Organisational culture and change: implementing person-centred care

The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person-centred care (PCC) for patients with chronic heart failure.

Surveys were sent out to 170 nurses. The survey included two instruments--the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC).

The results indicate that a culture with a dominating focus on social competence decreases "routine seeking behaviour", i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well-defined framework.

An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a change project. Managers can use instruments such as the ones used in this study to investigate and plan for change processes.

Earlier studies of organisational culture and its impact on the performance of healthcare organisations have often investigated culture at the highest level of the organisation. In this study, the culture of the production units--i.e. the health workers in different hospital wards--was described. Hospital wards develop their own culture and the cultures of different wards are mirrored in the hospital.