Interdependence of values shared by healthcare organization workers and quality of providing services to patients

Abstract

The present paper discusses the peculiarities of manifestations of three levels of organizational culture in a healthcare center: the level of artifacts, of values and of underlying assumptions. The first level is determined through the average “patient day” factor, which implies the percentage of total amount of medical services provided. The second level is determined through the extent of occupational burnout of health care workers. It manifests itself through the type of organizational culture and the index of personnel’s loyalty to a medical department. The third level manifests itself through the parameters of the value profile of staff members belonging to separate medical departments. The parameters of the third level of organizational culture were mostly examined in the present paper.

The authors developed a theoretical model of the level of underlying assumptions of the organizational culture in the situation of professional uncertainty. For each of the key indicators there were specified personal systems of values of health care workers. For the indicator “openness to change” these values are self-direction, stimulation and hedonism; for the indicator “self-enhancement” they are achievements and power; for the indicator “conservation” – security, traditions, conformity; for the indicator “self-transcendence” – benevolence and universalism.

The paper provides the results of comparing the structures of different value systems and describes the gap between moral views and personal preferences in behavior of the workers of two surgery units in the multi-specialty Moscow city hospital. The research was conducted in relation to the objective parameters of staff activities of the departments under consideration.

Schwartz personal values questionnaire was used as the diagnostic test instrument. It was assumed that objective parameters of work efficiency in two similar departments depend on a value profile of the core staff – the change leaders. The gap between moral ideals and personal preferences of the heads of two surgery units under consideration differs by approximately four times, of surgeons – by two times, of nurses – no difference in gaps was observed.

The investigation performed is the implementation of the first stage – distinguishing peculiarities of organizational culture of health care workers. The data obtained within this research should be taken into account when working out a PCDA cycle for a change leader. The cycle presented in the present work can be implemented when holding a set of certain group events called moderation sessions. During such sessions, heads of departments and nurses act out their interaction. Implementation of certain cases has become the main form of work.