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Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

What characterizes the work culture at a hospital unit that successfully implements change – a correlation study

Authors: Beate André, Endre Sjøvold

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

To successfully achieve change in healthcare, a balance between technology and “people ware”, the human recourses, is necessary. However, the human aspect of the change implementation process has received less attention than the technological issues. The aim was to explore the factors that characterize the work culture in a hospital unit that successfully implemented change compared with the factors that characterize the work culture of a hospital unit with unsuccessful implementation.

Method

The Systematizing Person-Group Relations method was used for gathering and analyzing data to explore what dominate the behavior in a particular work environment identifying challenges, limitations and opportunities. This method applied six different dimensions, each representing different behavior in a work culture: Synergy, Withdrawal, Opposition, Dependence, Control and Nurture. We compared two different units at the same hospital, one that successfully implemented change and one that was unsuccessful.

Results

There were significant statistical differences between healthcare personnel working at a unit that successfully implemented change contrasted with the unit with unsuccessful implementation. These significant differences were found in both the synergy and control dimensions, which are important positive qualities in a work culture.

Conclusion

The results of this study show that healthcare personnel at a unit with a successful implementation of change have a working environment with many positive qualities. This indicates that a work environment with a high focus on goal achievement and task orientation can handle the challenges of implementing changes.
Literature
1.
go back to reference Andre B, Ringdal GI, Loge JH, Rannestad T, Laerum H, Kaasa S. Experiences with the implementation of computerized tools in health care units: a review article. Int J Hum Comput Interact. 2008;24(8):753–75.CrossRef Andre B, Ringdal GI, Loge JH, Rannestad T, Laerum H, Kaasa S. Experiences with the implementation of computerized tools in health care units: a review article. Int J Hum Comput Interact. 2008;24(8):753–75.CrossRef
2.
go back to reference Richards D, Hallberg IR. Complex interventions in health an overview of research methods. New York: Routledge; 2015. Richards D, Hallberg IR. Complex interventions in health an overview of research methods. New York: Routledge; 2015.
3.
go back to reference Berg M. Implementing information systems in health care organizations: myths and challenges. Int J Med Inf. 2001;64(2):143–56.CrossRef Berg M. Implementing information systems in health care organizations: myths and challenges. Int J Med Inf. 2001;64(2):143–56.CrossRef
4.
go back to reference Sijpkens MK, Steegers EA, Rosman AN. Facilitators and barriers for successful implementation of interconception care in preventive child health care services in the Netherlands. Matern Child Health J. 2016;20(1):117–24.CrossRefPubMedPubMedCentral Sijpkens MK, Steegers EA, Rosman AN. Facilitators and barriers for successful implementation of interconception care in preventive child health care services in the Netherlands. Matern Child Health J. 2016;20(1):117–24.CrossRefPubMedPubMedCentral
5.
go back to reference Craig LE, Churilov L, Olenko L, Cadilhac DA, Grimley R, Dale S, Martinez-Garduno C, McInnes E, Considine J, Grimshaw JM. Testing a systematic approach to identify and prioritise barriers to successful implementation of a complex healthcare intervention. BMC Med Res Methodol. 2017;17(1):24.CrossRefPubMedPubMedCentral Craig LE, Churilov L, Olenko L, Cadilhac DA, Grimley R, Dale S, Martinez-Garduno C, McInnes E, Considine J, Grimshaw JM. Testing a systematic approach to identify and prioritise barriers to successful implementation of a complex healthcare intervention. BMC Med Res Methodol. 2017;17(1):24.CrossRefPubMedPubMedCentral
6.
go back to reference Ramsey A, Lord S, Torrey J, Marsch L, Lardiere M. Paving the way to successful implementation: identifying key barriers to use of technology-based therapeutic tools for behavioral health care. J Behav Health Serv Res. 2016;43(1):54–70.CrossRefPubMedPubMedCentral Ramsey A, Lord S, Torrey J, Marsch L, Lardiere M. Paving the way to successful implementation: identifying key barriers to use of technology-based therapeutic tools for behavioral health care. J Behav Health Serv Res. 2016;43(1):54–70.CrossRefPubMedPubMedCentral
8.
go back to reference Jacobs SR, Weiner BJ, Reeve BB, Hofmann DA, Christian M, Weinberger M. Determining the predictors of innovation implementation in healthcare: a quantitative analysis of implementation effectiveness. BMC Health Serv Res. 2015;15(1):6.CrossRefPubMedPubMedCentral Jacobs SR, Weiner BJ, Reeve BB, Hofmann DA, Christian M, Weinberger M. Determining the predictors of innovation implementation in healthcare: a quantitative analysis of implementation effectiveness. BMC Health Serv Res. 2015;15(1):6.CrossRefPubMedPubMedCentral
