Showing papers on "Culture change published in 2003"
TL;DR: To transform the culture of a whole health system such as the UK National Health Service would be a complex, multi-level, and uncertain process, comprising a range of interlocking strategies and supporting tactics unfolding over a period of years.
Abstract: Objectives. To review some of the key debates relating to the nature of organizational culture and culture change in health care organizations and systems.
Methods. A literature review was conducted that covered both theoretical contributions and published studies of the processes and outcomes of culture change programmes across a range of health and non-health care settings.
Results. There is little consensus among scholars over the precise meaning of organizational culture. Competing claims exist concerning whether organizational cultures are capable of being shaped by external manipulation to beneficial effect. A range of culture change models has been developed. A number of underlying factors that commonly attenuate culture change programmes can be identified. Key factors that appear to impede culture change across a range of sectors include: inadequate or inappropriate leadership; constraints imposed by external stakeholders and professional allegiances; perceived lack of ownership; and subcultural diversity within health care organizations and systems.
Conclusions. Managing organizational culture is increasingly viewed as an essential part of health system reform. To transform the culture of a whole health system such as the UK National Health Service would be a complex, multi-level, and uncertain process, comprising a range of interlocking strategies and supporting tactics unfolding over a period of years.
421 citations
TL;DR: The research argues that the resident voice must be sought in reaching operational definitions for quality of life and as reporters on the quality of their own lives, and that resident burden is a spurious concern that should not deter direct interviews with residents.
Abstract: Purpose: This article identifies challenges in defining, measuring, and studying quality of life of nursing home residents. Design and Method: A theoretical analysis was conducted based on literature and the author’s own large-scale studies of quality of life of nursing home residents. Results: Measuring quality of life is a relatively low priority in nursing homes because of focus on markers of poor quality of care, pervasive sense that nursing homes are powerless to influence quality of life, and impatience with research among those dedicated to culture change. The research argues that the resident voice must be sought in reaching operational definitions for quality of life and as reporters on the quality of their own lives, and that resident burden is a spurious concern that should not deter direct interviews with residents. Five challenges in measuring quality of life were identified: (a) designing questions with appropriate response categories and time frames, (b) developing a sampling strategy, (c) aggregating information at the individual andfacilitylevel,(d)validatingwhatare ultimately subjective constructs, and (e) developing an approach using observations and proxies to assess quality of life for approximately the 40% of the residents who will be impossible to interview. Implications: Although residents’ perceived quality of life is partly a product of their health, social supports, and personalities, nursing homes can directly influence quality of life through their polices, practices, and environments, and, indirectly, through their approaches to family and community. A research agenda is needed, which includes both methodological research and studies of the correlates of quality of life.
287 citations
TL;DR: In this article, the authors summarize 59 organisational change efforts that had culture change as an objective and find that the success rate for culture change was low. But, success was more likely when the sponsors were perceived to be mid-level rather than senior executives.
Abstract: Summarizes 59 organisational change efforts that had culture change as an objective. Culture change was a common type of organisational change and usually occurred in combination with other types of change. The success rate for culture change was low. Success was more likely when the sponsors were perceived to be mid‐level rather than senior executives. Culture change was most often undertaken because of competition and customer issues. Statistical data were most often cited to describe successful culture change while unsuccessful change efforts were usually described by opinions. Success correlated most highly with the variables that reflected stakeholder management, manageability of the project, project staffing, sponsorship and progress monitoring. Failure correlated most strongly with ineffective leadership and the clash with the existing culture. Success factors and barriers for cultural change resembled the profile for other types of organizational change. Ends with recommendations for managing cultural change.
154 citations
Posted Content•
TL;DR: In this article, the authors report on the impact of a program of culture change on managers at one of Britain's leading grocery retail chains and conclude that at least changes in managerial behaviour are related more to surveillance, direct control and the threat of sanction than any transformation of managerial values.
