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Organizational culture and the implementation of person centered care: Results from a change process in Swedish hospital care

Journal article
Authors Tariq Alharbi
Inger Ekman
Lars-Eric Olsson
Kerstin Dudas
Eric Carlström
Published in Health Policy
Volume 108
Issue 2-3
Pages 294-301
ISSN 0168-8510
Publication year 2012
Published at Institute of Health and Care Sciences
Pages 294-301
Language en
Links dx.doi.org/10.1016/j.healthpol.2012...
Keywords Organizational culture, Person centered care, Sweden, Public health
Subject categories Health Care Service and Management, Health Policy and Services and Health Economy

Abstract

Abstract Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.

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