Fostering Change in Organizational Culture Using a Critical Ethnographic Approach

Healthcare organizations are striving to meet legislated and public expectations to include patients as equal partners in their care, and research is needed to guide successful implementation and outcomes. The current research examined the meaning of customer service as related to the culture of care relationships within a Canadian hospital in southeastern Ontario. The goals were to better understand these expectations, develop shared meanings and influence cultural change from the perspective of the organization’s employees about their interactions with patients, families and work colleagues, and to generate ideas and groundswell for change. An ethnographic approach within the critical research paradigm was used over the course of a three phase study, where direct care healthcare providers (Phase 1), mid-level leaders (Phase 2) and senior leaders (Phase 3) volunteered to explore their values, philosophies and suggestions for change in the organization’s care relationships. This paper describes Phase 2 of the overall research project. A mixed methodology was used where mid-level leaders were individually surveyed and then participated in a focus group and/or interview to discuss these concepts. Mid-level leaders indicated that providing excellent customer service was important in their own work with many customers including staff, patients and their families, students, volunteers and outside agencies. They believed that this in turn led to improved partnerships for care, health service transitions and linkages, customer satisfaction and health outcomes. The majority stated that the organization’s culture would support change related to customer service relationships and opportunities for this were explored

Symbolic uses of export information: implications for export performance

As export competition becomes more intense and export success vital for survival (Katsikeas, 1994), so the effective processing and use of information regarding the international environment becomes a critical prerequisite for gaining competitive advantage (Leonidou and Theodosiou, 2004). Symbolic use of information is one type of information use, which although relatively underexplored to date, may be the most prevalent form of information use within organisations – especially in an export setting (Beyer and Trice, 1982). Symbolic use occurs when information is used for purposes other than the ones which led to its collection (Menon and Varadarajan, 1992). Symbolic use of information has been conceptualised as a multi-dimensional construct encompassing various dimensions (Vyas and Souchon, 2003). Examples include “exporters that engage in distorting market research findings, taking conclusions out of context, disclosing only the findings that confirm an executive‟s predetermined position or consciously ignoring information” (Toften and Olsen, 2004, p. 106). Symbolic use can also legitimate decisions reached on the basis of intuition or managerial assumptions (Vyas and Souchon, 2003). Although conceptual propositions of the potential relationship between each of the symbolic use dimensions and performance exist (Vyas and Souchon 2003), no empirical research has yet been undertaken. As a result, little is known about how and why symbolic use of export information may affect export performance, and under what circumstances. Furthermore, reliable and valid measures for each one of the symbolic use dimensions are absent in the literature. The purpose of this thesis is to fill in these research gaps. In so doing, a combination of both qualitative and quantitative methods is employed. The exploratory phase takes the form of in depth interviews with export decision makers in the UK. The data collected in this exploratory phase are analysed through the use of within-case and cross-case displays as per Miles and Huberman (1994) and are used not just for hypothesis development, but also to identify potential outcomes of using information symbolically in specific ways and to create pools of items for the development of measures of symbolic use. (Continues...)

The identification, development and application of information culture in the Western Australian public sector

Information can be found in government departments in many forms. It exists, for example, as performance indicators, statistics, economic analysis, policy advice, political know-how or opinions. Using information is a daily and oft repeated activity in government departments. Information is central to the achievement of outcomes and the delivery of services. It is critical to the government’s success in the information economy. It is central to the development of products and services. It supports policy making and it underpins accountability. Government departments are built on the generation and use of information that is relevant to the largest of all customer groups, the citizens. Even though information is all-pervasive in government departments, how government departments relate to information, what value they ascribe to it, and how their attitudes about information influence their behaviours towards information, is not well understood. The focus of this study was the values, attitudes, beliefs and behaviours which government departments in the Western Australian Public Sector exhibited towards information. That is, it investigated information culture. While there has been considerable research in the area of organisational culture, there is limited evidence of the study of information culture, particularly in the public sector. The abstract nature of information culture and the limited research mean that the concept is not widely acknowledged or appreciated. What constitutes information culture, its influence on an organisation, and the potential benefit of a high performing information culture are unresolved issues in the study of information culture. In the context of the Western Australian Public Sector, this study revealed information culture as complex, systemic and reflexive. Intricate and influential relationships with organisational culture, information management and information use were identified. The key findings of this study led to the development of a model for information culture in the public sector, and a definition which reflects the systemic, complex and multidimensional nature of information culture. This was a qualitative study within an interpretivist paradigm. Case study method was employed with the Western Australian Public Sector, in particular those departments which delivered services directly to the citizens, being the single case. The key participants were drawn from the public sector and academe. Interviews with best practice organisations and those who had undertaken research previously into information culture added to the richness of the data collection

Towards a model of information behaviour of a information provider: a mixed methods study.