Abstract: The strategic importance of managing organizational culture has been a central theme in organizational literature over the past two decades. But relatively little attention has been given to the impact of culture change initiatives on managers. This paper reports on the impact of a programme of culture change on managers at one of Britain's leading grocery retail chains. Based on a series of detailed interviews with managers together with examination of company documents and an understanding of trends in grocery retailing, we explain the purpose and content of change, and document and analyse the reactions of those managers who are expected to change their own cultural orientations as well as persuade their subordinates to change. We conclude that in this case at least changes in managerial behaviour, as with previously documented changes in the behaviour of shopfloor workers, are related more to surveillance, direct control and the threat of sanction than any transformation of managerial values. Indeed, the situation and experiences of managers - one of reduced autonomy, close monitoring and control, and perceived career insecurity - are explained less in relation to 'organizational culture', more in relation to organizational (re-)structuring intended to create a more centralized form of organizational control.
149 citations
TL;DR: In this paper, the authors report on the impact of a program of culture change on managers at one of Britain's leading grocery retail chains and conclude that at least changes in managerial behaviour are related more to surveillance, direct control and the threat of sanction than any transformation of managerial values.
Abstract: The strategic importance of managing organizational culture has been a central theme in organizational literature over the past two decades. But relatively little attention has been given to the impact of culture change initiatives on managers. This paper reports on the impact of a programme of culture change on managers at one of Britain's leading grocery retail chains. Based on a series of detailed interviews with managers together with examination of company documents and an understanding of trends in grocery retailing, we explain the purpose and content of change, and document and analyse the reactions of those managers who are expected to change their own cultural orientations as well as persuade their subordinates to change. We conclude that in this case at least changes in managerial behaviour, as with previously documented changes in the behaviour of shopfloor workers, are related more to surveillance, direct control and the threat of sanction than any transformation of managerial values. Indeed, the situation and experiences of managers - one of reduced autonomy, close monitoring and control, and perceived career insecurity - are explained less in relation to `organizational culture', more in relation to organizational (re-)structuring intended to create a more centralized form of organizational control.
133 citations
TL;DR: In this paper, the authors consider how certain notional organisational culture elements became embedded in the design of an innovative management accounting system (MAS) and how the alignment between the cultural premise of the MAS and that espoused by MAS users influenced the perceived success of the new system.
Abstract: This study considers how certain notional organisational culture elements became embedded in the design of an innovative management accounting system (MAS) and how the alignment between the cultural premise of the MAS and that espoused by MAS users influenced the perceived success of the new system. The research data for the study were obtained over a three and half year period and derive from interviews, questionnaire responses and public as well as internal corporate documents. The site chosen for the study is a division of Siemens—a global firm in the electronics and electrical components industry. Two employee groups with functional expertise in engineering and business economics respectively comprise the MAS user groups. During the development and implementation phases of the new MAS, Siemens was actively engaged in a corporate-wide culture change programme that was supportive of the new MAS initiative. The study results are in two parts. First they report on the manner in which the organisational programme of culture change affected the cultural premise of the new system. Second, they indicate that the degree of alignment between the organisational culture elements which were embedded within the MAS and the organisational outlook of the two user groups significantly influenced the system's perceived success.
130 citations
Book•
09 Dec 2003
TL;DR: This book discusses culture change in Long-Term Care, the role of state government in Catalyzing Change, and the power of Circles to Promote Culture Change.
