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Organizational Culture and Climate Final

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Chrissie Speca

on 15 April 2014

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Transcript of Organizational Culture and Climate Final

Organizational Culture vs. Climate
Although organizational culture and climate have distinct meanings, both contribute to the overall success or failure of an organization.

So , what is the difference?
What is Organizational Climate?
Organizational Climate is:
an atmosphere related to working and practice conditions
more grounded in the psychological experience of organizational life than culture
“Some see climate factors as the most obvious or immediate reflections or results of culture” (Clarke, 2006).
1. Differentiate organizational culture from organizational climate.
2. Comprehend the implications of organizational culture and climate for nurses and health care professionals.
3. Identify different subcultures that embody an organization's culture.
4. Understand the impact of organizational culture and climate on patient outcomes, job satisfaction, and overall safety.
5. Discuss the impact of leadership style on organizational culture and climate.

Organizational Culture and Climate
Data From Survey Monkey
Example of organization’s culture and values displayed in the mission statement
CHOP Mission Statement

“The Children's Hospital of Philadelphia, the oldest hospital in the United States dedicated exclusively to pediatrics,
strives to be the world leader in the advancement
of healthcare for children by
integrating excellent patient care, innovative research and quality professional education
into all of its programs” (The Children's Hospital of Philadelphia, 2014).

What is Organizational Culture?
An organization’s values/mission
“The accumulation of invisible, often unspoken ideas, values, and approaches that permeate organizational life” (Clarke, 2006).
"What an organization perceives as its purpose and priorities” (Clarke, 2006).
Schein (1992) describes three levels of manifestation of culture:
-Artifacts (readily observed environment)
-Espoused values (the strategies, goals, and policies)
-Basic underlying assumptions (unspoken ideas at the heart of the organization’s success)

What makes up an organizational culture?
Organizational Culture: “ the assumptions, beliefs, attitudes, values, and experiences of the organization” (Ross, 2011).
Beliefs- understanding of how the organization works
Values- traits, qualities, activities or behaviors
Traditions-repetitive events
Norms-informal rules (dress work habits, hours,interpersonal behavior)

Organizational Climate (cont.)
Organizational climate refers to how an organization focuses on:
Appreciation and recognition
Concern for employee well-being
Learning and development
Citizenship and ethics
Quality performance
Involvement and empowerment

Climate: Chance or Design?
Organizational Climate can be the result of chance or design
Climate by
: no particular attempt to change natural environment
Climate by
: aims to improve motivation by the means of improving performance
Considerations in climate design:
Arrange work relationships within departments to promote working towards a common goal
Have an understanding of how workers and groups are alike and different

Positive Climate vs. Negative Climate
-Employee satisfaction
-Positive attitudes
-Increased sense of autonomy and self worth→ -Improved productivity and commitment to the organization
-Increased retention rate
-Strong support system

-Employee dissatisfaction; main reason for turnover
-High turnover can cause increased costs for the organization
-Employees have little trust or motivation if they feel that system is unfair or inconsistent
-Lack of support- feelings of alienation
Subcultures are smaller groups and factors within the organization that influence the overall organizational climate.
Social Culture is a cultural concept that is created by individuals of a social system, and their interactions with other individuals.
Social (cont.)
Generational Differences
The global nursing workforce represents four generations of nurses
“Nurses eat their young”
Bullying and hostility in the workplace
Working against each other rather than helping each other rise to the top
The older generation or “baby boomers” want meaningful work; newer generation nurses or “millennials” tend to desire flexibility

Generational Differences: Implications for Practice
Acceptance of generational diversity in the workplace allows for a richer scope of practice
The experiences and knowledge of each generation are valuable in the nursing environment
The use of the 3 C’s (
communication, commitment, and compensation
), creates a harmonious environment that facilitates nursing retention .
Proper education, boosts in morale, and promoting a zero-tolerance environment helps to diminish abuse and improve proper communication

Overcoming Generational Differences

“Develop the ideas that shared visions enhance nursing knowledge and practice by shifting the focus of being different to having a common patient-centered purpose” (Hendricks & Cope, 2012).

Safety Culture
“Patient safety culture describes the commitment to safety that permeates a healthcare organization” (Arnetz, et al., 2011).
Key elements include:
blame free environments
communication regarding adverse events
allocation of resources for healthcare professionals
compliance with procedures
promoting a collaboration between the multiple health care disciplines
“Evidence supports that organizations with higher levels of safety climate have fewer adverse events, higher reporting of errors and near misses, better communication among managers and staff, and higher patient safety” (Ross, 2011).

