A case study of organizational culture change in a hospital

Abstract

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] This dissertation presents a case study that describes and analyzes the organizational culture change that occurred at a hospital over a period of time (i.e., about 12 years, from 1993 through 2004). Qualitative data from five sources -- questionnaires, interviews, focus groups, observations, and documents -- was analyzed by applying the 'transformation of intentions model' for policy analysis. This dissertation proposes that this sociological model is a theoretical framework that is conceptually applicable to the empirical analysis of organizational culture change. The application of the 'transformation of intentions model' of policy analysis to the analysis of organizational cultural change resulted in a detailed description of the organizational structures and processes that were essential to the organizational culture change at the hospital. The analysis revealed a pattern in the transformation of intentions at the hospital. More specifically, it was revealed that the organizational culture change at the hospital was 'top-down' -- administratively led -- change initiated in response to interorganizational directives -- specifically, policy changes by the healthcare organization that managed the hospital.