A tale of two hospitals: assessing cultural landscapes and compositions

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dc.contributor.author Braithwaite, J
dc.contributor.author Westbrook, M
dc.contributor.author Iedema, RA
dc.contributor.author Mallock, NA
dc.contributor.author Forsyth, R
dc.contributor.author Zhang, K
dc.date.accessioned 2010-05-28T09:55:45Z
dc.date.issued 2005-01
dc.identifier.citation Social Science and Medicine, 2005, 60 (5), pp. 1149 - 1162
dc.identifier.issn 0277-9536
dc.identifier.other C1UNSUBMIT en_US
dc.identifier.uri http://hdl.handle.net/10453/10354
dc.description.abstract Clinical directorate service structures (CDs) have been widely implemented in acute settings in the belief that they will enhance efficiency and patient care by bringing teams together and involving clinicians in management. We argue that the achievement of such goals depends not only on changing its formalised structural arrangements but also the culture of the organisation concerned. We conducted comparative observational studies and questionnaire surveys of two large Australian teaching hospitals similar in size, role and CD structure. Martin's conceptualisation of culture in terms of integration, differentiation and fragmentation was applied in the analysis of the data. The ethnographic work revealed that compared to Metropolitan Hospital, Royal Hospital was better supported and more favourably viewed by its staff across six categories identified in both settings: leadership, structure, communication, change, finance and human resource management. Royal staff were more optimistic about their organisation's ability to meet future challenges. The surveys revealed that both staff groups preferred CD to traditional structures and shared some favourable and critical views of them. However Royal staff were significantly more positive, reporting many more benefits from CDs e.g. improved working relations, greater accountability and efficiency, better cost management, more devolvement of management to clinicians and a hospital more strategically placed and patient focused. Metropolitan staff were more likely to claim that CDs failed to solve problems and created a range of others including disunity and poor working relationships.
dc.publisher Elsevier Ltd
dc.relation.isbasedon 10.1016/j.socscimed.2004.06.046
dc.title A tale of two hospitals: assessing cultural landscapes and compositions
dc.type Journal Article
dc.parent Social Science and Medicine
dc.journal.volume 5
dc.journal.volume 60
dc.journal.number 5 en_US
dc.publocation Oxford, UK en_US
dc.identifier.startpage 1149 en_US
dc.identifier.endpage 1162 en_US
dc.cauo.name FASS.Faculty of Arts and Social Sciences en_US
dc.conference Verified OK en_US
dc.for 1608 Sociology
dc.personcode 100638
dc.personcode 100973
dc.percentage 100 en_US
dc.classification.name Sociology en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords Hospitals; Organisational culture; Clinical directorates; Australia en_US
dc.description.keywords Hospitals
dc.description.keywords Organisational culture
dc.description.keywords Clinical directorates
dc.description.keywords Australia
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Arts and Social Sciences
pubs.organisational-group /University of Technology Sydney/Strength - Research in Learning and Change
utslib.copyright.status Closed Access
utslib.copyright.date 2015-04-15 12:17:09.805752+10
utslib.collection.history Closed (ID: 3)

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