The organizational culture of a Brazilian public hospital

Abstract

The objective of this research was to analyze the organizational culture of a Brazilian public hospital. It is a descriptive study with quantitative approach of data, developed in a public hospital of São Paulo State, Brazil. The sample was composed by 52 nurses and 146 nursing technicians and auxiliaries. Data were collected from January to June 2011 using the Brazilian Instrument for Assessing Organizational Culture – IBACO. The analysis of the organizational values showed the existence of hierarchical rigidity and centralization of power within the institution, as well as individualism and competition, which hinders teamwork. The values concerning workers’ well-being, satisfaction and motivation were not highly valued. In regard to organizational practices, the promotion of interpersonal relationship, continuous education, and rewarding practices were not valued either. It becomes apparent that traditional models of work organization support work practices and determine the organizational culture of the hospital.

Teamwork in a coronary care unit: facilitating and hindering aspects

“…This may be due to the hierarchy among professions and medical hegemony (17)(18) , which compromises cooperation and communication among agents, integrated work, and teamwork (13,17,19) . This lack of coordination among professionals, among other factors, may reflect the absence of a formal structure that promotes systematic interaction among them (17) , the construction of fragile and uncooperative relationships among them; the process of professional training that can make interaction and collaboration difficult (2,20) while establishing very strict hierarchical limits among different professions (17) .…”

Cultura organizacional: Revisão sistemática da literatura

“…Outra similaridade entre o estudo de Júnior e BorgesAndrade (2004) e outras pesquisas é a preocupação quanto a relações de poder e a características culturais das instituições, embora haja uma diversidade temática das conclusões relacionando configurações de poder com variados aspectos de conflitos e de tomadas de decisões (Carvalho et al, 2013;Rocha et al, 2014). Organizações familiares foram pouco estudadas, com apenas duas investigações da amostra, dado este que confirma a reflexão apontada por Júnior e Borges-Andrade (2004) no que tange à dificuldade de coleta e de análise de dados nessas instituições.…”

“…Nove pesquisas da amostra abordaram conflitos ocupacionais, hierarquia funcional, papel do gestor na distribuição do poder e processos decisórios categorizando-os como configurações de relações de poder. Destacaram-se estudos com análise e com coleta de dados realizados em ambiente hospitalar (Carvalho, Rocha, Marziale, Gabriel, & Bernardes, 2013;Rocha, Marziale, Carvalho, Cardeal Id, & Campos, 2014). Tais pesquisas indicaram que valores e práticas caracterizadores da cultura do hospital apresentam elementos, como uma estrutura rí-gida e hierarquizada, que reforçam a centralização do poder.…”

Apprehensions of nurse managers on evidence-based practice

“…3,[10][11][12] In this way, the hospital organization's support for the implementation of the EBP should be designed as a guideline, which would include the provision of continuous training to nurses or specialized advisory services, so that they would increasingly present improved skills to perform this action in their daily life. [10][11][12] However, the level of organizational maturation, functionality and decision-making harmony of its structures, availability of resources, decentralized commands, and openness and autonomy to new projects would be areas that facilitate the incorporation of innovations 22,23 such as EBP. The strictly hierarchical hospital organizational practices, in the traditional model of management and production, would lead to individualistic and competitive work relations, fragmenting care.…”

“…These characteristics of the traditional organizational culture would hinder integration and sharing among the teams, implying the lack of motivation of the workers and reduction of commitment to the quality of care. 22,23 Inpatient units were characterized, above all, as potential places to respond to the needs of the people assisted. However, it has been observed that the management of these units coexists with the absence of planning, difficult coordination of care and administrative processes, communication problems and lack of participatory planning, and also with the lack of systematization of information to measure performance at these websites.…”