Abstract: * Foreword * SECTION 1 INTRODUCTION TO CULTURE AND VALUES IN LONG-TERM CARE * Unloving Care Revisited: The Persistence of Culture * Managing Organizational Culture Change: The Case of Long-Term Care * Culture Change in Long-Term Care Facilities: Changing the Facility or Changing the System? * The Historical Context of "Humanistic" Culture Change in Long-Term Care * Leading Culture Change in Long-Term Care: A Map for the Road Ahead * Achieving Organizational Change Within the Context of Cultural Competence * The Changing Consumer: The Social Context of Culture Change in Long-Term Care * Family Caregivers, Health Care Professionals, and Policy Makers: The Diverse Culture of Long-Term Care * Pioneer Network: Changing the Culture of Aging in America * SECTION 2 MODELS OF CULTURE CHANGE IN LONG-TERM CARE * Evolution of Eden * Culture Change in Long Term Care: The Wellspring Model * Models for Individuals with Alzheimer Disease: Beyond the Special Care Framework * Peer Mentoring of Nursing Home CNAs: A Way to Create a Culture of Caring * The Live Oak Regenerative Community: Championing a Culture of Hope and Meaning * SECTION 3 CASE STUDIES: IMPLEMENTING CHANGE * Teresian House--Using the Environment to Support Cultural Change * Center for Nursing and Rehabilitation--Culture Change in an Urban Environment * The Providence Mount St Vincent Experience * Organizational Culture and Bathing Practice: Ending the Battle in One Facility * The Power of Circles: Using a Familiar Technique to Promote Culture Change * SECTION 4 CASE STUDIES: CULTURE CHANGE BRIEFS * Introduction to Case Studies: Culture Change Briefs * Apple Health Care: Culture Change in a Privately Owned Nursing Home Chain * Case Study Brief: The Lyngblomsten Care Center, St Paul, MN * SECTION 5 AN INTERNATIONAL PERSPECTIVE * Using Strengths-Based Practice to Support Culture Change: An Australian Experience * Implementing the Eden Alternative(R) in Australia * Beyond the Medical Model--The Eden Alternative(R) in Practice: A Swiss Experience * Changes in Long-Term Care for Elderly People with Dementia: A Report from the Front Lines in British Columbia, Canada * SECTION 6 IS CHANGE REALISTIC? * Quality Oversight and Culture Change in Long-Term Care * Policy Values and Culture Change in Long-Term Care--The Role of State Government in Catalyzing Change * Selecting a Model or Choosing Your Own Culture * Successfully Surviving Culture Change * Index * Reference Notes Included
91 citations
TL;DR: In this paper, the authors present a heuristic that serves as a step toward exemplifying the role of changing employment modes and organizational subcultures in enabling or constraining the implementation of HR strategy.
Abstract: Past research suggests that most culture change efforts proceed with limited attention to the pluralistic nature of contemporary organizations. We argue that the relationship between organization subcultures and the implementation of new HR strategies into HR practice has not been adequately explored because of the lack of a comprehensive framework for defining and integrating culture change and the strategic HR literature. We review the organization culture and strategic HR literature and present a heuristic that serves as a step toward exemplifying the role of changing employment modes and organizational subcultures in enabling or constraining the implementation of HR strategy.
80 citations
01 Aug 2003
TL;DR: In this paper, the authors present a framework for cross-cultural learning in the context of International Human Resource Management, focusing on the experience of cross-culture change through Fiddler on the Roof and the Hero's Journey.
Abstract: Section 1 Not the Beginning 1 Culture, Passion, and Play Section 2 Framing the Culture Concept: What is Culture / How can we Characterize it? 2 Are we the Same or are we Different? - A Social Psychological Perspective of Culture 3 What is Culture and Why Does it Matter? - Current Conceptualizations from Anthropology 4 One's Many Cultures: A multiple Cultures Perspective 5 Learning about Our and Other Selves: Multiple Identities and Their Sources Section 3 Culture Scanning and Sense-Making: How do we 'Learn' and Characterize Culture? 6 Context / Culture Interaction: Teaching Thick Descriptions of Culture 7 Cultural Scanning: An Integrated Cultural Frameworks Approach 8 Teaching Cultural Sensemaking 9 Examining Culture Change Through 'Fiddler on the Roof' Section 4 The Experience of Crossing Cultures 10 Using the Hero's Journey: A Framework for Making Sense of the Transformational Expatriate Experience 11 Apples and Oranges: An Experimental Exercise in Crossing Cultures 12 Building Transpatriate Skills: The Star Trek Case 13 Cultural Transitions: A Biophysical Model for Cultural Adaption, Section 5 Going Deeper: Developing a Global Mindset 14 Turning Frogs into Interculturalists: A Student Centered Developmental Approach to Teaching Intercultural Competence 15 Shaping the Global Mindset: Designing Educational Experiences for Effective Global Thinking and Action 16 Limitations of the Culture Perspective in Teaching International Management: The Case of Transitional Economies 17 Reflective Silence: Developing the Capacity for Meaningful Global Leadership Section 6 The Cultural Context of Work: Collaborative Relationships Today 18 Building Multinational Teams: Learning to Manage the Challenges of Homogeneity and Heterogeneity 19 Teaching Culture 'On the Fly' and 'Learning in Working' with Global Teams 20 Teaching Mindful Intercultural Conflict Management 21 Effective Cross-Cultural Leadership: Tips and Techniques for Developing Capacity Section 7 The Cultural Context of Work: Impacts on Functional Performance 22 Global Ethics 23 Negotiating Culture 24 Conceptualizing and Designing a Course in International Human Resource Management 25 Incorporating Culture in Joint Venture and Alliance Instruction: The Alliance Culture Exercise 26 Teaching Culture in the Capstone Strategy Course Section 8 Not the End 27 As We Go Forward
56 citations
TL;DR: The Pioneer Network as discussed by the authors is a grass-root network of individuals in the field of aging, working for deep systemic change through both evolutionary and revolutionary means, using Pioneer values and principles as the foundations for change.
