time points, far surpassing other studies, even those in which hierarchical culture prevailed.

Nurses' Perceptions Regarding Disclosure of Patient Safety Incidents in Korea: A Qualitative Study

The purpose of this study was to determine nurses' perceptions of the disclosure of patient safety incidents (DPSI), which is known to be effective in reducing medical litigation and improving the credibility of medical professionals. Three focus group discussions were conducted with 20 nurses using semistructured guidelines. Transcribed content including a record of the progress of the focus group discussions and researchers' notes were analyzed using directed content analysis. Most participants thought that DPSI is necessary because of its effectiveness and for ethical justification. However, participants held varied opinions regarding the primary responsibility of DPSI. Participants agreed on the necessity of explaining the incident and expressing sympathy, apologizing, and promising appropriate compensation that are chief components of DPSI. However, they were concerned that it implies a definitive medical error. A closed organizational culture, fear of deteriorating relationships with patients, and concerns about additional work burdens were suggested as barriers to DPSI. However, the establishment of DPSI guidelines and improving the hospital organization culture were raised as facilitators of DPSI. Most nurse participants acknowledged the need for DPSI. To promote DPSI, it is necessary to develop guidelines for DPSI and provide the appropriate training. Improving the hospital organization culture is also critical to facilitate DPSI.