Safety & Blame-free Environment

Blame-free environment: nonpunitive response to mistakes lessens the fear among nurses to report errors or safety issues.
Establishing a successful safety culture encourages reporting of errors, shared accountability, and learning from errors which have occurred.
An Ohio study reported that “8% of nurses and 9% or nursing assistants avoided reporting mistakes, whereas 27% of nurses and 22% of nursing assistants felt they were being punished after filing an incident report (Arnetz, et al., 2011).
Conversely, a recent study on violence in healthcare settings showed “a higher likelihood of reporting violent incidents in care facilities that discouraged blame and encouraged patient and employer safety” (Arnetz, et al., 2011).

Safety & Patient Outcomes
Patient Safety Outcomes
A recent study showed that hospital which reported a “high perception of the fear of blame and punishment reported higher rates of decubitus ulcers and postoperative deep vein thrombosis and pulmonary emboli” (Ross, 2011).
Organizations with successful safety cultures encourage nurses to provide adequate interventions, promote round-the-clock patient care, and ultimately diminish errors.
Ethical Climate
Ethical climate is defined as “the individual perceptions of the organization that influences attitudes and behavior and serves as a reference for employee behavior” (Schluter et al., 2008).
Poor ethical climate in a healthcare organization can be caused by:
Hierarchical power that inhibits nurse autonomy
Inadequate nurse to patient ratios
Hospital policies
Legal constraints

Ethical Climate: Moral Distress

Ethical Climate:
Impact on Nurses
Moral distress has a large impact on a nurse’s attitudes toward the profession, including:
reduction in nurse’s interactions with patients, resulting in limited patient advocacy, disjointed care and declining patient outcomes.
higher level of burnout among nurses
increased nurse turnover rates related to poor job satisfaction
exacerbation of nursing shortage among healthcare organizations.

Ethical Climate: Moral Distress (cont.)

Moral distress developed by nurses working in a poor ethical climate is caused by obstacles such as:
inability to provide appropriate care
orders to provide futile care
unsuccessful patient advocacy
provision of unrealistic hope to patients and their families
lack of respect by physicians for patient’s and family’s wishes
Nurses’ perceptions of the ethical climate of their organization are related to level of job satisfaction and commitment to the organization.

Ethical Climate:
Social Exchange Theory

This theory explains that “when an employee experiences a positive influence in an organization, he or she will return the favor in the most economical and effective way” (Huang & Tsai, 2012).
Many studies have found this theory to hold true in the healthcare organizations. If an employee experiences a caring, positive climate from his or her healthcare organization, he/she will experience a desire to return the favor by implementing dedicated working habits with positive behaviors.
Healthcare organizations must make the implementation of a strong ethical climate in their establishment a priority to prevent unethical behaviors and professional negligence of its employees .

Ethical Climate: Benefits

The formation of positive ethical atmosphere in a healthcare organization:
increases nurse efficiency
enhances quality of care
improves patient satisfaction
increases ethical behaviors among nurses
improved collaboration among healthcare professionals
increases nurse’s job satisfaction
decreases nurse’s experience of moral distress
decreases burnout among nurses
lower costs related to decreased nurse turnover

Job Satisfaction
Magnet Status and Culture
The characteristics associated with Magnet hospitals are strongly related to employee support and empowerment structures.

Magnet hospitals strongly encourage nurse managers to provide staff nurses with readily available support resources.

The link between nurse empowerment and Magnet hospital characteristics of professional practice are reflective of a positive organizational culture.

By implementing surveys and questionnaires, researchers have found that employees are satisfied with their jobs when they work in an organization with a strong organizational culture .
Their surveys and questionnaires identified important factors that contribute to employee job satisfaction, including:
communication among members
a common vision between leaders and subordinates
encouragement and support of members to achieve a common vision

Implications for Nurses and Health Care Professionals

Organizational Culture and Climate influences the quality of performance that can take place in a given situation
High quality performance is more likely to take place in settings where the climate is primarily positive relative to:
the organization and its goals
to the individual workers and their needs
ie. Manager actions are important for employee level outcomes

An organizational culture allows for an organization to share values and beliefs
Effective leadership helps implement the core values of an organization in nursing units.
A strong culture is established when the leaders values and visions are aligned with the rest of the organization
Consistent behaviors among members of the organization helps reduce conflicts and create a supportive, healthy environment for employees
Creating a positive environment therefore increases job satisfaction

Management and leadership behavior also affect nurses’ job satisfaction
Employees receive positive reinforcement from their unit managers when they are able to successfully complete tasks assigned to them.
Organizational culture provides guidelines for behavior within organizations
Strong organizational culture allows employees to develop common values and codes of conduct that will facilitate the achievement of a common goal.
Achieving these shared goals positively impacts job satisfaction among nurses.

Patient Outcomes

Organizational climate has been shown to have potential relevance for the effective management of both chronic and preventative care.

VA Study on Organizational Climate

A study was conducted in the U.S. Department of Veterans Affairs, which is organized in regional networks divided into hospitals and outpatient clinics.
Organizational climate was measured through an annual voluntary survey of all VA employees collected in May 2007.