Not much is not known about the totality of information behaviours of information providers from among the plethora of library and information science literature. This research aims to describe, categorise and devise a representation of information workers experiences as they engage in information behaviours in a health information provider organisation in Scotland. The organisation is a typical example of an information services provider where decision makers constantly strive to improve the quality of their information outputs by attempting to understand the information behaviours of their employees and respond to changes in the external information environment. A model of information behaviour becomes a useful tool for understanding what goes on within the information provider organisation. With pragmatism as its philosophical tether, the qualitatively-driven sequential mixed methods study uses critical incident interviewing within Heideggerian phenomenology and then a questionnaire survey to capture value-adding information behaviours, feeling states as outcomes of information behaviour, and perceptions of internal impact of information behaviour. The research subjects are invited to participate in a respondent validation workshop where a model of provider information behaviour is co-created. The findings reveal 3 core information behaviour types (information acquisition behaviour, information production behaviour and information dissemination behaviour) and 2 associated information behaviour types (multitasking and collaborative information behaviours) in a non-linear relationship. Several positive and negative feelings are identified together with information workers perceptions of how their information behaviours impact on the internal information environment of their organisation. The core and associated information behaviours are further categorised and their subtypes are validated on returning to the research participants. Recommendations for practice and further research include introducing Web 2.0 technologies in the provider organisation to enhance information dissemination, reviewing the value of some information activities in the provider organisation, investigating the mechanism of the information behaviour trigger, and further research on the role of feelings and individual characteristics before and after information interactions. The findings provide insights of information interactions of an information provider that make a significant contribution to LIS knowledge

The role of age and illness in the adoption of tele-health

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonAbstract — This study investigates how the introduction of Tele-Health impacts the lives of the frail elderly and older adults, and how their condition influences this experience. This study investigates the underlying issues with the adoption of Tele-health by the patients. It also considers the lived experiences of the patients in reference to their disease and age. Method: A qualitative approach was adopted, which was an in-depth interview conducted in Chorleywood Health Centre, a GP practice to the North West of London. Participants consisted of older adults living with chronic diseases, mainly diabetes and COPD, in order to gain a complex understanding of their reaction towards Tele-Health, as they are usually the target market for such tools. 30 participants took part in the study and were provided with a Tele-health service tool. The data were then thematically analysed using the thematic analysis method and transcribed using NVIVO10. Four databases were searched to find relevant literature namely: ScienceDirect, PubMed Central, Scopus and Medline. Research Design: The study adopted Interpretative Phenomenological Analysis (IPA) to collect and analyse data. In IPA, the researcher transcends or suspends past knowledge and experience to understand a phenomenon at a deeper level (Creswell, 2007). It is an approach, which seeks to explore, describe, and analyse the meaning of individual lived experience: “how they perceive it, describe it, feel about it, judge it, remember it, make sense of it, and talk about it with others” (with a sense of ‘newness’ or ‘rawness’ to obtain descriptive and rich data). Results: Nine main themes emerged as influences on their acceptance and adoption of Tele-health: Attitude to aging and Illness, Coping Strategy, Relationship and Support, Patient-Doctor Interaction, Incorporating Patients, Self-Efficacy, Personality, Personal Meaning and Knowledge. The themes were also reviewed at the end of the study to validate the results. Moreover the themes were observed to be considered explicitly by the patients before accepting and adopting the Tele Health service. A new framework, the Patient Technology Adoption Model (PTAM) is derived from the themes. The PTAM indicates the relationship between the factors and may be used to understand the ways in which the patients made their decision to accept the technology or not. Conclusion: This study encourages healthcare providers and decision makers who are responsible for the innovation and implementation of services to make all efforts to understand the consumer and consider conditions that might influence their decisions to accept, adopt or reject health technologies. The study proposes a new framework (PTAM) that highlights that a patient-centred approach should be adopted by healthcare providers and decision makers, as it would facilitate more successes in the health services provided by the NHS

Information-seeking needs and behaviours of complementary health (chiropractic) practitioners and students

Background: Research into the information-seeking behaviours and needs of alternative and complementary health professionals continues to be limited. Interest in complementary medicine is growing worldwide, reflected in New Zealand by the increase in numbers of practitioners, and the demand for accessible, reliable information and resources by professionals and consumers grows also. Objectives: The aim of this study was to examine the information seeking behaviours (access, sources, frequency of search, and motivation) and needs (research, practice or education) of students and professionals in one area of complementary health (chiropractic), and by investigating their reported practices and preferences identify their requirements, preferred approaches and any barriers that may limit their information-seeking. The intention is to use the information to assess a possible requirement for information services and information skills programmes for practitioners in the community and to add to the small body of research on information use among CAM professionals. Methods: The research project surveyed a random sample of both students and registered chiropractic practitioners by questionnaire and interview. The mailed questionnaire included twenty question intended to elicit information on the information-seeking behaviours of the respondents, with interview questions expanding on these responses. Results: Although the response was very low at 41.1%, (a known risk in survey research), results indicated that the information needs and behaviours of chiropractic professionals is similar to that of other health professionals. Respondents used the Internet and books frequently, but were unlikely to use databases or a library when seeking information. Respondents were generally confident in their skills but often lacked confidence in the information they located. Conclusions: Although the chiropractic field is quite narrow in scope, chiropractors' information seeking needs and behaviours are similar to those of other health professionals. They seek information regularly and use a number of sources, primarily for clinical reasons and for personal interest. They do not search for research-based information frequently and rely on the Internet, colleagues and their own collections to supply their main information needs. Although the results cannot reliably be extrapolated to the whole chiropractic community owing to the small scale of the survey, it appears that there is need to encourage the use of research-based information and to provide easier access to those resources contained in databases and libraries. As the overwhelming majority of chiropractors of all levels of experience use the Internet, the investigation of the provision of targeted web-based services and training in their use may be profitable. More precise investigation is required