HR Assignment report writing help on: Organizational culture model of health care sector

1. Executive summary

The report has been formulated to highlight a pilot study of the organizational culture model within the health care sector. The study was conducted amongst the health care sector taking into consideration the questionnaire method to gather reviews. The questionnaire based study will help to perform an in depth qualitative as well as quantitative analysis of the reviews so gathered. Based upon the various authors it has been concluded that, organizational culture model would be considered to be as one of the useful tools which would narrow down the sub cultural differences. Pilot study conducted over organizational culture will showcase opportunities which would help to exchange the information as well as encourage an open discussion within the various sub groups. The quantitative as well as the qualitative results attained from the pilot study will help to have a better understanding within the healthcare sector.2. Introduction

The Academic Medical Clinic Centre is a highly complex organization. The medical clinic constitutes of individuals belonging to diverse language, culture, artifacts, division of labor, rules etc. The individuals working within the medical centre interact with one another in order to achieve a common goal pre decided by the organization. The individuals within the medical centre operate interdependently hence a small change in any of the parts will lead to changes within the entire system.

This report takes into consideration an exploratory study regarding the value of the organizational model within the medical clinic Veteran Affair (VA). It has been assumed within the report that, various types of existing sub-cultures within the medical center would be held responsible for certain types of conflicts within the capitated model (Wade & Yarbrough, 1996).Pilot study refers to preliminary research which is carried on a temporary or trial basis. The pilot study refers to a type of study which takes into consideration an extensive training program. Within the pilot study, an extensive training program is carried out with fewer participants. In achieving the goals & objectives of the same various aspects such as improvising upon data collection, checking out standards the pilot study will provide improvements within the entire training program. The pilot study helps to reduce or minimize the unforeseen problems which might help in the redesigning of the training programs (Institute of Health & Care Research, 2010).

3. Body

Based upon the research carried out by Schein, it has been that development of culture on the basis of shared experiences & common history. Hence, Schein believes that development of culture consists of various sub cultures. A minute change within any of the sub-cultures will act as a major threat as it will create problems in the levels of stability and defend against the effects of change. According to Schein, it has been concluded that there are three types of cultures. In order to have a detailed understanding regarding the dynamics of change, the three types of cultures shall be known. They are as follows:

3.1  Engineer culture

3.2  Operator culture

3.3  Executive cultureÞ    Operator culture: The operator culture takes into consideration people who are involved within the front line delivering of the products which have been guaranteed by the enterprise. After applying the Schien concepts regarding the culture, it consists of the nurses, staff members within the clinic, trainees, and faculty members. Their main focus would be to provide health maintenance as well as prevention of the illness within the population of patients currently in the academic medical centre. It has been seen that, the operator culture majorly relies upon trust, hard work, working in teams as practice high levels of communication. According to Schein, this type of culture has been referred to provide daily experience no matter how many rules & procedures are associated with it. It shall be taken into consideration that there are unpredictable surprises or contingencies which might arise anytime(Wade & Yarbrough, 1996).

Þ    Engineer Culture: The second type of culture which is highlighted according to Schien concepts of culture refers to Engineer Culture. This type of culture takes into consideration the processes with which the organization manufactures the products as well as services offered to the public at large. The engineer culture is based upon technology, education & work experience. It has been seen that, this type of culture relies upon achieving reliable as well as efficient operations. It shall be seen that, engineer culture within the medical clinic takes into consideration the guideline developer, managers operating the systems & other specialists (Institute of Health & Care Research, 2010). The operator culture takes into consideration interdependence with the other groups but at the same time the engineer culture takes into consideration culture from a global perspective. It identifies the professional groups which are linked from the outside world rather than the colleagues within the enterprise.

Þ    Executive culture: The last type of culture refers to the executive culture. The executive cultures are mainly responsible for the survival of the enterprise which would mainly focus upon decreasing the costs & maximize the profits earned by the medical clinic. Based upon the executive culture, the executives believe that hierarchy within an enterprise plays one of the most important roles in control & coordination the various activities. The executives are generally away from the front line operations. The executives just like the engineers will identify the people situated outside the organization rather than communicating within the enterprise (Institute of Health & Care Research, 2010).METHODS

The method which would be used to conduct pilot study within the medical centre will be with the help of a well established questionnaire.

The hospital underwent high levels of pressure that is to add new patients since the VA system switched towards the capitated reimbursement. The organizational model applicable within the medical centre had various types of difficulties. A hypothesis was undertaken i.e. the executive along with the operators and engineers existed within the organization (Wade & Yarbrough, 1996). Their views regarding the capitated model would be lined up with their own sub cultures. In order to review the same, a three test question was taken into consideration wherein various assumptions of subculture were positioned against one another. A descriptive clinical questionnaire was framed & each question was rated on a five pointer scale i.e. agree, strongly agree, strongly disagree, much more & much less (Smith & Tillema, 1998).

