How to change organisational culture: Action research in a South African public sector primary care facility.
BACKGROUND
Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision.


OBJECTIVE
To explore how to transform the organisational culture in line with the desired values.


METHODS
Retreat Community Health Centre, Cape Town, South Africa.


METHODS
Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching.


RESULTS
Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability.


CONCLUSIONS
Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.
Division of Family Medicine and Primary Care, Stellenbosch University. rm@sun.ac.za.
Robert
R
Mash
Angela
A
De Sa
Maria
M
Christodoulou
D055812:Community-Based Participatory Research / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D007857:Leadership; D015279:Organizational Culture; D009936:Organizational Innovation; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration*; D017150:Public Sector / Q000458:organization & administration; D013019:South Africa