Cultural characteristics of “high” and “low” performing hospitals

Cultural characteristics of “high” and “low” performing hospitals Purpose – To compare and contrast the cultural characteristics of “high” and “low” performing hospitals in the UK National Health Service (NHS). Design/methodology/approach – A multiple case study design incorporating a purposeful sample of “low” and “high” performing acute hospital Trusts, as assessed by the star performance rating system. Findings – These case studies suggest that “high” and “low” performing acute hospital organisations may be very different environments in which to work. Although each case possessed its own unique character, significant patternings were observed within cases grouped by performance to suggest considerable cultural divergence. The key points of divergence can be grouped under four main headings: leadership and management orientation; accountability and information systems; human resources policies; and relationships within the local health economy. Practical implications – As with any study, interpretation of findings should be tempered with a degree of caution because of methodological considerations. First, there are the limitations of case study which proceeds on the basis of theoretical rather than quantitative generalisation. Second, organisational culture was assessed by exploring the views of middle and senior managers. While one should in no way suggest that such an approach can capture all important cultural characteristics of organisations, it is believed that it may be at least partially justified, given the agenda‐setting powers and influence of the senior management team. Finally “star” performance measures are far from a perfect measure of organisational performance. Despite such reservations, the findings indicate that organisational culture is associated in a variety of non‐trivial ways with the measured performance of hospital organisations. Originality/value – Highlights considerable cultural divergence within UK NHS hospitals. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Health Organisation and Management Emerald Publishing

Cultural characteristics of “high” and “low” performing hospitals

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Publisher
Emerald Publishing
Copyright
Copyright © 2005 Emerald Group Publishing Limited. All rights reserved.
ISSN
1477-7266
DOI
10.1108/14777260510629689
Publisher site
See Article on Publisher Site

Abstract

Purpose – To compare and contrast the cultural characteristics of “high” and “low” performing hospitals in the UK National Health Service (NHS). Design/methodology/approach – A multiple case study design incorporating a purposeful sample of “low” and “high” performing acute hospital Trusts, as assessed by the star performance rating system. Findings – These case studies suggest that “high” and “low” performing acute hospital organisations may be very different environments in which to work. Although each case possessed its own unique character, significant patternings were observed within cases grouped by performance to suggest considerable cultural divergence. The key points of divergence can be grouped under four main headings: leadership and management orientation; accountability and information systems; human resources policies; and relationships within the local health economy. Practical implications – As with any study, interpretation of findings should be tempered with a degree of caution because of methodological considerations. First, there are the limitations of case study which proceeds on the basis of theoretical rather than quantitative generalisation. Second, organisational culture was assessed by exploring the views of middle and senior managers. While one should in no way suggest that such an approach can capture all important cultural characteristics of organisations, it is believed that it may be at least partially justified, given the agenda‐setting powers and influence of the senior management team. Finally “star” performance measures are far from a perfect measure of organisational performance. Despite such reservations, the findings indicate that organisational culture is associated in a variety of non‐trivial ways with the measured performance of hospital organisations. Originality/value – Highlights considerable cultural divergence within UK NHS hospitals.

Journal

Journal of Health Organisation and ManagementEmerald Publishing

Published: Dec 1, 2005

Keywords: Organizational culture; Hospitals; Performance management; United Kingdom

References

  • Implementing culture change in health care: theory and practice
    Scott, T.; Mannion, R.; Davies, H.; Marshall, M.

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