Organizational values in Finnish healthcare organizations

Building Organizational Value Themes for a Health Care Organization

Maria Wan
MA 1995; Master of Business Administration graduated in 2017
LinkedIn

Both public and private health care industry in Finland is in the eye of a hurricane. The speed of changes and number of on-going acquisitions easily overlook questions regarding organizational values such as “who we are”, “how we work”, “how we perceive ourselves and others”, and “what is important to us”. This ambiguity of existence gave the needed boost for a private Finnish health care organization (1) to look into its values, which they felt were outdated. The company wanted to create new organizational values to which the personnel could commit.

My thesis (1) in the Master´s Degree Programme in Health Business Management in Metropolia aimed at establishing perceptions of organizational values, which the employees of the organization hold valuable. The objective was to offer the organization a set of value themes aligned with the employees’ value perceptions. The value themes needed to be something the employees would find practical and something they can commit to, instead of them being just words on the cafeteria wall. This article describes briefly how the study was carried out and what its impact was.

The management presented some aspirations and limitations for the study listed in the box below.

On studies of organizational value themes

Without entering into a deep a philosophical discussion, (organizational) values are often described as “guidelines” or “strong beliefs”. Values are reluctantly, if at all, compromised; people tend to “stand behind their beliefs”. (2.) But with this strong description, an organization would be a cohort of restricted although unanimous people. A number of academic studies support the connection between personal and organizational values (e.g. 3). However, people’s personal values may have no meaning in organizational settings, as what is important for them in organizations may fall outside their top five personal values (4, 5). As a conclusion, it is less rewarding to study personal values of employees than it is to study how the personnel perceives values in their organization (6).

To find an academic study on how organizational values are created from non-existence proved to be painstaking. The studies tend to compare e.g. present and future values or values’ impact on e.g. employee congruence or customer experience (see e.g. 7, 8, 9, 10). This research therefore gave me the opportunity to create groundwork to find an appropriate tool and methodology on studying values specifically from scratch.

The guideline for the research included the following:

1. The objective was to find employees’ perceptions of organizational value themes, instead of exact values.
2. The empirical data should be collected through a very brief web survey for respondent friendliness.
3. The word “value” was to be rephrased as “important issue”
4. There is no one single recognized tool to create organizational values from scratch.
5. The empirical data was frequency and content analyzed, results of which were further clustered into value themes. These were then presented and discussed with the help of Competing Values Framework.

Conducting the research and discussing the value themes using competing values framework

Conducting the survey had several limitations to which no known method was able to answer (11). Therefore, the questions were carefully composed and reviewed. The survey questions (one demographic, two qualitative, two multiple choice, and two control questions) were formulated. In addition, the number or length of answer(s) was limited in order for the survey answer time to not exceed ten minutes. The survey was introduced on the company Intranet and it was open for almost two months. It collided time-wise with an Employee Satisfaction Survey (considered more important) and no reminder of the survey was sent causing unfortunately a low respondent rate.

The empirical data was analyzed and gathered in Excel for frequency and content analysis. The quantitative/ closed responses were ordered based on the frequency of responses they received, while the quantitative/ open responses were first content grouped to common/main themes after which the themes were ranked based on the frequency. The results were then clustered to two main themes: what is valuable/important to us as employees and how we attain meaningfulness in our daily work.

The themes gathered in the survey were transferred to the Competing Values Framework (CVF) (see 12) for a more tangible summary. Although CVF is most often used in studying organizational cultures after OCAI assessment (13), I found it a useful framework for the purposes of my thesis. The empirical data was matched to CVF’s quadrants (Control, Create, Compete, Collaborate) visualizing the present situation. It was then compared to the predictive situation (drawn based on mission and perceptions of the management). The organization was able to see how the present situation differed from their desired or predictive situation (see e.g. 13).

Trustworthiness of the study

How well can a mainly quantitative very brief survey give adequate and reliable enough results? It goes without saying that some lengthier and deeper (e.g. interviews) tools and a push for a higher response rate would have helped. The trustworthiness of the study, in the end, is best evaluated by the organization itself. In the words of Human Resources Manager of the organization “the study provided us with the groundwork we were looking for. It is now easier for us to start formulating such organizational values that can be lived-by presently and guide us forward to the future”. Also, for them, the respondent-friendliness was more important than the response rate.

It is unknown to me whether the organization has taken the value themes for further execution. Still, knowing the value themes is only the start; implementing, sharing, and committing to the values require a bigger effort and time (see e.g. 14).

Conclusion and applicability to other organizations

The organization received what they expected: a set of value themes specifically applicable to them. What could others learn then? First of all, values can be studied from scratch by asking a minimal number of questions about employee perceptions. Second, with the help of CVF values can be clustered to visible quadrants for easier comprehension towards further summary and implementation. Others can also learn that values matter, because they show from where to where the employees are guiding the boat of organizational culture and business.

