Organizational culture and resistance to change in the chania general hospital. Upgrade of service quality

Abstract

OBJECTIVE Assessment of the possibility of applying a new model of management (Total Quality Management) in the General Hospital of Chania in Crete, aimed at upgrading service quality. METHOD The present organizational culture in the hospital was investigated, along with the wishes for the next five years of the hospital personnel, and the level of resistance to change among the personnel was assessed. The study participants were 160 hospital employees selected by the method of non-random sampling, based on quota per service category (doctors, medical personnel other than doctors, nursing personnel, administrative and technical service personnel and other scientific specialties). The Organizational Culture Assessment Instrument (OCAI) and the Resistance to Change (RTC Scale) were completed by the participants for the measurement of organizational culture and resistance to change, respectively. RESULTS The current dominant culture that emerged from the responses to the OCAI is the hierarchical, which is based on control (32.49%), and the desirable culture reported for the next five years is the clan culture, which is based on cooperation (32.67%). The cultures with the lowest recorded rates were, for the present, the adhocracy culture, which is based on creation (18.69%), and for the next five years the market culture, which is based on competition (18.73%). Concerning attitudes towards change, the scores showed marginally average values for total resistance to change (3.01 on a scale from 1 to 6), with slightly higher scores on the subscale of cognitive rigidity (3.75), expressing the cognitive processing of change. Non-parametric tests, applied to detect possible variation in scores according to the demographic characteristics of the sample, showed no statistically significant differences (p<0.05). Spearman correlations showed no relationships between cultures and resistance to change, with the exception of correlation between the current adhocracy culture and cognitive rigidity (p=0.00) and between the current hierarchical culture and total resistance (p=0.002). CONCLUSIONS Success in implementing the Total Quality Management model presupposes the coexistence of elements of all cultures in an organization. The presence of elements of all cultures in the General Hospital of Chania (indicating the absence of one strong culture) and the mean values in resistance to change, are positive aspects for the application of such a model in this hospital. © Athens Medical Society.