How to change organisational culture: Action research in a South African public sector primary care facility

Background: 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 car...

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Main Authors: Robert Mash, Angela De Sa, Maria Christodoulou
Format: Article
Language:English
Published: AOSIS 2016-08-01
Series:African Journal of Primary Health Care & Family Medicine
Subjects:
Online Access:https://phcfm.org/index.php/phcfm/article/view/1184
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author Robert Mash
Angela De Sa
Maria Christodoulou
author_facet Robert Mash
Angela De Sa
Maria Christodoulou
author_sort Robert Mash
collection DOAJ
description Background: 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. Aim: To explore how to transform the organisational culture in line with the desired values. Setting: Retreat Community Health Centre, Cape Town, South Africa. Methods: 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. Results: 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. Conclusion: 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.
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spelling doaj.art-49176c3583f14801a837df53e288543a2022-12-22T03:45:29ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362016-08-0181e1e910.4102/phcfm.v8i1.1184407How to change organisational culture: Action research in a South African public sector primary care facilityRobert Mash0Angela De Sa1Maria Christodoulou2Division of Family Medicine and Primary Care, Stellenbosch UniversityDivision of Family Medicine, University of Cape Town and Western Cape Department of Health, District Health ServicesDivision of Family Medicine and Primary Care, Stellenbosch UniversityBackground: 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. Aim: To explore how to transform the organisational culture in line with the desired values. Setting: Retreat Community Health Centre, Cape Town, South Africa. Methods: 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. Results: 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. Conclusion: 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.https://phcfm.org/index.php/phcfm/article/view/1184organizational cultureorganizational changeprimary careleadershiphealth services research
spellingShingle Robert Mash
Angela De Sa
Maria Christodoulou
How to change organisational culture: Action research in a South African public sector primary care facility
African Journal of Primary Health Care & Family Medicine
organizational culture
organizational change
primary care
leadership
health services research
title How to change organisational culture: Action research in a South African public sector primary care facility
title_full How to change organisational culture: Action research in a South African public sector primary care facility
title_fullStr How to change organisational culture: Action research in a South African public sector primary care facility
title_full_unstemmed How to change organisational culture: Action research in a South African public sector primary care facility
title_short How to change organisational culture: Action research in a South African public sector primary care facility
title_sort how to change organisational culture action research in a south african public sector primary care facility
topic organizational culture
organizational change
primary care
leadership
health services research
url https://phcfm.org/index.php/phcfm/article/view/1184
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