Problematik von Veränderung von Unternehmenskulturen im Gesundheitswesen

There is increasing interest in managing organizational culture as a lever for health care improvement. Although a precise definition of culture is lacking, a range of culture change model has been developed. Changing the organizational culture along with its structure has become a familiar prescription in health system reform. Planned culture change is difficult, uncertain and a risky enterprise. Professional values, affirmed over centuries and woven into the fabric of health care organizations are resilient enough to frustrate many reengineering attempts. Key factors that impede culture change are: inappropriate leadership, professional allegiances, perceived lack of ownership and subculture diversity within health care organizations and systems. As an example for the importance of culture in the health care industry the lessons of a failing children's heart surgical program are discussed.