Culture change

About: Culture change is a research topic. Over the lifetime, 1531 publications have been published within this topic receiving 41922 citations. The topic is also known as: cultural change & culture changes.

Doing the dance of culture change: Complexity, evidence and leadership: commentary

Abstract: The challenge of culture change in hospitals must address three distinct but interwoven tensions: the need to shift paradigm and understand healthcare as a complex adaptive system; the challenge of knitting together the contributions of both evidence-based medicine and practice-based evidence; and the critical role of distributed, problem-focused leadership.The authors of the lead paper highlight five key issues in addressing this challenge: (1) the implementation of strategies like front-line ownership (FLO) in the context of macro-level social forces; (2) the central role of distributed leadership and its strengthening within the organization; (3) the need to attend to developing systems thinking skills at all levels; (4) the very significant challenge of how to scale up the labour-intensive change strategies within FLO, the role of "simple rules" and the potential for systems thinking tools such as concept mapping and dynamic modelling; and (5) the concurrent orchestration of not one culture change but three tensions in the challenge FLO represents to simpler versus complex adaptive systems, leadership and management and the balance between evidence-based medicine and practice-based evidence, at the clinical, organizational and macro-system levels.

Experts' views on long-term care in New Zealand.

Abstract: Aims This study reports findings from the first national survey of long-term care opinion leaders in New Zealand. Methods Potential respondents were chosen purposively based on their knowledge and experience in long-term care policy and planning. Questions focused on assessing views regarding long-term care quality, financing, services, workforce, organisation, and regulation. The survey was administered via Web-based format during May-June 2007. Seventy-three individuals responded for an overall response rate of 47.7%. Results Experts support cost-sharing, insurance, and individual savings/preparation as supplements to predominately government-based financing. They view increased compensation and improved work environments as the key to recruiting/retaining paraprofessionals and educational assistance and curriculum reform as the key to attracting professionals. Most would expand access to home-based support through adoption of comprehensive service packages and various navigational aides (e.g. care coordination, counselling). Consumer-direction and public payment of family members were also deemed desirable. There was a lack of knowledge regarding emerging models of culture change/client-centred care in long-term care. Promoting quality by advising providers about how to improve quality and increasing public availability of comparative provider information was highlighted. Conclusions There are varying degrees of consensus regarding the kinds of solutions to long-term care problems that are viable from a policy perspective. Results should help determine how best to improve the current system to meet the needs of the growing elderly population.

Supporting culture change: working toward smarter state nursing home regulation.

Abstract: The traditional nursing home regulatory approach, which uses survey and enforcement to achieve performance improvement, has created tensions between providers and surveyors. It has had limited success in improving quality overall and not necessarily allowed innovation to flourish. This has been the perception of many homes wanting to undergo transformative "culture change" reforms. To move toward a new model of nursing home regulation, the states and federal government must strike a balance between the traditional regulatory approach to weed out substandard facilities and a partnership model aimed at promoting high performance. This issue brief highlights the importance of how such a model is structured, as well as the need to adequately train and educate regulatory staff and providers about culture change. Regulators, providers, consumer groups, residents, and their families also will need to commit to the principles of person-centered care to ensure the success of the new collaborative approach.

Got the results, now what do you do? Safety culture transformation from theory into practice.

Abstract: Members of the Civil Air Navigation Services Organisation have committed themselves to measure and improve safety culture within their organizations by 2013 (CANSO, 2010). This paper attempts to offer support to air navigation service providers that have already implemented a standardized safety culture survey approach, in the process of transforming their safety culture based on existing survey results. First, an overview of the state of the art with respect to safety culture is presented. Then the application of the CANSO safety culture model from theory into practice is demonstrated based on four selected case studies. Finally, a summary of practical examples for driving safety culture change is provided, and critical success factors supporting the safety culture transformation process are discussed.