PURPOSE: The purpose of this paper is to explore the different subcultures and the employees' preparedness for change at an orthopaedic clinic in a university hospital in Sweden. DESIGN/METHODOLOGY/APPROACH: Surveys were sent out to 179 nurses and physicians. The survey included the two instruments Organisational Values Questionnaire and resistance to change (RTC) Scale. FINDINGS: The results suggest a dominance of a human relations culture, i.e. flexibility, cohesion and trust, in the orthopaedic clinic. These characteristics seemed to decrease RTC. Opposite to this, planning, routines and goal setting appeared to increase change-resistant behaviour. PRACTICAL IMPLICATIONS: By predicting potential obstacles in a certain context prior to a change process, resources can be used in a more optimal way. An instrument that pinpoints the culture of a particular healthcare setting may be a useful tool in order to anticipate the possible outcome of change. ORIGINALITY/VALUE: The rational goal/internal processes dimension exerted a stronger association with RTC than in earlier studies. Deeply rooted standards and routinised care models, governed by work schedules, could be an obstacle to introducing a care model based on the individual needs of the patient. There was, however, a surprisingly low RTC. The results are contrary to the accepted understanding of public organisations known to be slow to change.
PURPOSE: The purpose of this paper is to explore the different subcultures and the employees' preparedness for change at an orthopaedic clinic in a university hospital in Sweden. DESIGN/METHODOLOGY/APPROACH: Surveys were sent out to 179 nurses and physicians. The survey included the two instruments Organisational Values Questionnaire and resistance to change (RTC) Scale. FINDINGS: The results suggest a dominance of a human relations culture, i.e. flexibility, cohesion and trust, in the orthopaedic clinic. These characteristics seemed to decrease RTC. Opposite to this, planning, routines and goal setting appeared to increase change-resistant behaviour. PRACTICAL IMPLICATIONS: By predicting potential obstacles in a certain context prior to a change process, resources can be used in a more optimal way. An instrument that pinpoints the culture of a particular healthcare setting may be a useful tool in order to anticipate the possible outcome of change. ORIGINALITY/VALUE: The rational goal/internal processes dimension exerted a stronger association with RTC than in earlier studies. Deeply rooted standards and routinised care models, governed by work schedules, could be an obstacle to introducing a care model based on the individual needs of the patient. There was, however, a surprisingly low RTC. The results are contrary to the accepted understanding of public organisations known to be slow to change.
Authors: R van der Gulden; N D Scherpbier-de Haan; C M Greijn; N Looman; F Tromp; P W Dielissen Journal: BMC Med Educ Date: 2020-09-03 Impact factor: 2.463