The respondents were told to circle the most appropriate option with respect to their view point over the question listed in the questionnaire. After circling the most appropriate option the respondents were asked to write a statement providing a formal justification for the same.In order to have more specific answers & results a pilot study was conducted taking into consideration a testing sample consisting of 6 members. These members included people from various cultures, sub-cultures as well as people belonging to the current organizational model. After an in depth discussion with the focus group, the questionnaire was duly revised and circulated amongst 60 odd people (Radhakrishna, 2007). The final draft of the questionnaire focused mainly three questions i.e. increase in the workload will have a negative affect over the levels of quality & satisfaction, secondly, guidelines as well as models could be used on day to day basis within the hospital and lastly, VAMC devotes right amount of resources in order to support the various guidelines as well as the models. The questionnaire was distributed amongst the clinical staff members, faculty members, residents, people at the administration levels, etc. the overall response rate which was analyzed from the results was approximately 65 percent. Before a well define discussion regarding the results of questionnaire were done, the authors took into consideration the culture where in the respondents could best fit in the job description, familiarity levels, etc. There were three types of cultures which could be seen within the medical centre. They are executive culture, engineer culture & operator culture. The executive culture consisted of 6 people in number i.e. chief staff, administrative staff, hospital director, staff assistant, associate staff & executive secretary (Fischer & King, 1995). The engineer culture consisted of 5 people in number i.e. a physician who created the clinical guidelines; a practitioner, a nurse, physician & assistant to the physician were involved. The rest 49 people were considered to be a part of the operator culture which involved patient care duties, etc.

Questionnaire

The questionnaire was duly revised and circulated amongst 60 odd people.

5. RESULTS AND ANALYSIS

5.1 Quantitative analysis

Based upon the review of the questionnaire, a quantitative analysis was made. The response rate which was analyzed was approximately 65 percent. It was clearly seen that 67 percent response rate was seen amongst the executive culture, 61 percent was seen amongst the operator culture & 100 percent was seen amongst the executive culture. Executives belonging to the top level management did not respond which lead to an error while analyzing the results of the questionnaire. On an average, all the respondents gave a score ranging from 3 – 4 on a five pointer scale (Heesmans, 2007). The standard deviation which was calculated was approximately 0.92. This highlights the fact that, there were less effect on the questionnaire and high variability amongst the responses were seen within the same. The scores generated from the questions were used to calculate the analysis of variance or ANOVA.

The first question which was highlighted within the questionnaire was to see whether an increase in the workload leads to a negative affect over the quality & levels of satisfaction. This question was designed to separate the executive as well as operator cultures

As mentioned above, the statement, “Increasing workload is negatively affecting quality and satisfaction,” was designed to separate the executive and operator cultures, pitting desire to increase market share against time pressures and perception of quality. The results have been shown as under:

                                    Figure 1 (Source: Institute of Health & Care Research, 2010)

Engineer v/s operator: The guidelines along with models can be used in day to day activities in the medical clinic. The guidelines along with the models have been designed to provide separate cultures for both engineer as well as the operators. The results have been shown as under:

                                    Figure 2 (Source: Institute of Health & Care Research, 2010)

Executive v/s Engineer: The guidelines as well as the models were used in order to figure out the right amount of resources which would support as well as separate the engineer culture from the executive culture. The results have been shown as under:

                        Figure 3 (Source: Institute of Health & Care Research, 2010)

 5.2 Qualitative analysts

Approximately 42 percent of the respondents provided their responses & the qualitative analysis over the same was performed.Respondents provided brief statements in support of their beliefs in 42 percent of the responses. There was no difference among groups in willingness to offer qualitative responses. Statements were analyzed blindly by recursively grouping them into conceptual bins using Non-numerical, Unstructured Data – Indexing, Structuring and Theorizing. The data then were analyzed within the new coding system until new discrepancies were found and negotiated. This iterative process continued (six iterations) until the following stable set of coding concepts was created: cost; market share; efficiency; variability; guideline; poor quality; good quality; capacity; increased resources; time pressure; stress; and not work (meaning the concept didn’t or wouldn’t work) (Cheng Chang, 2001). Coding with this stable set of concepts showed a final inter-rater agreement of 85 percent, which was consistent across subcultures.

Executive versus operator: In case of an executive & an operator, the statement which led to a response was an increase in the workload will have a negative impact which would affect the quality as well as satisfaction level of the same. The statement is corresponded by various other statements which would provide qualitative analysis over the same.

Engineer versus operator: In case of an engineer & an operator, the statement which led to high levels of response was the guidelines and models will have practical use within the day to day activities in the clinic. This statement further has various sub statements which provides qualitative analysis over the same (Cheng Chang, 2001).

Engineer versus executive: In case of engineer and executive, the qualitative statement which made the response was that, right amount of resources were used in order to support the guidelines as well as the models. The statement is taken into consideration, followed by various types of statements which provide detailed qualitative analyses for the same.

6. Conclusion & Recommendation

Some of the recommendations within the enterprise have been described as under. They are:

Þ    The pilot study shall be utilized within the organization as it will help in strengthening the medical settings.

Þ    The pilot study will help to maintain balance between the different types of culture as well as provide fair understanding within the same.

Þ    The qualitative as well as quantitative analysis of the same will help the medical center to exaggerate the cultural polarization.

Hence, it can be concluded that pilot study provides a preliminary research taking into consideration limited number of target population. In this report, the Schein organizational culture model has been used within the academic medical clinic. It is an instrument which has been designed to provide change issues within the organizational culture. The questionnaire was piloted tested as well as administered by 65% of the staff members. The quantitative analysis clearly states that, there are various patterns for the “Executive v/s Operator” & “Engineer v/s Operator”. Within the medical clinic, there are various types of cultures which might act as a barrier in maintaining balance as well as fair understanding between the same.

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