Department of Management, Faculty of Economics, Management and Accountancy, University of Malta, Malta.
Department of Policy in Health, Ministry for Health, Malta.
Int J Qual Health Care. 2019 Jul 1;31(6):426-432. doi: 10.1093/intqhc/mzy204.
To study the organizational dynamics that either enable or inhibit the changes needed by the system for the ongoing organizational development of the major acute general public hospital in Malta.
The main public acute general hospital in Malta. Malta is the main island of a small archipelago in the Mediterranean with a total population reaching around 460 000.
This qualitative study utilized two major research methods: action research and in-depth interviews. Data collection and analysis were guided by the grounded theory paradigm and operated within a constructivist and informed grounded theory approach. The action research was conducted through the documentation and interpretation of a practitioner-researcher experience working within a multi-disciplinary hospital team consisting of up to 15 members from different healthcare professional groups. The in-depth interviews involved 25 interviewees using theoretical sampling techniques.
The findings affirmed the high potential and capabilities of the hospital workforce. This potential is nonetheless susceptible to be affected and gradually transformed by identified organizational and external forces into a workforce that is highly territorial, cynical and showing lack of 'ownership' of the organizational vision and objectives. The organizational culture, structures, systems and leadership as well as external factors that were frequently rooted at the national level were identified as strong impacting and underlying factors.
A theoretical framework was generated depicting a vicious circle that needs to be broken to enable the desired organizational development and learning. This additional knowledge can be used by and inspire other organizations operating within comparable conditions.
研究系统内部促进或阻碍变化的组织动态，以支持马耳他主要急性综合公立医院的持续组织发展。
马耳他主要公立医院。马耳他是地中海一个小群岛的主要岛屿，总人口约 46 万。
本定性研究采用了两种主要研究方法：行动研究和深入访谈。数据收集和分析以扎根理论范式为指导，并在建构主义和知情的扎根理论方法内进行。行动研究通过对多学科医院团队中一位从业者-研究者的经验进行记录和解释来开展，该团队由来自不同医疗保健专业群体的多达 15 名成员组成。深入访谈涉及使用理论抽样技术的 25 名受访者。
研究结果证实了医院员工的高潜力和能力。然而，这种潜力很容易受到组织和外部力量的影响，逐渐转变为具有强烈地域观念、愤世嫉俗和缺乏对组织愿景和目标的“所有权”的员工队伍。组织文化、结构、系统和领导力以及经常根植于国家层面的外部因素被确定为强有力的影响和潜在因素。
生成了一个理论框架，描绘了一个需要打破的恶性循环，以实现所需的组织发展和学习。这一附加知识可以被在类似条件下运作的其他组织使用和启发。
