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Health Care Organizations from the Inside-Out EPI 247: Week 3 The Central Problem of Managing Healthcare: Autonomy Vs. Control. Laura Schmidt, PhD, MSW,MPH Associate Professor. WEEK 4 EXERCISE. Understanding Organizational Culture: Beyond the Qualitative/Quantitative Divide.
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Health Care Organizations from the Inside-OutEPI 247: Week 3The Central Problem of Managing Healthcare: Autonomy Vs. Control Laura Schmidt, PhD, MSW,MPH Associate Professor
WEEK 4 EXERCISE Understanding Organizational Culture: Beyond the Qualitative/Quantitative Divide
Are Formal Organizations Rational or Irrational?Different Types of Authority (Weber) • Traditional: We do it because we’ve always done it this way. • Rational: We do it because that’s what the rules say. • Charismatic: We do it because somebody extraordinary wants us to do it.
Defining Culture • An integrated pattern of human knowledge, belief, and behavior that depends upon the capacity for symbolic thought and social learning • The set of shared attitudes, values, goals, and practices that characterizes an organization • A way of life
What to Look For • Symbols, slogans and buzz words • Mission statements, reworded ones • Verbal and non-verbal expressions • Physical objects, displays, office layout, dress, size and shape of the building • Practices and rituals, ceremonies that denote status changes, degradation, changes in group relations
Possible Functions of Culture • Produces solidarity, collective effervesence, sense of belonging, boundaries • Routinizes interactions among people, promotes efficiency • Reinforces power, legitimates authority by instilling values that are larger than the individual
Does Org Culture Matter? • NO: It’s just another instrument of managerial control-not intrinsically important • NO: Attitudes and beliefs don’t always influence behavior • YES: It carries institutional knowledge and is required for “learning the ropes” • YES: If reality is socially constructed, it’s all that matters
Key Debates about Org Culture Can it be intentionally managed? Can/should it be measured quantitatively? Are there one or many cultures? Can culture be used to improve performance in healthcare systems?