Abstract: SUMMARY The Pioneer Network is a national grass roots network of individuals in the field of aging, working for deep systemic change through both evolutionary and revolutionary means, using Pioneer values and principles as the foundations for change. Pioneers are individuals who work in residential long-term care settings and community based settings, in government, research, advocacy and education whose goal is to seed and cultivate a new culture of aging. In-depth change in systems requires transformation of individual and societal attitudes toward aging and elders, transformation of elders' attitudes toward themselves and their aging, changes in the attitudes and behavior of caregivers toward those for whom they care and changes in governmental policy and regulation. Pioneers refer to this work as culture change. While maintaining its work to recreate nursing homes, the Pioneer Network has expanded its vision, mission and focus to encourage and facilitate culture change values, principles and person-ce...
54 citations
TL;DR: In this paper, the authors argue that effective change requires understanding what organizational culture means, and understanding how organizational change typically occurs, and they conclude with implementation strategies for effective culture change management.
Abstract: SUMMARY Recent research has focused on organizations as continuously confronted by forces for change. These forces may cause organizations to rethink their deeply held cultural values and beliefs in order to survive in the changing landscape. Using the long-term care industry as an exemplar, we argue that effective change requires understanding what organizational culture means, and understanding how organizational change typically occurs. Though some scholars emphasize that change is largely out of the control of organization leaders and primarily the result of evolutionary and revolutionary forces, we argue that culture change can be effectively managed. We conclude with implementation strategies for effective culture change management.
TL;DR: In this article, three broad themes are selected for discussion: (I) the challenge of cultural translation of mainstream professional definitions of depression to culturally diverse groups; (II) sociopolitical discourses and power differentials regarding gender, class and race and their possible contributions to depression; and (III) the impact of migration, cultural change and generational conflict on manifestations of depression.
Abstract: The dilemmas inherent in the inclusion of the sociocultural variables in the assessment and treatment of depression are multifold. In this article, three broad themes are selected for discussion: (I) the challenge of cultural translation of mainstream professional definitions of depression to culturally diverse groups; (2) sociopolitical discourses and power differentials regarding gender, class and race and their possible contributions to depression; and (3) the impact of migration, cultural change and generational conflict on manifestations of depression.
TL;DR: The authors examined whether the 1996 welfare reform has led to the culture change in welfare offices advocated by welfare leaders and administrators, and found that welfare practitioners consider changes in structure and process as culture change, whereas scholars of organizational culture see these changes as only changes in artifacts.
Abstract: This article examines whether the 1996 welfare reform has led to the culture change in welfare offices advocated by welfare leaders and administrators. Examining a sample of state and local welfare systems, it asks whether and how welfare organizations are seeking to change their culture or, if not their culture, at least some of the structures and processes of their welfare systems. After unpacking the concept of culture in the context of welfare reform, the research finds that welfare leaders and administrators interpret the concept of culture change more broadly than do scholars of organizational culture.Welfare practitioners consider changes in structure and process as culture change, whereas scholars of organizational culture see these changes as only changes in artifacts. Scholars would consider these practitioners'interpretations to be superficial and would argue that they underestimate what it actually takes to effect changes in beliefs, perceptions, and feelings that are sufficiently deep to be c...
