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Organisational culture and change

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Organisational culture and change

  1. 1. Wissen durch Praxis stärkt Faculty 4: Health and Social Work Slide 1 29 November 2018 Organisational Culture and Change How the culture of an organisation influences it´s staff and functions Prof. Dr. Michaela Röber Professor for nursing sciences and clinical care Prof. Dr. Michaela Röber
  2. 2. Content 1. Organisational culture and change management 2. Organisational culture and Change in German health care facilities 3. People & Change in healthcare facilities: Success factors 4. Conclusion Slide 2 Prof. Dr. Michaela Röber 29 November 2018
  3. 3. Content 1. Organisational culture and change management 2. Organisational culture and Change in German health care facilities 3. People & Change in healthcare facilities: Success factors 4. Conclusion Slide 3 Prof. Dr. Michaela Röber 29 November 2018
  4. 4. Organisational culture 4 Prof. Dr. Michaela Röber 29 November 2018 Fundamental beliefs (non-observable / unconscious / emotional / based on experiences) • Assumptions • Perceptions • Thoughts • Feelings Artefacts, Norms and values (observable) • Commitment towards staff and public • Tradition Source (picture): https://www.sinus-art.com/120x80cm-wasser-eisberg-natur-unterwasser, Stand 14.11.2018.
  5. 5. Effects of organisational culture 5 Prof. Dr. Michaela Röber Goal orientation (compass effect) Anticipative problem solution Smooth communication Quick decision-making Motivation and team spirit Stability Tendency to lock up Tendency to inertia Blocking new orientations ("we've always done that") Collective defense attitude Building emotional barriers Lack of flexibility 29 November 2018
  6. 6. Change Management • Systematic approach to dealing with a transition or transformation of an organization's goals, processes or technologies • Purpose: Implementation of strategies for effecting change, controlling change and helping people to adapt to change • Systematic approach for helping individuals impacted by "the change" be successful by building support, addressing resistance and developing the required knowledge and ability to implement the change (managing the people side of the change) Slide 6 Prof. Dr. Michaela Röber 29 November 2018 ? Sources (pictures): https://www.westwingnow.de/rattan-stuhl-ko-lanta-59331.html, https://www.furnissimo.de/stuhl-patchwork-bunt-2er-set-sit4717-30, Stand 14.11.2018;
  7. 7. Spheres of influence for change management 7 Prof. Dr. Michaela Röber 29 November 2018 Direct and indirect sphere of influence Source (picture): https://www.sinus-art.com/120x80cm-wasser-eisberg-natur-unterwasser, Stand 14.11.2018.
  8. 8. People´s reaction on change (1) 8 Prof. Dr. Michaela Röber 29 November 2018 Source: https://www.torbenrick.eu/blog/change-management/change-management-comic-strips, 16.10.2017.
  9. 9. People´s reaction on change (2) 9 Prof. Dr. Michaela Röber 29 November 2018 Source: In Anlehnung an Vahs, Dietmar, Organisation. Ein Lehr- und Managementbuch, 8. Aufl., 2012, S. 368, vgl. auch Streich, 1997, p. 243. Shock Surprise or shock at the event Denial Disbelief, looking for evidence that it isn´t true Integration Changes integrated a renewed individual Experiment Initial engagement with the new situation Decision Learning how to work in the new situation; feeling more positive Frustration Recognition that things are different; sometimes angry Depression Low mood; lacking in energy Morale and competence Time Information Communikation Training Coaching Mentoring
  10. 10. Content 1. Organisational culture and change management 2. Organisational culture and Change in German health care facilities 3. People & Change in healthcare facilities: Success factors 4. Conclusion Slide 10 Prof. Dr. Michaela Röber 29 November 2018
  11. 11. • Multi-professional teams • Expert-organization • Job satisfaction • Support for innovations • Interfaces between healthcare sectors • Collaboration / cooperation / mergers of health care institutions  Many projects fail! Importance of organisational culture in healthcare? 11 Prof. Dr. Michaela Röber 29 November 2018
  12. 12. Germany and Hessia…. Slide 12 Prof. Dr. Michaela Röber 29 November 2018 Source: xxx.
  13. 13. 61 265 334 Komm. Liga Private Outpatient nursing services in Germany by ownership (example: Hessia) Slide 13 Prof. Dr. Michaela Röber 29 November 2018 Source: Statistisches Bundesamt; 2015 33 815 265 1995 2015 9 % 40 % 61 % 3 % 23,8 % 73 % 660 services 1117 services Non-profit Public Private
  14. 14. Number of patients of nursing services in Germany (size and growth rate) Slide 14 Prof. Dr. Michaela Röber 29 November 2018 Source: https://www.pflegemarkt.com/2017/02/27/anzahl-ambulante-pflegedienste-in-deutschland/, Stand 10.11.2018. Growth rate in %Number of services Size by number of clients
