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Organizational Culture and Theories

Christine Rapa

Spring Arbor University

NUR522 Theoretical Perspectives for Advanced Practice

Candise Flippin

February 20, 2022

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Organizational Culture and Theories

Walonick (1993) described a system as an organized collection of parts that are highly

integrated to accomplish an overall goal. If one part of the system changes, then in turn the

nature of the overall system often changes, as well (p. 3). He states, "organizations are typically

open systems that depend on their environment for support." The more open and flexible in

terms of growth and change within an organization in relation to the changes within the

environment, the greater chance it has for survival. The ability of an organization to adapt is

contingent upon the very roots of its organization and the culture from which its framed defining

a company’s values and behaviors. Organizational culture is made up of multi facets including

their core values, beliefs, communication methods, learning systems, symbols, and artifacts all

make up an organizations culture (Baker, 2002). The various cultures within a hospital system

can be based on hypotheses such as Mission, Consistency, Involvement and Adaptability (Baker,

2002). An organization may operate within one of several organizational theories such as

Classical, Neo-Classical, Contingency, and Systems (Walonick, 1993). In this paper I will

discuss the organizational culture of my hospital and attempt to show how an organizational

theory might be beneficial to my hospital.

Organizational Culture

“Members of organizations tend to think and act similarly and seem to demonstrate

distinct personalities that are rather persistent over time “(Watson, 2017, p.158). Holy Cross

Health is a nonprofit Catholic hospital and is part of Trinity Health which is one of the largest

multi-institutional Catholic health care delivery systems in America. Our mission statement is

the foundation upon which our organizational culture is built. “We, Holy Cross Hospital and

Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming
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healing presence within our communities” (Holy Cross Health, n.d.). As a faith-based

organization we serve our community upholding our core values which are reverence,

commitment to those who are poor, safety, stewardship, and integrity (Holy Cross Health, n.d.).

Quality healthcare is our goal, and we strive to serve the he community above and beyond their

expectations with compassionate, ethical, and safe patient care treating each patient the same

regardless of their ability to pay. Employees are expected to communicate with respect and

have a positive attitude while caring for patients across all demographics and backgrounds.

Employees are valued as an individual and not simply a number, although we are a large

hospital system even as a charge nurse the CEO and CNO know me by name and come to see me

several times a week to check in to be sure I do not need anything while I am on the ground level

in the front lines in the Emergency department. A team approach with open and honest

communication is encouraged with an atmosphere of respect is promoted among all disciplines.

Organizational Cultural Hypothesis

The mission hypothesis closely aligns with my organizational culture. The mission

hypothesis is the idea “that a shared sense of purpose, direction, and strategy can coordinate and

galvanize organizational members toward collective goals” (Baker, 2002, p.5). Employees at all

levels are expected to be committed to providing compassionate, high-quality healthcare with

reverence, commitment to those who are poor, safety, stewardship, and integrity, upholding our

core values. As a full-service teaching hospital, we strive to research and educate using up to

date evidence-based practices. In each department we are encouraged and even required to have

daily huddles with management at all levels from charge nurses all the way up to the CEO or

CNO frequenting these huddles. Additionally, we have regularly scheduled monthly staff

meetings to ensure we are all on the same page with common goals. We address where we are
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excelling and where we could use some improvement within our department. We rely heavily on

our Press Ganey surveys to guide us in our approach to patient care throughout the hospital. As

discussed by Peter Dorfman (2003) organizations that are adaptable are driven by their

customers, take risks and learn from their mistakes, and have capability and experience at

creating change (Nadler, 1998; Senge, 1990). In one of last week’s morning huddles, we were

told that our Press Ganey scores were placing us in the top 97th percentile in the nation for patient

satisfaction within our emergency department. This has been no small feat amid a pandemic, and

it speaks volumes considering all the challenges that we are currently facing. Being given a

measurable marker of our hard work helps to boost team moral and solidifies our common goals.

Organizational Theory

Systems theory is the organizational theory that I am drawn to. Senge (1990) describes

“systems thinking” as the fifth discipline for learning organizations. This systems model is an

effective tool to use as we navigate this new healthcare terrain and will assist us in adapting,

changing, and learning from the ongoing grow of the healthcare system. Systems thinking states

that “all components of an organization are interrelated and changing one variable might impact

many others” (Walonick, 1993). Systems within our organization are constantly changing,

continuously interacting with external forces. The systems theory is the theory that resembles

the operation at my hospital. Each individual entity within the organization is centered around a

common vision. Although individual departments, units, and staff of my hospital operated as

their own entity each interacts with each other at different levels and degrees having an impact

on the ultimate mission of the organization. Systems theory helps to identify these micro level

interactions influencing them to optimize the operation of the hospital on a macro level. I believe

my organization does use systems thinking but it seems to fall short of including ancillary
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practices and specialists that are part of our Holy Cross Health family. Using systems theory to

its fullest extent would be particularly beneficial to my organization especially considering the

challenges we are facing as result of the worldwide pandemic. Systems theory would provide us

with the tools to identify and prioritize needs at the micro level to best adapt to changing

conditions, helping us to identify nonlinear relationships where small changes could yield big

benefits (Walonick, 1993).

Conclusion

Considering the pandemic and the large turnover of employees, using systems theory

would benefit the large hospital system I work for. We would benefit now more than ever to all

remember our mission and core values of our organization. For example, using systems thinking

we could be sure that each individual department understands and sees how important things like

timely outpatient follow ups are to the organization. The follow through with appointments post

emergency department visits are currently not scheduled in a timely manner causing repeat

emergency department visits for complaints that could be addressed in an outpatient setting thus

freeing up a bed in the emergency department for a “true” emergency. The increased visits are

directly related to increased emergency waiting room times. “Frequent users of emergency

departments (FUEDs) (≥5 ED visits/year) represent a vulnerable population with complex needs

accounting for a significant number of emergency department (ED) consultations, thus

contributing to EDs overcrowding” (Chastonay et al., 2021). As we navigated these ever-

changing waters that are more turbulent than ever working through these problems used tried and

true tools will not only help our organization survive, thrive, and grow.
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References

Baker, K. A. (2002). Chapter 11: Organizational Culture. In (pp. 1-13). Retrieved from:

http://www.au.af.mil/au/awc/awcgate/doe/benchmark/ch11.pdf

Chastonay, O.J., Lemoine, M., Grazioli, V.S. et al. Health care providers’ perception of the

frequent emergency department user issue and of targeted case management

interventions: a cross-sectional national survey in Switzerland. BMC Emerg Med 21, 4

(2021). https://doi.org/10.1186/s12873-020-00397-w

Holy Cross Health. (n.d.). Mission, vision, and core values | holy cross health. Retrieved

February 17, 2022, from https://www.holy-cross.com/about-us/mission-vision-and-

values/

Senge, P. M. (1990). The fifth discipline. The arts and practice of the learning organization.

New York, NY: Doubeday/Currency.

Walonick, D. S. (1993). Organizational Theory and Behavior. Retrieved from:

http://www.statpac.org/walonick/organizational-theory.htm

Dorfman, P. & Mobley. (2003). Advances in Global Leadership: Vol. 1st ed. JAI Press Inc
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