Mash Robert, De Sa Angela, Christodoulou Maria
Division of Family Medicine and Primary Care, Stellenbosch University.
Afr J Prim Health Care Fam Med. 2016 Aug 31;8(1):e1-9. doi: 10.4102/phcfm.v8i1.1184.
Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision.
To explore how to transform the organisational culture in line with the desired values.
Retreat Community Health Centre, Cape Town, South Africa.
Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching.
Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability.
Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.
组织文化是医疗服务中患者体验和员工体验的关键因素。患者满意度、员工敬业度和绩效都与这种体验相关。西开普省卫生部倡导一种以关怀、能力、问责、正直、响应能力和尊重为特征的基于价值观的文化。然而，需要对现有文化进行转变才能实现这一愿景。
探讨如何根据期望的价值观转变组织文化。
南非开普敦的静修社区健康中心。
参与式行动研究，领导层在18个月的时间里参与行动和反思。通过文化价值观评估（CVA）调查在基线时和18个月后测量组织文化的变化。健康中心的三位关键领导者还完成了360度领导价值观评估（LVA）并接受了6个月的辅导。
文化熵从33%降至13%，表明组织文化发生了重大转变。这种转变的关键驱动因素是领导风格和职能的变化。静修健康中心从一种强调等级制度、权威、命令和控制的文化转变为一种建立了更强凝聚力、共同愿景、开放沟通、赞赏、尊重、公平和问责感的文化。
通过一个参与式过程可以实现组织文化的转变，该过程侧重于领导风格、沟通以及通过CVA和反馈、360度LVA、反馈和辅导以及在合作探究小组中的行动学习来建立关系。
