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HCA 822 TOPIC 3 Discussion Question One

HCA 822 TOPIC 3 Discussion Question One

 

When creating a culture of quality outcomes in a health care organization, do the notions of diversity and shared values conflict with one another? Why or why not?

Too often the term culture is used as a metaphor for something the organisation is thought to have. But acknowledging that culture is a complex construct can allow more judicious application of the concept. Paying greater attention to the multilayered and multifaceted

complexity underlying the term—and recognising that many and varied cultural subgroups make up our healthcare organisations—opens new avenues for understanding the deeply social and discursive nature of complex organisations.

How these insights are used in quality improvement depends on both other conceptual framings of the healthcare setting, the aspect of

HCA 822 TOPIC 3 Discussion Question One

HCA 822 TOPIC 3 Discussion Question One

service quality or performance to be improved, and on the precise nature of the quality improvement methods to be used.6 For some framings and improvement methods, culture is key; for others, cultural aspects are in the background. Our view is that the cultural dimensions of organisations are an important substrate on which improvement focused change is being sought and that, although never fully manageable, cultures can be better understood and must be purposefully shaped.

 

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Finally, the cultural framing of healthcare organisations draws attention to specific aspects of organisational life: the shared patterns of feeling, thinking, talking, and accomplishing that underpin local practice. In doing so, other equally important aspects of organisational life may be marginalised or neglected, such as individual skill, attitude, and responsibility; governance and performance management arrangements; the macro structural arrangements within which local service lines are embedded; the incentives spread across the system; and the availability of material resources, human capital, and knowledge. Each of these aspects interacts with and can sometimes overwhelm cultural features, with a resultant effect on the ability to shape and improve culture and services. The choice to focus improvement efforts on healthcare culture to the exclusion of, say, policy frameworks or resource constraints, inevitably has political ramifications, and these should be dealt with rather than ignored. Cultural reform in healthcare is no substitute for adequate resourcing. That said, the cultural perspective outlined here provides an insightful way of thinking and a practical set of tools to support wider quality improvement work in healthcare.

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