VA Study Results

Relational climate was positively related to an increased likelihood of diabetic patients: receiving annual foot inspections and HbA1c tests, and maintaining blood pressure at recommended levels (Benzer et. al, 2011).

Patient care can be influenced by provider and system-level factors.

VA Study

The survey consisted of three focuses: individual, workgroup, and facility organizational levels.
The study measured both task and relational climate
Task climate: a management focus on achievement and improvement
Relational climate: a management focus on mutual support and respect

The study focused on primary care clinic effectiveness of the management of Diabetes.

Which leadership style results in a positive, effective organizational climate and culture?

Laissez-faire leadership & Organizational Culture and Climate

Laissez-faire leadership: “free reign;" the absence of a purposeful interaction between the leader and the follower, in which the leader avoids making decisions, abdicates responsibility, and does not use his or her authority.
Conversely, the laissez -faire leadership style does not influence a nursing unit’s culture because there is an absence of purposeful interaction between nurse managers and staff nurses. A strong organizational culture cannot be developed if there is a lack of leader-follower relationships

“Management's Role in Shaping Organizational Culture” (Kane-Urrabazo, 2006)

Managers/leaders in an organization play an important role as they have a direct impact in the organizational culture/climate
Trust and trustworthiness, empowerment and delegation, consistency and mentorship- were all common traits important for leaders to utilize in order to create a “good” environment for workers

Trust & Trustworthiness
Leaders need to have trust/ confidence in their staff
-Need to be honest with staff in order to gain their trust- trust must be given to be received
-Must be reliable

Today, nurse managers play a pivotal role in the success or failure of hospitals’ units. This affects the performance of the hospital as a whole.
Managers play a key role in maintaining this positive organizational culture and climate.
“Managers can reawaken in workers the spirit that makes an organization great” (Gohar-Murray & Langan, 2011).

Transformational Leadership & Organizational Culture and Climate

Transformational leadership: the ability to influence others toward achievement of extraordinary goals by changing the followers’ beliefs, values, and needs.
Data shows that
a nurse who implements a transformational leadership style is likely to shape an effective unit organizational culture characterized by the implementation of:

A mentor is an “experienced individual who guides a novice member's transition to a new culture and the expectations of a new role” (Bally, 2007).
The responsibility of the mentor is to introduce the new nurse to the philosophies, goals, policies, procedures, and professional developmental challenges within a new work environment
Factors that enhance mentoring interactions
value conflicts
recognition opportunities
support within the acute care hospital setting

Consistency and Mentorship
Don’t contraindicate yourself
Flexible but also consistent
Rewards/discipline needs to be consistent
No trust/motivation if feelings of unfairness
Help introduce organizations values- as well as provide a support system as well as a resource for new nurses to go to
Help alleviate some anxiety, decrease feelings of alienation, increase productivity, and increased retention

Empowerment and Delegation
Include the staff in problem solving/ decision making
-Use committees to allow input into decisions such as scheduling
-Don’t delegate for the wrong reasons
-*Helps to improve attitudes of employees- sense of worth since they are included

Strategies for Resolution

Organizational Support (i.e management support)
Build morale
Old rewards systems that support unsustainable behavior must be replaced by new reward systems that incent new objectives
Empower and foster independence and autonomy
Create a comfortable environment in which employees feel free to express new ideas and put their ideas into action.
Strengthen communication chains
Encourage suggestions
Encourage creativity
Encourage use of training and employee development opportunities
Energize enthusiasm for challenging work

Strategies for Resolution (continued)

A clear purpose and well-defined goals
Team spirit
This requires management and employees to collaborate in order to to pursue a common goal. This requires a sense of shared purpose and belonging.
Productive meetings
Team initiative
Team suggestions
Creative teams
Self-managed teams
Managers can design less-restrictive policies and procedures
Creating and maintaining a rewarding environment and benefits
Allowing community involvement during time at work
Arrange work relationships within and between departments

There are many factors that affect an organizational climate. In implementing these strategies, managers can provide a positive organizational climate and culture driven towards high-quality patient care.

Questions, Comments, Concerns?
Thank you for listening!
Has anyone experienced a negative social climate in past clinical rotations or summer internships?

Poor ethical climate leads to moral distress among nurses.
Moral distress is the “guilty” feeling experienced when a nurse is conscious of a moral action that should be taken, but is unable to follow through with performing that moral action due to restrictions beyond his or her control (Schluter et al., 2008).

*culture change takes 5-10 years*
Schein (1992)
Have you ever observed a situation in clincial that caused you moral distress?
Job Satisfaction (cont.)

-Long term

- Can be compared to an individual's personality

-Culture change takes 5-10 years
Culture vs. Climate

- Short term-can last from hours, to days to weeks

-Can be compared to an individual's mood

-Much easier to change by managers

Are organizational culture and organizational climate synonymous?
Survey Monkey
What does a positive organizational climate encompass?

What does a negative organizational climate encompass?

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