9.
go back to reference Bate P. Changing the culture of a hospital: from hierarchy to networked community. Public Adm. 2000;78(3):485–512.CrossRef Bate P. Changing the culture of a hospital: from hierarchy to networked community. Public Adm. 2000;78(3):485–512.CrossRef
10.
go back to reference Sleutel MR. Climate, culture, context, or work environment? Organizational factors that influence nursing practice. JNursAdm. 2000;30(2):53–8. Sleutel MR. Climate, culture, context, or work environment? Organizational factors that influence nursing practice. JNursAdm. 2000;30(2):53–8.
11.
go back to reference Boëthius SB, Ögren M-L, Sjøvold E, Sundin EC. Experiences of group culture and patterns of interaction in psychotherapy supervision groups. Clin Superv. 2004;23(1):101–20.CrossRef Boëthius SB, Ögren M-L, Sjøvold E, Sundin EC. Experiences of group culture and patterns of interaction in psychotherapy supervision groups. Clin Superv. 2004;23(1):101–20.CrossRef
12.
go back to reference Stone P, Harrison MI, Feldman P, Linzer M, Peng T, Roblin D, Scott-Cawiezell J, Warren N, Williams ES. Organizational climate of staff working conditions and safety—an integrative model. Adv Patient Safety. 2005;2:467–81. Stone P, Harrison MI, Feldman P, Linzer M, Peng T, Roblin D, Scott-Cawiezell J, Warren N, Williams ES. Organizational climate of staff working conditions and safety—an integrative model. Adv Patient Safety. 2005;2:467–81.
13.
go back to reference Gershon RRM, Stone PW, Bakken S, Larson E. Measurement of organizational culture and climate in healthcare. J Nurs Adm. 2004;34(1):33–40.CrossRefPubMed Gershon RRM, Stone PW, Bakken S, Larson E. Measurement of organizational culture and climate in healthcare. J Nurs Adm. 2004;34(1):33–40.CrossRefPubMed
14.
go back to reference Sjøvold E. Systematizing Person-Group Relations (SPGR) - A Field Theory of Social. Small Group Res. 2007;38(5):615–35. Sjøvold E. Systematizing Person-Group Relations (SPGR) - A Field Theory of Social. Small Group Res. 2007;38(5):615–35.
15.
go back to reference Lorenzi NM. Beyond the gadgets - non-technological barriers to information systems need to be overcome too. Br Med J. 2004;328(7449):1146–7.CrossRef Lorenzi NM. Beyond the gadgets - non-technological barriers to information systems need to be overcome too. Br Med J. 2004;328(7449):1146–7.CrossRef
16.
go back to reference Cummings TG, Worley CG. Organization Development & Change. Mason Ohio: South-Western College Publishing; 2001. Cummings TG, Worley CG. Organization Development & Change. Mason Ohio: South-Western College Publishing; 2001.
17.
go back to reference Lorenzi NM, Riley RT. Managing change: an overview. JAmMedInformAssoc. 2000;7(2):116–24. Lorenzi NM, Riley RT. Managing change: an overview. JAmMedInformAssoc. 2000;7(2):116–24.
18.
go back to reference Lorenzi NM, Riley RT, Dewan NA. Barriers and resistance to informatics in behavioral health. Medinfo. 2001;10(Pt 2):1301–4. Lorenzi NM, Riley RT, Dewan NA. Barriers and resistance to informatics in behavioral health. Medinfo. 2001;10(Pt 2):1301–4.
19.
go back to reference Strobe W. Social psychology and health. Third ed. Philadelphia: Open University Press; 2008. Strobe W. Social psychology and health. Third ed. Philadelphia: Open University Press; 2008.
20.
go back to reference Andre B, Sjovold E, Rannestad T, Holmemo M, Ringdal GI. Work culture among healthcare personnel in a palliative medicine unit. Palliative & supportive care. 2012:1–6. Andre B, Sjovold E, Rannestad T, Holmemo M, Ringdal GI. Work culture among healthcare personnel in a palliative medicine unit. Palliative & supportive care. 2012:1–6.
21.
go back to reference Frigstad SA, Nøst TH, André B. implementation of free text format nursing diagnoses at a university Hospital’s medical department. Exploring Nurses’ and Nursing Students’ Experiences on Use and Usefulness A Qualitative Study. Nurs Res Pract. 2015;2015:e179275. Frigstad SA, Nøst TH, André B. implementation of free text format nursing diagnoses at a university Hospital’s medical department. Exploring Nurses’ and Nursing Students’ Experiences on Use and Usefulness A Qualitative Study. Nurs Res Pract. 2015;2015:e179275.
22.
go back to reference Andre B, Ringdal GI, Loge JH, Rannestad T, Kaasa S. Implementation of computerized technology in a palliative care unit. Palliative & supportive care. 2009;7(1):57–63.CrossRef Andre B, Ringdal GI, Loge JH, Rannestad T, Kaasa S. Implementation of computerized technology in a palliative care unit. Palliative & supportive care. 2009;7(1):57–63.CrossRef
23.
