Reviewing the culture for a tertiary public teaching hospital2018-08-01T13:03:57+10:00

Reviewing the culture for a tertiary public teaching hospital

Organisational Culture Improvement Project – Public Hospital

Bendelta was engaged by the Organisational Development Unit of a tertiary public teaching hospital to conduct a qualitative review of some departments that had received very low employee engagement scores in a recent hospital-wide culture survey. The purpose of the project was to identify the root causes of the low engagement scores and to recommend initiatives to address those root causes.

Approach taken

A series of one-on-one interviews and focus groups were conducted with clinicians, support staff, and executives in the departments, adopting a modified appreciative inquiry method, i.e., the appreciative inquiry focus on strengths in the culture on which to build was adapted to address the participants’ preference for identifying problems (which was understandable given the low levels of engagement and the diagnostic focus of the professionals involved). Research of academic and management literature was conducted to understand the root causes.

Issues identified

A range of root causes were identified across the departments, some common and some applicable only in a particular department.

Examples of the root causes include:

  • A philosophy of leadership and management that results in leadership behaviours that inhibit or undermine team performance.
  • Organisational processes and structures that inhibit or undermine team performance.
  • Ways of working within a department that inhibit or undermine team performance.
  • Low or non-existent psychological safety for staff.
  • Poor or absent team identity.
  • Increasing volumes and variety of clinical work.

Proposed solutions

A range of initiatives has been recommended for each of the departments involved in the organisational culture improvement project.

These include:

  • The use of 360-degree feedback surveys to increase leaders’ self-awareness and a program of executive coaching to support development based on that new level of awareness of how the team experiences the leader’s actions.
  • Developing leadership capabilities.
  • Coach-supported quality improvement projects using the action-learning method, designed to change the ways in which the team works, breaking down unhelpful hierarchy.
  • Building a stronger team purpose and identity.
  • Developing ways of working within departments that better served that purpose.
  • Reviews to better understand department work profiles and resources to meet that profile.
  • Adaptation of organisational processes and structures to meet a department’s work profile.

The findings and recommended initiatives have been presented to the Organisational Development Unit and respective department executives and are now under consideration to determine which initiatives are to be implemented and how the implementation is to occur.

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