  15. 15. Organisational culture and ownership in German healthcare facilities 15 Prof. Dr. Michaela Röber 29 November 2018 Public Non- Profit Degree of risk taking Degreeofstafforientation Private • Private owners due to their livelihood market-oriented • Non-profit owners ecclesiastic and charitable (specific history with other legal and statutory framework) • Public owners (cities, municipals, federal states) focus on ensuring regional healthcare High Low
  16. 16. Content 1. Organisational culture and change management 2. Organisational culture and Change in German health care facilities 3. People & Change in healthcare facilities: Success factors 4. Conclusion Slide 16 Prof. Dr. Michaela Röber 29 November 2018
  17. 17. Stage Model of change 17 Prof. Dr. Michaela Röber 29 November 2018 Goal orientation / vision for change Motivation to start change (Unfreezing) Managing people and change (Move) Making people live with new framework (Refreezing) Quelle: In Anlehnung an Lauer, Thomas, Change Management, Grundlagen und Erfolgsfaktoren, 2. Aufl., S. 70 ff., (pictures): https://www.westwingnow.de/rattan-stuhl-ko-lanta-59331.html, https://www.furnissimo.de/stuhl-patchwork-bunt-2er-set-sit4717-30, Stand 14.11.2018.
  18. 18. What is the history of our facility? What is the way of making organisational decisions? What is the staff´s reaction to organisational changes? What factors are relevant in terms of rearranging the organisation (e.g. patients, staff, strategy, technology, level of digitization) Does the staff have certain routines to bridge the gap of organisational problems? Change Management is very complex and has to consider a variety of challenges… 18 Prof. Dr. Michaela Röber 29 November 2018
  19. 19. Means to overcome resistance • Transparent Change Processes -> Information and Communication • Participation of staff and Joint Decision Making (Better "Change" than “Beind changed") • Create confidence • Create acceptance by taking small steps • Stability and security / consideration of long-term work and social relations • Support measures: e.g. qualification of the people affected through training and coaching • Creating "quick wins“ • Rapid stabilization of changes 19 Prof. Dr. Michaela Röber 29 November 2018
  20. 20. Selected success factors of change 20 Prof. Dr. Michaela Röber 29 November 2018 Cooperative leadership (nurses, doctors, administration) Joint vision Involvement of all parties affected Communi- cation Re- education Project organisation
  21. 21. Content 1. Organisational culture and change management 2. Organisational culture and Change in German health care facilities 3. People & Change in healthcare facilities: Success factors 4. Conclusion Slide 21 Prof. Dr. Michaela Röber 29 November 2018
  22. 22. Consequences for change management in healthcare • Designing change and always is a huge challenge especially for healthcare organisations • Decision makers have to deal with change in addition to their everyday tasks • Successful change = sum of systematic, targeted work and creative search for possible solutions 22 Prof. Dr. Michaela Röber 29 November 2018 Creativity Hard factors • Strategy • Organisation • Systems Soft factors • People • Organisational culture +/-= Success of change
  23. 23. 23 Prof. Dr. Michaela Röber 29 November 2018 Source: https://me.me/i/lm-sure-glad-the-hole-isnt-in-our-end-none-19532380, Stand 14.11.2018.
  24. 24. Wissen durch Praxis stärkt THANK YOU for YOUR ATTENTION… Slide 24 29 November 2018Prof. Dr. Michaela Röber
  25. 25. 25 • Verbesserung der Pflegeinfrastruktur und Pflegequalität durch Markt und Wettbewerb? • Mit Einführung der Pflegeversicherung gesetzlich verankerte Gleichstellung von gemeinnützigen und privat-gewerblichen Trägern von Pflegeeinrichtungen • Rechtsanspruch auf Abschluss von Versorgungsverträgen und damit Zugang zum „Pflegemarkt“ unabhängig vom konkret vorliegenden Bedarf. • „…damit soll ein geschlossener Markt der zugelassenen Einrichtungen verhindert, neuen innovativen Anbietern der Zugang zum Pflegemarkt offen gehalten werden und der Wettbewerb unter den Einrichtungen gefördert werden…“ (Deutscher Bundestag, 1993) Prof. Dr. Michaela Röber 29 November 2018
  26. 26. Development of number of inpatient home care units by ownership Slide 26 Prof. Dr. Michaela Röber 29 November 2018 Source: Gesellschaft für Wirtschaftliche Strukturforschung (Hrsg.), Struktur des Pflegemarktes in Deutschland und Potentiale seiner Entwicklung. Kurzfassung der Studie im Auftrag des Bundesministeriums für Wirtschaft und Energie, p. 8, https://www.gws-os.com/discussionpapers/Kurzfassung_ProjNr_019_16.pdf, Date: 06.11.2018.. Numberofhomecareunits Estimation Private PublicNonprofit

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