Transcript Exploring Organisational Culture Senior Nurse Advisor

Senior Nurse Advisor
Clinical Leadership Development Programme
Exploring
Organisational
Culture
Every enterprise has four
organisations: the one that
is written down, the one that
most people believe exists,
the one that people wished
existed, and finally, the one that
the organisation really needs.
NHS Chief Executive
Why is culture important?
The understanding of the importance of culture
change has come from a number of sources, most notably:
• Investigations into recent high profile
problems
Isolation
Since the inception of the NHS,
Disempowerment
of
more than 50 NHS public inquiries
staff and patients
Inadequate
have been conducted to address
leadership
/
catastrophic failures in patient care.
management
The same 5 common
themes
Failure
of
systems
and
Poor
emerge from each inquiry.
communication
processes
Walshe & Higgins (2002)
Why is culture important?
The understanding of the importance of culture
change has come from a number of sources, most notably:
• Investigations into recent high profile
problems
• A growing awareness that a history of
structural changes has not always
improved services
It is the culture, the informal
psychological and social aspects
of an organisation that influences
how people think, what they see as
important, how they behave and
which ultimately determines the
success of structural reforms.
(Cameron and Quinn, 1999)
Why is culture important?
The understanding of the importance of culture
change has come from a number of sources, most notably:
• Investigations into recent high profile
problems
• A growing awareness that a history of
structural changes has not always improved
services
• Research has shown the importance of
culture in contributing towards high quality
patient outcomes
Case Study
In a study of over 5,000 intensive care
patients, it was found that there
were significant differences in the
deaths of patients between hospitals,
despite the hospitals having similar
levels of funding and staff, and
serving similar populations. These
differences appeared to relate to the
quality of interaction and communication
between healthcare professionals, two
important aspects of organisational culture.
(Knaus, 1986)
What is culture?
• Culture is about how things are done within the
workplace (Team Culture Q)
• The way things are done within a team is heavily
influenced by shared ‘unwritten rules’
• Cultures reflect what has worked 'well' in
the past (Who defines what approach works ‘well’ and should be repeated?)
An Improvement Culture
•
•
•
•
•
•
•
Patient Centeredness
Belief in human potential
Innovation and change are encouraged
Recognition of the value of learning
Effective team working
Communication
Honesty and trust
An improvement culture can be judged by the extent to which
these aspects are shared and lived by the people within the team.
How to understand
your own culture
• Using metaphors and frameworks
• Gaining a deeper understanding
• Why the culture of a team
continues, despite it being unhelpful
• Increase your cultural awareness (C. A’ness Q)
Is your culture helpful?
Vital Signs (Q)
• Change and learning
• Power
• Identity
• Conflict
Building and nurturing a
culture of improvement
When building a culture of improvement,
you need to work like a farmer, planting
seeds and nourishing the ground.
This is distinct from working like
a car mechanic, who replaces
faulty parts with new ones.
These new parts do not always work
well with the old engine and often
cause the whole car to break down!
(Marshall, 2002)
Basic Principles
• Actions speak louder than words
• Ensure the right kind of people to
deliver the required changes
• People live what they have helped to
create
• Say what is not said
• Recognising and understanding
‘polarities’
Four Steps to Building
an Improvement Culture
• Decide what needs to change and
what needs to stay the same
• Describe what an ‘improvement
culture’ means and doesn’t mean
• Define the new ways of doing things
in terms of practice
• Test out news ways of working
Every enterprise has four
organisations: the one that
is written down, the one that
most people believe exists,
the one that people wished
existed and finally, the one that
the organisation really needs.
NHS Chief Executive
What am I going to do
to contribute to the
‘improvement
culture’
of my organisation?
Final
Thoughts
What am I (are we)
going to
do differently
after today?
If we always do
what we’ve
always done…
…we’ll always
get what we’ve
always got!
The ‘Trim
Tab’ effect
HMS
‘Trim Tab’
Be a TRIM TABBER!
and
finally…
If we do nothing
about it in 24 hours…
…we’ll probably
do nothing about it!
Diolch
Website: www.ctrtraining.co.uk
http://www.ctrtraining.co.uk/resources.php
Thank You