Presentation is loading. Please wait.

Presentation is loading. Please wait.

Staff Sub-Cultures & Perceptions of the Organisation: An Historical Perspective North Tees & Hartlepool Foundation Trust.

Similar presentations


Presentation on theme: "Staff Sub-Cultures & Perceptions of the Organisation: An Historical Perspective North Tees & Hartlepool Foundation Trust."— Presentation transcript:

1 Staff Sub-Cultures & Perceptions of the Organisation: An Historical Perspective North Tees & Hartlepool Foundation Trust

2 ∂ Service Line Management Resource interconnections Systemisatised care processes Multidisciplinary based care Transparent accountability SERVICE LINE MANAGEMENT

3 ∂ Staff Views on Organisational Practices Views on: Management models appropriate for improving the overall performance of clinical units The management style of Trust Trust’s organisational goals Staff affiliation with their Trust

4 ∂ Abbreviations MC Medical Clinician MM Medical Manager GM General Manager NM Nurse Manager NC Nurse Clinician AHM Allied Health Manager AHC Allied Health Clinician

5 ∂ 1995 (111 staff)2002 (102 staff) 1Financial viability 2Service quality 3Productivity improvementEqual access 4Organisational stabilityProductivity improvement 5Service innovation 6Equal accessOrganisational stability 7Teaching and researchStaff welfare 8 Teaching and research Ranking of Organisational Goals for Whole Trust

6 ∂ Trust Goals 1995 (Ranked by Mean Score) Total MCMMGMNMNC Financial viability Service quality Productivity improvement Organisational stability Service innovation Equal access Teaching and research Staff welfare

7 ∂ Trust Goals 2002 (Ranked by Mean Score) Total MCMMGMNMNCAHMAHC Financial viability Quality Equal access Productivity Service innovation Organisational stability Staff welfare Teaching and research

8 ∂ Trust Work Values, 2002 MCMMGMNMNCAHMAHCSig. Conformity to rules and risk avoidance Inequalities of power are natural and beneficial

9 ∂ Collegial (inclusion, freedom, belief, satisfaction) Meritocratic (encouragement, degree of freedom, individual achievement, competition) Unit based paternalistic leadership (loyalty, belonging, team solidarity and achievement) Hierarchy (direction, compliance, rules, discipline, surveillance) Styles of Management

10 ∂ Perceptions of Management Structures and Style, 2002 Styles Identified Style 1 Style 2 Collegial Meritocratic Unit based paternalistic leadership Hierarchy

11 ∂ Staff Perceptions of Received Management, 2002 MCMMGMNMNCAHMAHCSig. Collegial/ meritocracy vs Hierarchy Unit based Paternalistic Leadership

12 ∂ Affiliation Modes of Staff, 2002 MCMMGMNMNCAHMAHCSig. Value Identification Cynical Calculative identification

13 ∂ Sub-Culture/KnowledgeMapping Views on : Health care issues Strategies for addressing hospital resource issues Autonomy and accountability Clinical governance Clinical and resource interconnections Causes of clinical practice variation Basis for setting clinical standards

14 ∂ Stances of Acute Care Trusts and PCT for the Study as a Whole Emphasis on financial realism and transparent accountability Emphasis on clinical purism and opaque accountability Individualistic concepts of clinical work Systematised concepts of clinical work

15 ∂ NC MM MC GM NM MC MM GM NM NC AHC AHM 2002 Individualistic concepts of clinical work Systematised concepts of clinical work Emphasis on financial realism and transparent accountability Emphasis on clinical purism and opaque accountability Professional Subcultures in NTHFT; 1995 & 2002

16 ∂ Summary of NTHFT Professional Cultures, 2002 Acute MCMMGMNMNCAHMAHC Recognise the interconnections +/ Balance accountability and accountability +/ Systematisation of clinical work --+/-+ - Multidisciplinary teams --+++/-+

17 ∂ Professional Subcultures of Acute Trusts in an International Sample Individualistic concepts of clinical work Emphasis on financial realism and transparent accountability Emphasis on clinical purism and opaque accountability Systematised concepts of clinical work

18 ∂ International Sample MCMMGMNMNCTotal N&Y Region Project England Wales Australia New Zealand Total

19 ∂ Medical Clinicians’ Views on Performance Improvement, 2002 Emphasised Improvement of the internal organisation of clinical work Increased resources and improved decision-making about their use More effective organisational management Tended to believe that Decision making processes within the Trust were ineffective Past amalgamations and policy implementation had been poorly handled Doubted that Managers would be able to ensure the Trust functioned decisively and effectively in the (then) new health economy environment

20 ∂ Emphasised Improvements in the internal organisation of clinical work within the Trust Making better use of resources the Trust already had Would have appreciated More time for both clinical work and management activities Better access to clinical information to guide service design and inform service delivery Greater emphasis in team working Greater skills development in team development and management Medical Managers’ Views on Performance Improvement, 2002

21 ∂ Emphasised Reorganisation of clinical work internally Concerned to Rein in the power of the consultants Wanted More effective team working within the organisation Partnership and joint organisational working within health economy, including subsuming aspects of primary care into the Trust Characterised at times by Some blame shifting to DoH and clinicians Apparent lack of ideas to resolve difficulties General Managers’ Views on Performance Improvement, 2002

22 ∂ Nurse Managers’ Views on Performance Improvement, 2002 Emphasised The belief that clinical performance outcomes were related to virtually all aspects of organisational life A concern that clinical work should be better organised and managed Concerned about Time pressures Lack of experience in working in and leading teams Lack of forums for cross-disciplinary and cross-directorate meetings Wanted Leadership development Reshaping of Trust management structures Concrete suggestions the new service developments (not just abstract ideas)

23 ∂ Nurse Clinicians’ Views on Performance Improvement, 2002 Emphasis upon Pay and conditions Concerned about Accessing more training opportunities Sorting out anomalies in working conditions Poor management-staff relationships Characterised by Extremely low response rates Appeared disengaged with the organisation Focused upon personal development and personal needs

24 ∂ Allied Health Managers’ Views on Performance Improvement, 2002 Emphasis upon The organisation’s relationships with external bodies Organisational requirements for improved clinical organisation (on which they had many and wide ranging opinions) Believed that Resources, especially time, were critical for achieving the reorganisation of clinical work Concerned about The role of AHP within the Trust In effective voice in clinical decision making (though having a wider understanding of how care were structured) Pay and conditions, poor access to training, poor accommodation Characterised by Disenchantment with work and the way the Trust was managed

25 ∂ Allied Health Clinicians’ Views on Performance Improvement, 2002 Emphasis upon Better access to training Improvements to the organisation of clinical work and to organisational management practices More resources Concerned about Difficulties in working in ‘integrated’ teams (though supportive of these) Poor management both within the profession within the Trust and the wider Trust management Better care planning especially in regards to discharge Characterised by Unhappiness with their line managers

26 ∂ Percentage Predicted Group Membership, 2002 MCMMGMNMNCAHMAHCTotal MC MM GM NM NC AHM AHC

27 ∂ Traditional Service Delivery Model Nursing GM Medicine AHP

28 ∂ “Clinical Product Line” Model Final Products Intermediate Products

29 ∂ Previous Improvement Efforts Final Products Intermediate Products


Download ppt "Staff Sub-Cultures & Perceptions of the Organisation: An Historical Perspective North Tees & Hartlepool Foundation Trust."

Similar presentations


Ads by Google