What's the diagnosis? Organisational culture and palliative care delivery in residential aged care in New Zealand

Abstract

Organisational culture has been shown to impact on resident outcomes in residential aged care (RAC). This is particularly important given the growing number of residents with high palliative care needs. The study described herein (conducted from January 2013 to March 2014) examined survey results from a convenience sample of 46 managers, alongside interviews with a purposively selected sample of 23 bereaved family members in order to explore the perceptions of organisational culture within New Zealand RAC facilities in one large urban District Health Board. Results of the Organisational Culture Assessment Instrument (OCAI) completed by managers indicated a preference for a 'Clan' and the structured 'Hierarchy' culture. Bereaved family interviews emphasised both positive and negative aspects of communication, leadership and teamwork, and relationship with residents. Study results from both managers' OCAI survey scores and next of kin interviews indicate that while the RAC facilities are culturally oriented towards providing quality care for residents, they may face barriers to adopting organisational processes supportive of this goal.

What factors predict the confidence of palliative care delivery in long‐term care staff? A mixed‐methods study

“…An emphasis on hierarchy and professional fiefdoms in LTCF, however, can block empowerment by limiting independent practice (Quinn & Spreitzer, ). Such impediments must be removed to create organisational cultures in which staff members are empowered (Frey et al, ). Empowered nursing staff are more committed to their place of employment, an important factor in the delivery of high‐quality care for residents (Kanter, ).…”

“…New Zealand, the setting for the current study, has the highest number of reported deaths in LTCF internationally at 38% and ranks higher than any other country (Broad et al, ). Increasingly, much palliative care at the end of life in LTCF is provided by generalist clinical staff, who provide care and work in partnership with specialist palliative care providers, such as hospice (Boyd et al, ; Frey, Boyd, Foster, Robinson, & Gott, ). Specialist palliative care providers are defined as clinicians with certifications or specific experience in palliative and/or hospice care while generalist clinical staff include clinicians who provide palliative care as a routine part of their job within general health settings, such as long‐term care (Quill & Abernethy, ).…”

“…Continuing education contributes to perceived clinical competence and confidence (Latta & Ross, ). LTCF staff's desire to engage in further palliative care education is based in part on previous palliative care experience (Frey, Boyd, Foster, Robinson, & Gott, ). However, the conditions within LTC (e.g.…”

“…However, the conditions within LTC (e.g. low staffing levels, resource shortages) can create barriers to education uptake and ultimately the delivery of palliative care to residents (Frey et al, ; McKeown, ).…”

Generational Differences in the Perception of Corporate Culture in European Transport Enterprises

“…The company began operating in April 1981 and was the major airline in 1984 (with revenues exceeding two trillion US dollars) [58]. Clan corporate culture as well as hierarchy culture dominated the research study conducted from January 2013 to March 2014 in New Zealand in the area of senior healthcare [59]. The findings of Turkish research show that the Turkish construction industry was dominated by firms with a mixture of clan and hierarchy cultures [60].…”