The healthcare industry has undergone considerable transformations during the past decades becoming a sphere where people expect to receive a variety of high-quality services related to their (or their close ones’) health and wellness. In order to gain a competitive advantage, health-related companies have to pay more attention to organizational behavior and culture.
The analysis of employees’ performance, attitudes, communication patterns, and motivation is critical for the development of a strong organizational culture that can ensure excellent performance of an organization (Borkowski, 2016). This paper includes an assessment of the current organizational culture at a skilled nursing facility (SNF) and a description of the changes to be implemented to create a collaborative culture and improve the organization’s performance.
Organizational Behavior Review and Assessment
The skilled nursing facility under consideration consists of such units as long-term nursing home, acute care and recovery, respite care, and respiratory and physical rehabilitation. In order to assess the facility’s organizational culture, it is necessary to consider the central aspects of organizational behavior that should be addressed in detail. Organizational behavior is a study of people’s behaviors within an organization, the interaction between people and the organization, as well as the behavior of the organization as a whole (Borkowski, 2016). When addressing these areas, it is important to concentrate on such aspects as attitudes and perceptions, motivation, and communication.
People’s attitudes and perceptions shape their behavior, so these concepts deserve specific attention. Attitude can be defined as “a mind-set or a tendency to act in a particular way toward an object or entity… due to both an individual’s experience and temperament” (Borkowski, 2016, p. 47). Therefore, when analyzing employees’ attitudes and perceptions, the focus should be on their beliefs, values, personality traits, motivations, as well as behaviors (Borkowski, 2016).
Perception is the human’s ability to process information and interpret certain sensations based on their experiences in order to produce new experiences. Motivation is a psychological process that implies the reaction to stimulus in order to achieve certain goals (Borkowski, 2016).
Employees’ motivation is often associated with gaining some benefits (salary, perks, and other positive outcomes) through the display of a particular behavioral pattern (improved performance or involvement in specific processes). Finally, communication is the exchange and generation of information, ideas, emotions between senders and receivers (Borkowski, 2016). The brief description of the major components to be considered is instrumental in the effective analysis of the organizational culture at the facility in question.
The attitudes and perceptions of the nursing staff of the skilled nursing facility are mainly positive and fair, which can be regarded as a positive trend. Healthcare professionals are overwhelmed with tasks, which may have a negative effect on their emotional state. However, they try to remain positive, committed to organizational goals, and complete tasks effectively. The attitude towards conflicts in the organization is rather negative, so nurses try to avoid any conflict situations.
Another strength related to employees’ attitudes and perceptions is practitioners’ showing respect and helpfulness to patients, as well as their colleagues. Nevertheless, such elements as motivation and communication are primarily characterized by weaknesses. The personnel’s performance is deteriorating due to fatigue and burnout. Poor communication is one of the most influential factors contributing to current performance and motivation. Nurses are reluctant to collaborate with their peers effectively or even interact more with each other.
Organizational Culture at the SNF
The organizational culture has a significant impact on employees’ performance, attitudes, motivations, and interactions. A strong culture facilitates effective communication, increases the staff’s productivity while reducing turn over and minimizing work-related stress (Lei, Le, & Nguyen, 2017). If an organization has a weak or no organizational culture, the staff has no set values and models to display a pro-active behavior. The organizational culture of the facility under consideration is characterized by certain strengths and weaknesses.
As far as the positive aspects of the existing culture, such values as autonomy, integrity, and fairness are shared by the staff, which contributes to high performance. The personal is diverse in many areas including but not confined to age and ethnicity. This diversity is also beneficial for any healthcare facility because employees can deliver high-quality services to diverse populations. Nevertheless, teamwork as the facility is ineffective and is not properly integrated into the organizational culture. People are not motivated to grow professionally, which has a negative impact on their performance. Nurses are unwilling to participate in training and development initiative when the administration launches such projects. Finally, work-life balance is another weakness that demotivates the staff.
Proposed Cultural Change
Collaborative Culture
The existing organizational culture can be replaced by the collaborative culture that encompasses values and practices contributing to the creation of a healthy working environment. The collaborative culture presupposes mutual respect and interdependence, and every employee brings in certain values (Lei et al., 2017). Under such conditions, all members of the staff support each other and remain active in different work-related situations. Effective communication is an important component of this culture since employees are able and willing to share knowledge, experience, ideas, and information freely. The focus on such principles and practices is beneficial for any organization as this working environment ensures high performance and, as a result, a competitive advantage.
Appreciative Inquiry Approach
In order to implement change successfully, it is beneficial to use a sound framework that would guide the process. The appreciative inquiry (AI) approach can be instrumental in changing the current culture at the SNF in question. AI “engages and energizes” employees to become “an active component of the positive change process” by sharing knowledge and experiences (Ohmer, Barclay, & Merkel, 2018, p. 40).
The model implies the focus on five stages leading to change: define, discover, dream, design, and deliver (Borkowski, 2016). The change agent or a group of people implementing the change are leading the process, but they attempt to engage as many members of the group as possible. The chosen change model is the most appropriate under such circumstances because it contributes to the creation of a collaborative environment.
