Transcript An assessment of organisational values, culture and

An assessment of
organisational values, culture
and performance in Cape
Town’s primary care services
Bob Mash, Srini Govender, Arina Schlemmer, Family
Medicine and Primary Care, Stellenbosch University
Angela De Sa, Abdul Isaacs, Family Medicine,
University of Cape Town
Vision 2020: A value-based approach
“The department renders a
large and complex service
every day of the year and the
clinical environment is often
stressful. ..
Staff attitudes are the common
source of complaints. ..
A key issue is how greater
commitment and engagement
from our staff can be
promoted on a daily basis,
moving towards a more
client-centred service with a
greater focus on quality
improvement.”
Espoused organisational values:
 Caring
 Competence
 Accountability
 Integrity
 Responsiveness
 Respect
Aim and objectives
To evaluate how staff within the
Metropolitan District Health Services of
Cape Town perceive their values and
organisational culture.
 To measure:

◦ Current personal values of staff,
◦ Current organisational values
◦ Desired future organisational values

To evaluate the alignment of personal,
current and desired organisational values.
Methods
Cultural values assessment (crosssectional survey)
 All staff at 5 community health centres in
Cape Town Metropole
 Validated CVA questionnaire
 Analysis and report by Barrett’s Value
Centre www.valuescentre.com

Conceptual framework
Organisational
values
e.g. Quality
Organisational
behaviour
e.g. Quality
improvement
cycle
Patient
experience
Health outcomes
Our people’s
values
e.g. Empathy
Our peoples
behaviour
e.g. Patientcentred
consultation
Quality of care
The Barrett Seven Levels of Organisational
Consciousness
Positive Focus / Excessive Focus
Service
Service to population and nation
Social responsibility, future generations, long-term perspective,
ethics, compassion, humility
Making a Difference
Making a difference to the local community
Collaboration, community involvement, partnerships
Staff fulfilment, coaching/mentoring, leadership dev
Internal Cohesion
Building internal organisational community
Shared values, vision, commitment, integrity,
trust, passion, creativity, openness, transparency
Transformation
Continuous renewal and learning
Accountability, adaptability, empowerment, teamwork, goals
orientation, personal growth
Self-esteem
High performance and quality of care
Systems, processes, quality, best practices,
pride in performance. Bureaucracy, complacency
Relationship
Relationships with colleagues and patients
Loyalty, open communication, patient experience, friendship.
Manipulation, blame
Survival
Resources and safety
Sufficient budget, equipment, employee health, safety. Control,
corruption, greed
Location of respondents (N=154)
Mitchells Plain
Khayelitsha
Hanover Park
Kraaifontein
Retreat
Job category of respondents
(N=154)
Manager
Administrator
Doctor
Nurse
Allied health professional
Support staff
Unknown
Personal values
Are people’s
personal values
congruent with
the commitment
in Vision 2020 to
improving the
patient’s
experience?
Current
organisational values
Are organisational
values congruent
with the
commitment in
Vision 2020 to
improving quality of
care?
Department of Health (154)
Personal
Values
C
S
9%
7
6
8%
6
10%
6
5
11%
5
32%
20%
4
9%
3
0%
2
0%
1
18%
5%
40%
12%
23%
26%
17%
4
3
11%
17%
3
1%
2
0%
1
4%
1%
7%
7%
3%
1
20%
7%
7
4
2
2%
2%
0%
12%
0%
CTS = 49-20-31
Entropy = 2%
C = Common Good
T = Transformation
S = Self-Interest
Values Distribution
Desired Culture
Values
7
5
T
Current Culture
Values
Copyright 2011 Barrett Values Centre
20%
40%
CTS = 26-17-57
Entropy = 36%
14%
12%
0%
20%
40%
CTS = 42-26-32
Entropy = 2%
Positive Values
Potentially Limiting
Values
December 2011
Entropy Risk Bands
10% or less:
Prime: Healthy functioning
11% - 19%:
Minor Issues: Requiring cultural and
structural adjustments
20% - 29%:
Significant Issues: Requiring cultural and
structural transformation and leadership coaching
30% - 39%:
Serious Issues: Requiring cultural and structural
transformation, leadership mentoring/coaching,
and leadership development
40 - 49%:
Critical Issues: Requiring cultural and structural
transformation, selective changes in leadership,
leadership mentoring/coaching, and leadership
development
More than 50%:
Cultural Crisis: For private sector or corporations,
high risk of bankruptcy, takeover or implosion
Future values
What are the
desired values
for the
organisation in
future?
Key findings



Staff are potentially aligned with the desire
to improve patient experience and quality of
care and have values congruent with this
The organisation invests a lot of energy in
trying to improve quality and manage staff,
but most of this is experienced negatively
and is unproductive.
Staff experience of the organisation is
currently incongruent with the values of
Vision 2020 and their own personal values
Implications
Transformation of the organisational
culture is needed
 Leadership mentoring/coaching and
leadership development will be necessary
 Family physicians are part of this
leadership