TL;DR: In this paper, the authors analyse a project to make a simple clear communication tool, without jargon, to communicate the meaning of sustainable development in different dimensions to small and medium sized businesses.
TL;DR: In this paper, the authors explore the value of investigating cultural change programs as exercises in engineering deviance, through a case study of an organizational development cultural change program, and show that such programs are exercises in deviance.
Abstract: This article explores the value of investigating cultural change programmes as exercises in engineering deviance. It does so through a case study of an organizational development cultural change pr...
TL;DR: The culture change movement in long-term care is seeking to balance the power of the medical professions with more consumer empowerment as mentioned in this paper, and consumer empowerment will be supported by important demographic and socio-economic changes in the older population.
Abstract: SUMMARY Sustaining “culture change” in long-term care or any other social system requires change in the underlying social structures that support a given culture. Due to the “medicalization” of contemporary long-term care, the cultural meanings of aging and disability have been increasingly defined and maintained through social structures associated with the medical professions. The “culture change” movement in long-term care is seeking to balance the power of the medical professions with more consumer empowerment. Over the next two decades, consumer empowerment will be supported by important demographic and socio-economic changes in the older population. Demographic empowerment will come from relatively small cohorts of older persons, declining disability rates, and stronger supports from informal caregivers. Socio-economic empowerment will come from higher levels of income, wealth, and educational attainment. Together these trends should provide powerful support to a more consumer-driven culture of long...
TL;DR: An eight stage process for creating major change is presented as a basis of mapping culture change programs in long-term care that aspire to be humanistic in nature and involve all stakeholder groups in ongoing, empowering activity.
Abstract: SUMMARY Leaders of culture change in long-term care should have a plan to guide the entire process before they begin. This optimizes the human and financial resources devoted to ongoing culture change programs and prevents the serious mistakes that are usually visual with hindsight. An eight stage process for creating major change is presented as a basis of mapping culture change programs in long-term care that aspire to be humanistic in nature and involve all stakeholder groups in ongoing, empowering activity.
TL;DR: The author reviews the practical issues related to implementing culture change in nursing homes and identifies the major elements required to maximize the potential for nursing homes to create and sustain culture change.
Abstract: SUMMARY In this article the author reviews the practical issues related to implementing culture change in nursing homes. The merits of model replication are discussed and the barriers to creating and sustaining culture change in nursing homes are highlighted. This is followed by a description of the various dimensions of culture that must be changed including the approach to clinical training and practice, the nature of management and job design, the approach to caring, and the characteristics of the residential environment. The article then identifies the major elements required to maximize the potential for nursing homes to create and sustain culture change.
TL;DR: This paper found that sixth form colleges are dissimilar to general further education colleges in how their culture has changed and that the reasons for the retention of this culture are complex and reflect issues of stability or instability in the market, student mix, different attributions of leadership and the choices of leaders.
Abstract: Analysis of change in the English further education sector since its incorporation in 1993 has assumed a similarity between different types of college and asserted that government policy has led to a sector-wide change in culture. The research reported in this article suggests that sixth form colleges are dissimilar to general further education colleges in how their culture has changed. Unlike many general further education colleges, they haveretained a professional culture and avoided the extremes of managerialism. The reasons for the retention of this culture are complex and reflect issues of stability or instability in the market, student mix, different attributions of leadership and the choices of leaders. Their experience refutes any simple belief that government policy impels cultural change or style of leadership. Rather, both leadership and culture are shown to be complex constructs of context and choice.
TL;DR: In this paper, the authors describe the components that influence an organization's culture and provide seven indicators that the culture might be in trouble, and draw on over 20 years of experience to offer five practical strategies to change performance and change an organisation's culture.
Abstract: Corporate culture – the integrated patterns of human behavior that describe “how we do things around here” – is making a comeback in business literature and discussion. It is an important tool for winning the hearts, minds, and commitment of people. Some believe it is the intangible that provides a sustainable competitive advantage in a world where products and services are commodities. This article asserts that changing performance is the critical component in any culture change initiative. It describes the components that influence an organization’s culture and provides seven indicators that your organization’s culture might be in trouble. Finally, the author draws on over 20 years of experience to offer five practical strategies to change performance and change an organization’s culture.
