Running head: Organizational Culture 1

Organizational Culture

By: Danica Pauline F. Nuestro

Concordia University Chicago ADP Program

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INTRODUCTION

Culture is a critical part in healthcare safety and quality. Culture change has been an

important factor for innovating organizations in recent years; In geriatrics, much has been placed

in changing the delivery of care; from an institutionalized approach to a more patient centric,

individualized and qualitative approach. Culture change began as a grassroots movement in the

1990s, led by The National Citizens Coalition for Nursing Home Reform (NCCNHR) to pass the

legislation; from the passage of the Omnibus Budget Reconciliation Act of 1987 (OBRA 87)

and the requirement that nursing homes meet the physical, mental, and psychosocial needs of

each resident.

Despite national efforts, there are still issues and questions that needs to be addressed

today, specially to those who provide care for patients; one, is the lack of quality healthcare

education to meet current healthcare needs. In a micro level, there is a need for checks and

balances on Private Vocational institutions, since they are some of the leading trainers of the

healthcare workforce today.

Halstead (2016) said that To produce nurses prepared to practice in reformed health care

environments, we can no longer educate our nursing students using the traditional educational

practices that we have long embraced. There exists no substantive evidence to suggest that our

traditional means of clinical education in nursing and other health professions are particularly

effective in developing clinical reasoning, so it is an opportune time to closely examine our

educational practices and create new learning paradigms that are grounded in evidence. As an

employee of a small healthcare vocational school in the suburbs of Illinois; I can see multiple

operational issues, a low employee morale and need for enforced rules and regulations within our

company.
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COMPANY PROFILE

General Business Activities: ABC Healthcare and Training Center (not the real company

name) has been established as an Allied Health and Practical Nurse Training Institute. It provides

education for individuals interested in entering the Healthcare field. The companys mission is to

promote the health and well-being of Illinois residents, primarily by providing proper patient

care and patient safety. Furthermore, the goal is to ensure that the healthcare workforce

deployed are highly competent and empowered. As well as to support the ever-growing patient

care and health care needs of Illinois residents. CMK Healthcares vision is committed to

providing high standards of training and services to prepare nursing and healthcare workforce of

present and future as well as providing low cost tuition and flexible payment schedules.

Majority of the company's student population are attending programs to be Nurse

Assistants and Practical Nurses. Student career opportunities are within the Long-term care

facilities, whether home health care, assisted living or nursing homes. Currently, the company

employs 1 part time general office worker, 1 dean, 6 part - time instructors and is run by the

owner and his family. To understand the current situation of the company as well as its strategic

directions, a SWOT analysis was completed:

Strengths Weaknesses
- Fast Paced program - No financial aid
- Diverse student body - Not accredited
- Central location - Limited schedule options
- Proactive partnership with senior living - Sluggish response to student needs
facilities in the area - Limited resources for faculty and staff
- Reasonable tuition rate - Limited personnel
- Decent amount of student enrollees and an - Poor operational structure
extensive student database
Opportunities Threats
- Increased demand for healthcare workforce - Increased in reporting expected by the govt. and
- Increased focus on qualitative vs. numerical society
achievement - Increased competition
- Partnership in - Societal and student perception of education as
- Technological advancements means for job only
- Reporting requirements absorb large resources
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CURRENT CULTURE/NORMS

The companys owner and his family control most of the daily operating decisions, there

is no organizational chart developed; this results in miscommunication as well as confusion in

decision making. There is only one employee that assists in daily operations, business

development, marketing, public relations and overall strategic actions; This employee wears

multiple hats within the organization and only works part time. Because of that, there are issues

in mastery as well as function design. Instructors usually has limited resources. One example is

the lack of proper clinical laboratory equipment, sometimes instructors will provide their own. In

one instance, an instructor was forced to copy examination materials outside because the office

has no paper. These are small operational issues that are easy to fix, however, improper

management makes it difficult to get a solution.

New technologies are also being implemented statewide, and the company is pressured to

adapt to these changes. Furthermore, in the past 6 months, there is an increase in instructor call

offs and high turnover rates; Unqualified instructors are being hired to fill in the position of the

qualified instructors who decided to quit. To make it worst, scheduled classes has been cancelled

multiple times, registered students are not happy and income is lost. Nursing student enrollment

process is quantity and not quality based. Because of this, the company has a lower than average

pass rate. ABC Healthcare and Training Centers vision and mission are explicitly found in their

website and plastered in every corner of the company. However, they are not enforced. Company

values are not articulated as well as prominently communicated among the employees.

