Changing the ward culture in a clinic during the implementation of person-centred care

Abstract

Objective: The purpose of this study was to explore the impact of an intervention on the organizational culture in five hospital wards in Sweden. The organizational culture was measured at the start of the project and compared with data collected five years later. The intervention was aimed at changing activities towards a new evidenced-based care model called the Gothenburg Person-centred Care model (PCC).
Methods: In total, 230 registered nurses and assistant nurses participated in this cross-sectional health-care culture survey during 2009 and 2014. The Organizational Values Questionnaire was used.
Results: The results indicated cultural change in all five wards at the clinic. A dominating culture of flexibility decreased and a culture of routines and structure increased. The wards moved towards a higher degree of cultural uniformity. The combination of cultural dimensions also seems to have become more equal during the study period.
Conclusions: Few studies have focussed on the development of organizational culture in health-care contexts over time. The results suggest that the implementation of a new model of care has an impact on organizational culture. This implies that health-care managers should have confidence in the outcomes from change projects. It seems that systems of dual logic can develop over time to facilitate change and sustainability. However, if a new working model is to change the culture profoundly, it requires years of zealous implementation.