go back to reference Andre B, Ringdal GI, Loge JH, Rannestad T, Kaasa S. The importance of key personnel and active management for successful implementation of computer-based technology in palliative care: results from a qualitative study. Computers, informatics, nursing : CIN. 2008;26(4):183–9.CrossRefPubMed Andre B, Ringdal GI, Loge JH, Rannestad T, Kaasa S. The importance of key personnel and active management for successful implementation of computer-based technology in palliative care: results from a qualitative study. Computers, informatics, nursing : CIN. 2008;26(4):183–9.CrossRefPubMed
24.
go back to reference Nøst TH, Frigstad, SA. André, B. : Impact of an Educational Intervention on Nursing Diagnoses in free-text format in Electronic Health Records. Nord J Nurs Res 2016, In press. Nøst TH, Frigstad, SA. André, B. : Impact of an Educational Intervention on Nursing Diagnoses in free-text format in Electronic Health Records. Nord J Nurs Res 2016, In press.
25.
go back to reference Hare AP, Sjøvold E, Baker HG: Analysis of social interaction systems: SYMLOG research and applications: University Press of America; 2005. Hare AP, Sjøvold E, Baker HG: Analysis of social interaction systems: SYMLOG research and applications: University Press of America; 2005.
26.
go back to reference Sjøvold E. Maturity and effectiveness in small groups. Nordic Psychology. 2006;58(1):43–56.CrossRef Sjøvold E. Maturity and effectiveness in small groups. Nordic Psychology. 2006;58(1):43–56.CrossRef
27.
go back to reference Sjøvold E, Hare A, Sjovold E. Bions theory on group emotionality. In: Hare AP, Sjovold E, Baker & Powers, editors. Analysis of social interaction systems. New York: University Press of America; 2005. Sjøvold E, Hare A, Sjovold E. Bions theory on group emotionality. In: Hare AP, Sjovold E, Baker & Powers, editors. Analysis of social interaction systems. New York: University Press of America; 2005.
28.
go back to reference Osgood CE: The measurement of meaning: University of Illinois press; 1957. Osgood CE: The measurement of meaning: University of Illinois press; 1957.
29.
go back to reference Koenigs RJ, Hare SE, Hare AP. SYMLOG reliability and validity. San Diego: Symlog Consulting Group; 2002. Koenigs RJ, Hare SE, Hare AP. SYMLOG reliability and validity. San Diego: Symlog Consulting Group; 2002.
30.
go back to reference Koenigs RJ, Hare SE, Hare AP, Cohen MA. reliability and validity In A.P. In: Hare E, Sj›vold HG, Baker J, editors. Powers, Analysis of Social Systems. New York: University Press of America; 2005. p. 482–503. Koenigs RJ, Hare SE, Hare AP, Cohen MA. reliability and validity In A.P. In: Hare E, Sj›vold HG, Baker J, editors. Powers, Analysis of Social Systems. New York: University Press of America; 2005. p. 482–503.
31.
go back to reference Sjøvold E. The SPGR manual. Oslo: SPGR publishing; 2002. Sjøvold E. The SPGR manual. Oslo: SPGR publishing; 2002.
32.
go back to reference André B, Frigstad SA, Nøst TH, Sjøvold E: Exploring nursing staffs communication in stressful and non-stressful situations. J Nurs Manag 2015:n/a-n/a. André B, Frigstad SA, Nøst TH, Sjøvold E: Exploring nursing staffs communication in stressful and non-stressful situations. J Nurs Manag 2015:n/a-n/a.
33.
go back to reference Heldal F, Sj›vold E, Heldal AF. success on the internet-optimizing relationships through the corporate site. Int J Inf Manag. 2004;24:115–29.CrossRef Heldal F, Sj›vold E, Heldal AF. success on the internet-optimizing relationships through the corporate site. Int J Inf Manag. 2004;24:115–29.CrossRef
34.
go back to reference Schultz JS, Sjøvold E, André B. Can work climate explain innovative readiness for change? The Journal of Organizational Change Management. 2017;30(30):1–12. Schultz JS, Sjøvold E, André B. Can work climate explain innovative readiness for change? The Journal of Organizational Change Management. 2017;30(30):1–12.
35.
go back to reference Erenstein CF, McCaffrey R. How healthcare work environments influence nurse retention. Holist Nurs Pract. 2007;21(6):303–7.CrossRefPubMed Erenstein CF, McCaffrey R. How healthcare work environments influence nurse retention. Holist Nurs Pract. 2007;21(6):303–7.CrossRefPubMed
36.
go back to reference Heath J, Johanson W, Blake N. Healthy work environments: a validation of the literature. J Nurs Adm. 2004;34(11):524–30.CrossRefPubMed Heath J, Johanson W, Blake N. Healthy work environments: a validation of the literature. J Nurs Adm. 2004;34(11):524–30.CrossRefPubMed
37.
go back to reference Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef
38.
go back to reference Andre B, Sjøvold E, Holmemo M, Rannestad T, Ringdal GI. Expectations and desires of palliative health care personnel concerning their future work culture. J Hosp Adm. 2013;2(3):46. Andre B, Sjøvold E, Holmemo M, Rannestad T, Ringdal GI. Expectations and desires of palliative health care personnel concerning their future work culture. J Hosp Adm. 2013;2(3):46.
Metadata
Title
What characterizes the work culture at a hospital unit that successfully implements change – a correlation study
Authors
Beate André
Endre Sjøvold
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2436-4

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