The SWOT analysis above showed how most of the companys issues are internal. In

further detail, the weaknesses are mostly attributed to human resource and lack of efficient

operational process. Due to the above circumstances, organizational change is needed.

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DEGREE OF CHANGE

Knowing the above deficiencies help in deciding whether the organization requires a

transformation in its degree or functioning. Radical change is not fit for the current issues of the

company. Using incremental change, helps in the ongoing process of evolution overtime, during

which many small adjustments occur routinely (Hellriegel, Jackson & Slocum, 2008).

DRIVERS OF CHANGE

The organizations goal includes the deployment of highly competent healthcare workers

who would provide high quality care. However, such goals are impeded by the current

organizational culture.

Creating a new culture within an organization can be challenging, ambiguous and

baffling. Since culture is somewhat uncertain in nature and shift of culture does not occur by

chance; a strategic plan of action must be made and implemented accordingly.

The call for the organizations change must come from above. Management must take

into action and address the current issues they are facing. They can offer seven driving factors,

such as: (a) leadership, (b) evidence-based practice, (c) teamwork, (d) communication, (e) a

learning culture, (f) and a just culture (Halstead, 2012). But there should also be emphasis as to

who will lead the change specifically. A change driver should be assigned to take charge in the

change initiatives.

HUMAN CAPITAL

Understanding what motivates employees help management make better decisions while

positively impacting the workplace. However, employee needs are not only intrinsic but extrinsic
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as well. Knowing what fit their overall needs, making sure that they are doing their job well and

rewarding them appropriately may reduce turnover rate. Using the model of expectancy theory

can help understand the nature of behavior and build more effective organizations.

However, people need to share what they know, coordinate with others, putting all the

pieces together helps in improving performances. Employee performance depends on available

resources, the help from coworkers and the infrastructure to help the work.

NEW EDUCATIONAL MODEL

The organization requires a redesign in its structure and processes. There are different models

that need to be done. First is building right faculty capacity; second is creatively designing new

models of clinical education; third, developing innovative models of academic/practice collaboration;

and advancing the science of nursing education through research. These models would only work

with the help of competent faculty members and an alignment of goals with the change leader.

CONCLUSION

Transforming the health care system requires a significant re-examination of current

education models not only in the macro level but in the micro level as well. To produce a

healthcare workforce prepared in the reformed healthcare environment, traditional practices can

no longer be embraced. A reference instrument must also be designed to help promote and

monitor the continuous improvement of vocational education and training systems based on

commonly agreed references. The adoption of change takes time; proper execution is required

for successful implementation. Recognition of deficiencies is the first indication for the need to

change.
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REFERENCES

Hellriegel, D., Jackson, S. E., Slocum, J. W., & Hellriegel, D. (2008). Managing: a

competency-based approach. Mason, OH: Thomson South-Western.

Jabbarian, J., & Chegini, M. G. (2016). The Effect of Perceived Organizational

Support on Employee Resistance to Change: A Study on Guilan Municipal Staff. Journal

Of History, Culture & Art Research / Tarih Kltr Ve Sanat Arastirmalari Dergisi, 5(4),

642-654. doi:10.7596/taksad.v5i4.627

Osland, J. (2007). The organizational behavior reader. Upper Saddle River, NJ:

Pearson Prentice Hall.

Patient Safety Culture: The Nursing Unit Leader's Role. (n.d.). Retrieved February

10, 2017, from

http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJ

IN/TableofContents/Vol-16-2011/No3-Sept-2011/Patient-Safety-Culture-and-Nursing-Unit-

Leader.aspx

Quality assurance in vocational education and training (EQAVET) - Education and

training - European Commission. (n.d.). Retrieved February 12, 2017, from

https://ec.europa.eu/education/policy/vocational-policy/eqavet_en

Transforming Nursing Education to Meet Emerging Health Care Needs. (2012,

September 21). Retrieved February 12, 2017, from http://www.rwjf.org/en/culture-of-

health/2012/09/transforming_nursing.html
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