title: Restructuring the organizational culture of medical institutions: a study on a community hospital in the I-Lan area.
abstract: Launched in 1995, the National Health Insurance Program has imposed tremendous pressure on hospitals across Taiwan. As a result, most hospitals, especially those of small and medium scale, have gone to great lengths to restructure their organizations in order to continue operating under the new medical setting. Using a community hospital in I-Lan area as its focus, this study attempts to identify the process of organizational culture restructuring in medical institutions. This process includes the two phases of (1) analyzing difficulties faced, with particular emphasis on three problems associated with the existing organizational culture and (2) restructuring the organizational culture and evaluating the restructuring process, with emphasis on four strategies geared to modify the organizational culture and a pre-and-post quasi-experimental study to evaluate outcomes. This study uses a triangulated data collection approach comprising four qualitative data collection techniques that include semi-structured interviews, focus groups, reflective participant observation, and critical review of relevant organizational materials. The evaluation reveals a significant level of difference between employee perspectives on organizational culture before and after restructuring. In short, employees expressed that, after the restructuring, they feel more respected and recognized than before. Research results, based on an organization's cultural restructuring process, show the process by which a hospital successfully restructured its organizational culture. Empirical data derived from the restructuring process may serve as reference for other hospitals contemplating restructuring.
authors.affiliation: Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC. ycchen@vghtpe.gov.tw
authors.forename: Yu-Chih
authors.initials: YC
authors.lastname: Chen
mesh_terms: D003625:Data Collection; D003659:Decision Making, Organizational; D017144:Focus Groups; D006764:Hospitals, Community / Q000458:organization & administration*; D015279:Organizational Culture; D013624:Taiwan