TL;DR: The authors reviewed the UK government's Science Enterprise Challenge (SEC) initiative, giving particular emphasis to the SEC objective of achieving cultural change, and proposed a "cultural web" framework to achieve cultural change.
Abstract: This paper reviews the UK government's Science Enterprise Challenge (SEC) initiative, giving particular emphasis to the SEC objective of achieving cultural change. A ‘cultural web’ framework is app...
TL;DR: It is Australia's challenge to change the culture of ageing and the perceptions held by the community that elders are powerless and feeble, and some homes in Australia are now beginning to gather base data and some comparative data, which in preliminary fashion indicate positive outcomes for staff and residents.
Abstract: SUMMARY Many Aged Care facilities in Australia are continuing to operate in a traditional medical model, with elders being dependant, living in large institutions and living a life of mere existence. It is Australia's challenge to change the culture of ageing and the perceptions held by the community that elders are powerless and feeble. Australia needs to turn Aged Care facilities into homes, making them attractive for residents, families and staff and to create a life worth living. In recent times some Aged Care providers have begun to research and implement new practices and philosophies such as the Eden Alternative(tm) and culture change, believing that they can create an environment filled with animals, plants and children. Australia has seen the positive results and data from the USA, and some homes in Australia are now beginning to gather base data and some comparative data, which in preliminary fashion indicate positive outcomes for staff and residents. Australia has to continue on the culture cha...
TL;DR: In this paper, the authors argue that the long-term care system is lacking in clear, coherent conceptual underpinnings, and that societal values, public policy, and provider behavior must be responsive to the clear preference of consumers for services that respect their dignity by balancing the system toward home-and community-based services and home-like residential care when needed.
Abstract: SUMMARY This essay asserts that the long-term care system, as we know it, has grown in response to public policy initiatives in other areas. This system is lacking in clear, coherent conceptual underpinnings. If significant culture change is to occur, societal values, public policy, and provider behavior must be responsive to the clear preference of consumers for services that respect their dignity by balancing the system toward home- and community-based services and home-like residential care when needed.
01 Jan 2003
TL;DR: In this paper, the authors investigated a large industrial minerals refinery to analyse the working lives of shop floor employees and the effectiveness of various communication channels, focusing on one group to whom safety messages were communicated, the shop floor ''crews''.
Abstract: Many organisations which aim to achieve excellent workplace safety choose 'culture change' as the means to achieve this. They make use of employee communication media to help re-form the values, beliefs, norms and behaviours which are generally thought to comprise culture. However, culture is a complex and profound phenomenon. Successful communication between two culturally separate groups requires each to achieve an understanding of the other, no less so in workplaces than in societies composed of different cultures.Yet even employers who believe in communicating fully with their workforces find it difficult to convey viewpoints other than their own. Their communication tends therefore to be one-directional, asymmetrical and controlling, typified by the ubiquitous staff newsletter containing articles about people's contribution to corporate goals. The messages contained in such media have little or none of their desired effect because they tend to be re-interpreted via the cultural forces of the workers to whom the messages are directed.This study investigated a large industrial minerals refinery to analyse the working lives of shop floor employees and the effectiveness of various communication channels. It focused on one group to whom safety messages were communicated, the shop floor `crews', and examined how the organisation's hierarchy, rules, and informal organisation mediated this communication.
TL;DR: Key elements of organizational culture that supported a new, more effective bathing practice for residents with dementia are examined, designed to increase their pleasure and comfort and decrease resistive, self-protective behaviors.
Abstract: SUMMARY This case study describes how, following an experimental study, an Oregon nursing home instituted a new, more effective bathing practice for residents with dementia, designed to increase their pleasure and comfort and decrease resistive, self-protective behaviors. Key elements of organizational culture that supported the practice change are examined: creating a shared vision, returning decision-making to residents, empowering caregivers and believing that change is possible.
