An assessment of organisational values, culture and performance in Cape Town’s primary healthcare services

Abstract

Objectives: Improving the quality of primary health care in South Africa is a national priority and the Western Cape Department of Health has identified staff and patient experience as a key component. Its strategic plan, Vision 2020, espouses caring, competence, accountability, integrity, responsiveness and respect as the most important organisational values. This study aimed to measure the personal values of staff, as well as current and desired organisational values.
Design: A cross-sectional survey used the cultural values assessment tool. Data were analysed by the Barrett Value Centre.
Setting and subjects: Staff and managers at five community health centres in the Cape Town Metropole.
Outcome measures: Personal values, current and desired organisational values, organisational entropy and organisational scorecard.
Results: In total, 154 staff members completed the survey. Participants reported personal values that are congruent with a move towards more patient-centred care. The top 10 current organisational values were not sharing information, cost reduction, community involvement, confusion, control, manipulation, blame, power, results orientation, hierarchy, long hours and teamwork. Desired organisational values were open communication, shared decision-making, accountability, staff recognition, leadership development and professionalism. Organisational entropy was high at 36% of all values. Only teamwork and community involvement were found in both the current and desired culture. The organisational scorecard showed a lack of current focus on finances, evolution and patient experience.
Conclusion: The organisational culture of the Metro District Health Services is currently not well aligned with the values expressed in Vision 2020, and the goal of delivering patient-centred care.

Keywords: primary care, organisational culture, values, staff experience, public sector, cultural values