My thesis proved that even with a minimal number of questions and a suitable framework one can probe a sufficient amount of data on organizational value themes. The results of the academic inquiry conducted by an outsider provide a direction the organization can take knowing that it supports the employees’ commitment as well. Such a reality check of values may well be needed in many health care organizations in the current turbulent situation. Personally for me, researching organizational values in an academic setting was a welcome process to enforce previous culture mappings I have done in my work. I hope my thesis provides a guideline on how to build and create organizational values from a point of non-existence.

Photo by Samuel Zeller on Unsplash

References:

1. Wan, M. 2017. Due to confidentiality agreement, the name of the Organization is anonymous, fictional. Thesis. Metropolia University of Applied Sciences. Master's Degree Programme in Health Business Management
2. Juuti, P. 1995. Johtaminen ja organisaation alitajunta. Aavaranta-sarja nro 38. Helsinki: Otava.
3. Ünal, Z. M. & Turgut, T. 2015. The Buzzword: Employee Engagement. Does Person-Organization Fit Contribute to Employee Engagement? Iranian Journal of Management Studies 8 (2), 157–179.
4. Gorenak, M. & Košir, S. 2012. The Importance of Organizational Values for Organization. Management, Knowledge and Learning International Conference. 563–569.
5. Hofstede, G. & Hofstede, G. J., & Minkov, M. 2010. Cultures and Organizations. New York: McGraw Hill.
6. Finegan, J. E. The impact of person and organizational values on organizational commitment. Journal of Occupational and Organizational Psychology 73. 162.
7. Seevers, S. B. 2000. Identifying and clarifying organizational values. Journal of Agricultural Education 41 (3).
8. Lauby, S. 2012. Company Values Create the Foundation for Employee Engagement.
9. Hoffman, B. J. & Woehr, D. J. 2006. A quantitative review of the relationship between person-organization fit and behavioural outcomes. Journal of Vocational Behavior 68. 389–399.
10. Boxx, W. R. & Odom, R. Y. & Randall, M. G. 1991. Organizational values and value congruence and their impact on satisfaction, commitment, and cohesion: an empirical examination within the public sector. Public Personnel Management 20 (2). 195–205.
11. Van Rekom, J. & van Riel, C. B. M. & Wierenga, B. 2006. A methodology for assessing organizational core values. Journal of Management Studies 43 (2). 175–201.
12. Cameron, K. S. & Quinn, R. E. 2011. Diagnosing and Changing Organizational Culture. Based on the Competing Values Framework. San Francisco: Jossey-Bass.
13. Cameron, K. S. & Quinn, R. E. & Degraff, J. & Thakor, A. V. 2014. Competing Values Leadership. Cheltenham & Northampton: Edward Elgar Publ. Ltd.
14. Thornbury, J. 2003. Creating a living culture: the challenges for business leaders. Corporate Governance 3 (2). 68–79.

Revision of organizational values in Finnish healthcare organizations

Marianne Pitkäjärvi
PhD, RN
Senior lecturer
Metropolia University of Applied Sciences
marianne.pitkajarvi [at] metropolia.fi (marianne[dot]pitkajarvi[at]metropolia[dot]fi)

The need to focus on the revision of organizational values is more relevant today than ever before. Such initiatives may be seen as foundational, as they set the direction for the organization’s approach to patient care, wellbeing of the staff, and ultimately, the success of the organization (1).

Several factors highlight the topicality of organizational values within the healthcare sector in Finland today. Such factors include, but are not limited to, the ongoing regional government, health and social services reform and the digitalization of the healthcare services.

In her Master’s thesis, Maria Wan (2) was able to position her academic and professional interests right in the center of this turbulent field.

Organizational values and the health service reform

The health and social care service reform aims at ensuring health and wellbeing for all citizens. Much like in Maria’s project commencement, the purpose of the reform itself is value-based in nature: to guarantee equal services and to reduce inequality across the country (3). Starting in January 2021, Finland will be divided into 18 counties which will take the responsibility of arranging health and social care services for the residents. The publicly funded health and social services may be offered by public, private or third-sector operators. The counties may also form unincorporated county enterprises to provide the services themselves (3, 4). As a result, the offering of the services to individual clients will be expanded.

A key element of the reform is the freedom of choice, allowing the residents to choose their particular health service provider from among the many organizations. The payment will take place with a service voucher given to the client, by allocating a personal budget to the clients, or by compensating the service for the provider. It has been anticipated that such a change would double the offering of private healthcare services to about 13 % out of all services by the year 2024 (4). With some pilot studies still ongoing (August 2018), the decisions regarding the arrangements involving the form of payment will take place in the future.

Such prospects have electrified the field of healthcare. The clients are likely to make their decisions according to the information and impression they gain about the quality of services of each service provider. At the same time, to cope with the accelerating competition, the service providers need to control the costs of their products. This scenario places pressure on all organizations providing healthcare services. Under such circumstances, the significance of exploring organizational values and ethical codes of conduct is momentous. Maria’s work is precious in that it presents a concrete model for doing just this.

