Selecting an Organizational Culture Assessment Instrument to Drive Strategies for Optimized Care Environments

Friday, 22 February 2019: 2:55 PM

J. Dwayne Hooks Jr., PhD, MN, BSN, APRN, FNP-BC, NEA-BC, AAHIVS, FACHE1
Becky Whisenhunt, BBA1
Tracy Brickey, MSA, PMP1
Amber Franklin-Lacey, BA2
Karen Smith, MEd, BA3
(1)Center for Strategic Initiatives, Augusta University, Augusta, GA, USA
(2)Quality Management Department, East Central Regional Hospital, Augusta, GA, USA
(3)East Central Regional Hospital Partnership, Augusta University, Augusta, GA, USA

Purpose:

The purpose of this presentation is to discuss the process that a partnership team took to evaluate and select a valid and reliable organizational culture assessment tool. Noting that having an understanding of organizational culture is a critical first step in designing healthy workplace improvement strategies.

Background:

Creating healthy work environments is a universal concern among healthcare organizations. Inpatient Psychiatric State Hospitals are of particular interest, due to the unique challenges that staff, as well as the individuals being served, face. Studies suggest that team members working in psychiatric specific healthcare environments experience various forms of workplace violence including aggressive and hostile acts. Often times, employees who work within these types of care settings are highly stressed which can lead to acts of incivility. Workplace incivility is a form of colleague-to-colleague mistreatment that is prevalent throughout most industries and can negatively impact an organization’s effectiveness. Mistreatment can include acts of rudeness, use of sarcasm, making disparaging remarks, disregarding co-workers, as well as many other negative interactions up to and including overt hostility. Incivility is often associated with burnout, anxiety, feelings of insecurity and lack of safety. These acts lead to high employee turnover which create a significant negative financial impact on the organization and an unhealthy work environment.

The Academic-Practice Partnership:

In an effort to ensure the highest level of quality in a state inpatient psychiatric facility and to evaluate and enhance the work environment, a College of Nursing and a Department of Psychiatry in a southeastern University partnered with the hospital to provide administrative, nursing, and medical services. The hospital takes great pride in providing excellent customer service to its patients and families and is focused on positive outcomes. Considering this, a healthy working environment for employees providing this specialized psychiatric care is critical. Metrics, including employee recruitment and retention as well as qualitative feedback on exit interviews, indicated that the work environment could be enhanced. Knowing this, the College of Nursing spearheaded an endeavor for the partnership team to assess and better understand the organizational culture of this hospital.

Organizational Culture Assessment Tool Selection Process:

In order to objectively measure the organizational culture of this inpatient psychiatric hospital, a core team of five members representing the academic-practice partnership reviewed multiple organizational culture assessment tools. The team believed that an important first step to create a healthy work environment, was to know and understand the current culture of the organization.

After reviewing the literature for various organizational culture assessment tools, and having a teleconference with Human Synergistics regarding their tools, it was determined that the Human Synergistics Organizational Culture Inventory (OCI) and Organizational Effectiveness Inventory (OEI) survey instruments would be the best tools to utilize for the work. The OCI and OEI provides the organization with data needed to identify potential issues that exists in the current culture and which areas were most in need of change. Identification of work environment issues is a catalyst for the creation of action plans needed to enhance the health of the organization’s workplace culture.

The Tools That Were Selected:

The OCI tool is made up of 120 items, which assesses shared norms and expectations that are likely to affect the ways of thinking and the behaviors of group members. Human Synergistics maps the data on a graphic (known as the circumplex) that “illustrates” the type of culture present in the organization. The circumplex is a visual tool that shows the 12 different organizational styles (Achievement, Self-Actualizing, Humanistic-Encouraging, Affiliative, Oppositional, Power, Competitive, Perfectionistic, Approval, Conventional, Dependent, and Avoidance) that are grouped into three general organizational culture clusters. These cultures are arranged in a circular fashion on the circumplex and include the Constructive, Aggressive Defensive, and Passive/Defensive cultures. The goal is to move the culture into the Constructive Culture as this has positive impacts on the health of the workplace environment and leads to favorable employee and patient outcomes metrics. A discussion regarding the interpretation of the data utilizing the circumflex will be included in this presentation.

Required Training To Administer the Organizational Culture Assessment Tools:

In order for the core team to be able to administer the OCI and the OEI, an accreditation process was necessary. The five-member team attended the culture accreditation workshop that prepares and accredits participants to administer and interpret the OCI and OEI survey tools and associated data. The accreditation process entailed attending a 4-day conference teaching the participants how to interpret, initiate, and monitor organizational change. The training also included the identification and mapping of progress using levers for change and organizational outcomes. The team successfully completed the accreditation process, which consisted of the analysis and interpretation of OCI and OEI Feedback Report results and an associated examination. The team was able to interpret and use the statistical information presented in the report to align the OCI and OEI scales to the organization’s mission, vision, and desired outcomes and make connections between the causal factors, operating culture, and outcomes. By comparing the organization’s current operating culture to the Ideal culture, the team was able to identify significant gaps, areas of improvement and levers for change to strengthen the associated Constructive culture styles and develop an action plan for moving to a healthier workplace environment. This presentation will include a discussion about the accreditation process as well as how to use the data to create action plans to contribute to an enhanced workplace culture.

This presentation has numerous implications for healthcare and non-healthcare organizations who desire to assess their organizational culture utilizing a valid and reliable instrument with the main goal of enhancing the health of their workplace environment.

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