11 Feb 2003
TL;DR: In this article, a framework is presented for creating lasting organizational change that incorporates an appreciation for chaos theory, and the underlying organizational dynamics that defeat planned change efforts are examined through the unique perspective of Grendel's mother (from the Old English prose poem, “Beowulf”).
Abstract: The study and successful application of organizational change strategies is assuming an increasingly timely relevance in this era of rapid change and increased pressures for competitiveness. Organizational change, whether focused on people, structure, processes, or technology, is inextricably linked with culture change. Much of the practitioner-oriented literature on organizational change treats culture as a tool that can be controlled, manipulated, and integrated by a senior management team and consultants. This paper draws upon lessons learned from cultural anthropology and organizational theory and offers a more complex view that takes into account the strength of organizational subcultures. A framework is presented for creating lasting organizational change that incorporates an appreciation for chaos theory. Secondly, the underlying organizational dynamics that defeat planned change efforts are examined through the unique perspective of Grendel's mother (from the Old English prose poem, “Beowulf”). Grendel's mother provides a provocative image to heighten awareness of the dynamics of organizational life that defeat change efforts. The role of the change agent is explored as Beowulf with a ‘realpolitik’ perspective. Two examples from organization development fieldwork (a failed effort and a successful change program) illustrate the power of chaos theory, the force of Grendel's mother, and the role of Beowulf in planned change programs. By combining theory and practice, this paper seeks to facilitate the dialogue between academics and practitioners about creating lasting organizational change.
TL;DR: A 625-bed teaching hospital in an inner city has implemented tenets of a healing environment using the guiding principles of its Planetree affiliation, and lessons learned in implementing this culture change in a large urban tertiary care facility are described.
Abstract: A 625-bed teaching hospital in an inner city has implemented tenets of a healing environment using the guiding principles of its Planetree affiliation. Patients, visitors, and staff have been the focal points of planning and innovation for 6 years. The challenges of security, safety, and limited resources have required Banner Health's Good Samaritan Medical Center in downtown Phoenix to take a pragmatic approach to implementation. Lessons learned in implementing this culture change in a large urban tertiary care facility will be described. Success factors and model modifications relative to our setting will be identified. Finally, planning efforts, which support continued emphasis on promoting a healing environment, will be outlined as they relate to a $90 million expansion project currently in progress.
TL;DR: It is suggested that peer mentoring is likely to improve CNA retention rates, improve orientation processes so that they reflect the values of the facility, and teach the value of caring.
Abstract: SUMMARY A carefully-crafted peer mentoring program for CNAs may be an appropriate component of any culture change movement in the long-term care setting. This paper contains a detailed description of the peer mentoring program developed bythe Foundation for Long Term Care (FLTC) and how peer mentoring may affect culture, with or without a formal cultural change movement within the facility. In it, we suggest that peer mentoring is likely to (a) improve CNA retention rates; (b) improve orientation processes so that they reflect the values of the facility; (c) reinforce critical skills and behaviors; (d) teach the value of caring; (e) use exemplary aides to role-model exemplary care; (f) support new staff as they make the transition to being part of the facility team; and (g) provide recognition and a career ladder for experienced nurse aides. The nurse aide subculture is critical to a supportive nursing home environment and a culture of caring, and hence, must be considered in any culture change movement.
TL;DR: A clear intervention model and the effects of strengths-based practice on carers, residents, family members and organizational culture when utilized in a nursing home consultation are described.
Abstract: SUMMARY Workplaces across the globe have experienced an unprecedented pace of change. The effects of a problem focus, de-personalisation and over regulation in long-term care settings are experienced similarly by carers, residents, their families and nursing homes as a whole. A pathology focus is no longer appropriate, inviting a paradigm shift to explore how accessing the unique strengths and resources of all parties becomes an imperative role in changing organizational culture. This paper draws comparisons between the experiences and tasks of all those involved in care settings. Adapting the powerful work of Eron and Lund (1996) to organizational settings, this paper describes a clear intervention model and the effects of strengths-based practice on carers, residents, family members and organizational culture when utilized in a nursing home consultation. The model is not only a reactive intervention model, but is a way of re-mobilizing and motivating carers, residents and care settings to be at their best.