A mere revision of the service structures and processes will not increase the quality of the services; commonly defined organizational values play a significant role, as well. Adhering to these values will help decision makers on all levels. There is evidence to suggest that implementation of such a strategy will result in increased well-being of the staff members, stronger confidence in caregivers, and coherence within the decision making (5, 6, 7).

Organizational values and digitalization of the services

Another major development in the field of healthcare is the digitalization of the services. This is seen to further allow for personalized services and better accessibility to them for the potential clients. In addition, it allows promoting a smooth, yet secure flow of relevant information between the different experts responsible for the care (4, 8, 9). From the individual client point of view, it is noteworthy that all of health-related information will be available through digital platforms and much of the primary care will be based on self-assessment by the client. Even access to the physical service will require communication through the digital channels. Client data will also be in digital form. Such developments require discussion about the values among and within the service providers.

Whilst healthcare organizations have the autonomy to design their service models, they will need to ensure client-centeredness in their operations, as required by the reform. In addition to the attractiveness of the organization, clearly defined values are needed to give direction when making decisions about advertising (6) and managing diversity (7).

Organizational values and ethics in Master´s level education

Master’s programmes at Finnish universities of applied sciences are required to match the criteria set by the European Qualifications Framework for level 7 (10). Furthermore, they are expected to contribute to the development of the working life (11). The two routes to achieve this are the core curricula and the research, development and innovation activities. For successful outcomes, following either of these routes requires close collaboration between the actors from the working life and from the learning community.

In the field of healthcare education, values have traditionally played a significant role also when it comes to the Master’s programmes. Hence, the learning communities at the universities of applied sciences must hold on to their proactive role in the discussion about prevailing values that are prominent in the working life. This is all the more important in the turbulent era of reforms taking place in the healthcare sector.

Conclusion

The reform and digitalization are here to shape the future of healthcare. Combining Master’s studies and the unknown yet inevitable changes of the healthcare sector offer co-operation opportunities that are too precious to waste.

Maria’s thesis is an example of how, at its best, a Master’s thesis may be an effective tool that offers customer designed solutions and suggestions that support the organization’s development. At the same time, a fruitful learning environment is established for the adult learner.

References:

1. Nelson W. 2013. The Imperative of a Moral Compass-Driven Organization. Frontiers of Health Service Management 31 (1). 39–45.
2. Wan, M. 2017. Due to confidentiality agreement, the name of the Organization is anonymous, fictional. Thesis. Metropolia University of Applied Sciences. Master's Degree Programme in Health Business Management.
3. The Ministry of Social Affairs and Health, the Ministry of Finance 2018. The regional government, health and social services reform is for all of Finland. Press release 11.5.2018.
4. The Ministry of Social Affairs and Health 2018.The Government proposes freedom of choice for health and social services. Press release 8.3.2018.
5. Peguero, E. & Berenguera, A. & Pujol-Ribera, E. & Roman, B. & Prieto, C. M. & Terribas, N. 2015. The workers’ opinions have value in the code of ethics: Analysis of the workers in Virtual Forum Catalan Institute of Health. BMC Med Ethics 16 (90).
6. Nelson, W. A. & Taylor, E. C. 2012. Ethics and advertising. Healthcare organizations must have an ethical framework in place for advertising. Healthcare Executive 27 (2). 52–55.
7. Denier ,Y. & Gastman, C. 2013. Realizing good care within a context of cross-cultural diversity. An ethical guideline for healthcare organizations in Flanders, Belgium. Social Science and Medicine 93. 38–46.
8. Digitalisaatio sote-uudistuksessa 2017. Sosiaali- ja terveysministeriö.
9. Neittaanmäki, P. & Kaasalainen, K. 2018. SOTE-toimintojen tehostaminen IT:n avulla – kehittämispotentiaali ja toimenpideohjelma. Jyväskylän yliopisto, informaatioteknologian tiedekunta.
10. European Qualifications Framework. Learning Opportunities and Qualifications in Europe 2018. European Commission.

Metropolia Master´s - Keskusteluja työelämän kehittämisestä
© Metropolia Ammattikorkeakoulu 2018

Metropolia Master´s - Discussions on the Development of Work Life
© Metropolia University of Applied Sciences 2018

Julkaisija (Publisher): Metropolia Ammattikorkeakoulu, Helsinki

Toimittanut (Ed.): Marjatta Kelo & Elina Ala-Nikkola
ISBN 978-952-328-130-1

Julkaisu saatavilla pdf-muotoisena täällä

Tämä teos on lisensoitu Creative Commons Nimeä-EiKaupallinen-EiMuutoksia 4.0 Kansainvälinen -lisenssillä

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

www.metropolia.fi/julkaisut
www.metropolia.fi/publications