Treating an unhealthy organisational culture: the implications of the Bundaberg Hospital Inquiry for managerial ethical decision making
Gian Luca Casali A C and Gary E. Day BA School of Management, Queensland University of Technology, Gardens Point, QLD 4000, Australia.
B School of Public Health, Griffith University, Brisbane, QLD 4500, Australia.
C Corresponding author. Email: luca.casali@qut.edu.au
Australian Health Review 34(1) 73-79 https://doi.org/10.1071/AH09543
Submitted: 4 June 2007 Accepted: 23 March 2009 Published: 25 March 2010
Abstract
This paper explores the interplay between individual values, espoused organisational values and the values of the organisational culture in practice in light of a recent Royal Commission in Queensland, Australia, which highlighted systematic failures in patient care. The lack of congruence among values at these levels impacts upon the ethical decision making of health managers. The presence of institutional ethics regimes such as the Public Sector Ethics Act 1994 (Qld) and agency codes of conduct are not sufficient to counteract the negative influence of informal codes of practice that undermine espoused organisational values and community standards. The ethical decision-making capacity of health care managers remains at the front line in the battle against unethical and unprofessional practice.
What is known about the topic? Value congruence theory focusses on the conflicts between individual and organisational values. Congruence between individual values, espoused values and values expressed in everyday practice can only be achieved by ensuring that such shared values are an ever-present factor in managerial decision making.
What does this paper add? The importance of value congruence in building and sustaining a healthy organisational culture is confirmed by the evidence presented in the Bundaberg Hospital Inquiry. The presence of strong individual values among staff and strong espoused values in line with community expectations and backed up by legislation and ethics regimes were not, in themselves, sufficient to ensure a healthy organisational culture and prevent unethical, and possibly illegal, behaviour.
What are the implications for practitioners? Managers must incorporate ethics in decision making to establish and maintain the nexus between individual and organisational values that is a vital component of a healthy organisational culture.
[1]
[2]
[3] Liedtka JM. Value congruence: the interplay of individual and organisational values systems. J Bus Ethics 1989; 8 805–15.
| Crossref | GoogleScholarGoogle Scholar | [verified 1 March 2010].
[10]
[11]
[12] Dion M. Organizational culture as matrix of corporate ethics. Int J Organ Anal 1996; 4(4): 329–51.
[verified 4 March 2010].
[16]
[17] Foster B, Mackie B, Barnett N. Bullying in the health sector: a study of bullying of nursing students. New Zealand Journal of Employment Relations 2004; 29(2): 67–83.
[verified 1 March 2010].
[19]
[20]
[21] Kabanoff B, Waldersee R, Cohen M. Espoused values and organizational change themes. Acad Manage J 1995; 38(4): 1075–104.
| Crossref | GoogleScholarGoogle Scholar |
[22]
[23] Hide P, Williamsons B. The importance of organisational values. Part 1. Is your organisation value congruent? Change Management 2000; 66 14–8.
[24] Campbell CR. A longitudinal study of one organisation’s culture: do values endure? Am J Bus 2004; 19(2): 41–51.
[25] Amis J, Slack T, Hinings CR. Value and organizational change. J Appl Behav Sci 2002; 38(4): 436–65.
| Crossref | GoogleScholarGoogle Scholar |
[26]
[27] Rouillard C, Giroux D. Public administration and the managerialist fervor for values and ethics. Administrative Theory & Praxis 2005; 27(2): 330–58.