The first stage is defining that presupposes the identification of the problem or the situation that has to be changed. During the discovery stage, the change agent or a group of people implementing the change discuss or initiate a wide discussion of different aspects of the issue (Ohmer et al., 2018). Meetings, surveys, interviews, conversations, and reports can be the employed data collection methods. The dream phase involves the development of potential solutions that can take the form of a description of the most desirable situation.
Similar methods can be utilized to come up with these solutions. The design stage is devoted to the creation of a detailed plan that will bring employees’ ideas and desires to life. An effective plan includes manageable tasks and people responsible for their completion, as well as realistic deadlines. Finally, the delivery phase is concerned with the exact implementation of the plan created in a collaborative manner.
Culture Change Plan
A change plan for the SNF under consideration is presented in Table 1 presented below. The plan is based on AI and the steps offered by Ohmer et al. (2018). This plan of change presupposes a considerable degree of collaboration of the employees, which, in turn, will have a positive effect on the development of the collaborative culture. In the five-stage process, employees will develop proper communication channels and will obtain certain skills necessary for effective interaction. Clearly, the process will be guided by a nurse leader as the coordination of the change-related activities is critical for success. It is important to emphasize the need to engage all employees including nursing staff, administration, and other groups.
As far as specific instruments involved in the process, surveys, reports, interviews, and discussions will be utilized. A set of these tools enables the researcher to elicit information from different sources and encourage all individuals to share (Davis, 2019). Reporting and surveys can be conducted with the help of the existing information system at the SNF. At that, all employees should have access to this technology, or have alternative ways to voice their ideas. Ineffective communication is the primary issue to be addressed, so it is necessary to use diverse methods and strategies, which will result in the adoption of the most appropriate channels and procedures.
An additional and quite central aspect to be mentioned is the need to provide training to the personnel alongside the implementation of the plan provided above. Davis (2019) notes that people should understand what they think and do differently to understand the need for change and see diverse ways of implementing change. The staff should have conflict management skills to share ideas freely because conflicts tend to be avoided while discontent is often unvoiced openly at the SNF.
The nurse leader should also have a specific set of ideas to make the process semi-structured. Clearly, collaboration is the key to the successful implementation of change, but the staff should remain focused on one or several problems instead of trying to solve all issues that arise. It is also critical to ensure the flexibility of the plan as the process of change may be affected by numerous factors and stakeholders. Therefore, the nurse leader should be prepared to introduce new aspects and activities or remove the ones that will prove to be ineffective or rather unpopular among the personnel.
Due to the employees’ reluctance to participate in any initiatives, it may be necessary to use different kinds of motivational strategies. First, the nurse leader should articulate the major outcomes of the process, which will be a better working environment, less job-related stress and workload. The personnel should understand that the ideas they will voice have a chance to become a part of their daily routine. Some monetary awards for best performance, active participation, or brilliant ideas can be considered as an option.
Measuring the Outcomes
The measurement of the change is an important stage of its implementation. The primary focus is on communication and collaboration, so these criteria will be central for evaluation. Self-reporting will be the major data collection tool employed to estimate the effectiveness of the process of change. At that, all employees will complete brief reports before the start of the project and two months after the start of the implementation stage. The staff will report about the communication channels they use, the communication channels they find effective, the level of support in the working place, the level of their satisfaction.
The final reports will have similar questions (but the wording will be different), and several other items will be added. For instance, the employees will express their views concerning the process of change implementation by grading some aspects and outcomes. Self-reporting will help all employees think of the changes they tried to introduce as well as the benefit (and downsides if any) of the collaboration with their peers.
Conclusion
On balance, it is possible to note that the major problem at the SNF under discussion is ineffective communication that contributes to the lack of support and motivation. The personnel members are overwhelmed with tasks, and job satisfaction is quite low. Effective communication can improve the situation and contribute to the improvement of the current culture. The goal of this change implementation is the development of a collaborative culture that implies employees’ mutual support, effective communication, and active participation in organizational processes. The use of the appreciative inquiry approach is beneficial in the present case as it facilitates the creation of collaboration.
Employees are involved in the process of change, and they acquire new communication skills through close interaction with each other. The proposed project will require the provision of training with the focus on such areas as conflict management and communication skills.
The measurement process will be divided into two parts as the employees will complete reports before the start of the project and two months after the start of the implementation stage. The change should be facilitated by the introduction of some motivational tools including monetary awards or other types of encouragement for employees. The organizational climate is likely to transform into a collaborative culture as the process of change presupposes a considerable degree of collaboration.
References
Borkowski, N. (2016). Organizational behavior in health care (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Davis, K. K. (2019). Exploring best practices among appreciative inquiry practitioners for determining impact. AI Practitioner, 21(3), 79-103. Web.
Lei, H., Le, P. B., & Nguyen, H. T. H. (2017). How collaborative culture supports for competitive advantage: The mediating role of organizational learning. International Journal of Business Administration, 8(2), 73-85. Web.
Ohmer, D. G., Barclay, A., & Merkel, B. (2018). Using appreciative inquiry to manage generation Y. Journal of Management Policy and Practice, 19(2), 37-49. Web.