Organizational Culture and Human Relations

June, 2013

Organizational Culture and Human Relations

EdPM-664

An Assessment of Organizational Culture in

Yekatit 12 Referral Hospital

A Seminar Paper

Prepared by

Feleke Yeshitila GSR/2991/05

Habte Terefe GSR/2993/05

Submitted to:

Yekunoamlak Alemu (PhD)

EdPM-664-Organizational Culture and human Relation

Feleke Yeshitila Habte Terefe Page ii

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Abstract ............................................................................................................ vi

Chapter One: Introduction ................................................................................ 7

1.1 Background of the Study ........................................................................................................................ 7

1.2 Background of the Organization ............................................................................................................ 8

1.3 Statement of the problem ...................................................................................................................... 9

1.4 Relevance and Justification .................................................................................................................... 9

1.5 Research Objectives ............................................................................................................................... 9

1.6 Research Questions .............................................................................................................................. 10

1.7 Scope of the Study ............................................................................................................................... 10

1.8 Limitation of the Study......................................................................................................................... 10

1.9 Significance of the Study ...................................................................................................................... 10

1.10 Operational definitions ...................................................................................................................... 10

Chapter Two:Research Methodology .............................................................. 12

2.1 Research Design ................................................................................................................................... 12

2.2 Population of study .............................................................................................................................. 12

2.3 Sampling Size and Sampling Procedure ................................................................................................ 12

2.4 Source of Data collection ..................................................................................................................... 12

2.5 Research Instrument ............................................................................................................................ 13

2.6 Data Analysis Procedure ...................................................................................................................... 13


Feleke Yeshitila Habte Terefe Page iii

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Chapter Three: Literature Review ................................................................... 14

3.1 Organizational Culture ......................................................................................................................... 14

3.2 Denison’s Framework of Organizational Culture .................................................................................. 14

3.2.1 Mission ............................................................................................................................................. 14

3.2.2 Adaptability ...................................................................................................................................... 15

3.2.3 Involvement ...................................................................................................................................... 15

3.2.4 Consistency ....................................................................................................................................... 15

3.3 Organizations with strengths in two of the traits ................................................................................. 15

3.3.1 External Focus (Adaptability + Mission) ............................................................................................ 15

3.3.2 Internal Focus (Involvement + Consistency) ....................................................................................... 15

3.3.3 Flexibility (Adaptability + Involvement)............................................................................................. 16

3.3.4 Stability (Mission + Consistency) ....................................................................................................... 16

3.3 Conceptual Model ................................................................................................................................ 16

Chapter Four: Presentation, Analysis and Interpretation of Data .................. 17

4.1 Demographic Information of the Sample ............................................................................................. 17

4.1.1 Professional Compositions of samples .............................................................................................. 17

4.1.2 Gender Distribution of Sample .......................................................................................................... 18

4.1.3 Educational Background ................................................................................................................... 18

4.1.4 Work experience of the sample ......................................................................................................... 19

4.1.5 Age distribution of the Sample .......................................................................................................... 19

4.2 Results of the Denison Organisational Culture Survey .............................. 20


Feleke Yeshitila Habte Terefe Page iv

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4.2.1 Analysis of Mission as a Cultural trait and its sub dimensions .............. 20

A. STRATEGIC DIRECTION AND INTENT ............................................................................................................. 20

B. GOALS AND OBJECTIVES ............................................................................................................................. 20

C. VISION .................................................................................................................................................... 21

4.2.2 Analysis of Adaptability as a Cultural trait and its sub dimensions ....... 22

A. CREATING CHANGE ................................................................................................................................... 22

B. CUSTOMER FOCUS..................................................................................................................................... 22

C. ORGANIZATIONAL LEARNING ...................................................................................................................... 23

4.2.3 Analysis of Involvement as a Cultural trait and its sub dimensions ....... 24

A. EMPOWERMENT ....................................................................................................................................... 24

B. TEAM ORIENTATION .................................................................................................................................. 24

C. CAPABILITY DEVELOPMENT ......................................................................................................................... 25

4.2.4 Analysis of Consistency as a Cultural trait and its sub dimensions ........ 26

A. CORE VALUES ........................................................................................................................................... 26

B. AGREEMENT ............................................................................................................................................. 26

C. COORDINATION AND INTEGRATION .............................................................................................................. 27

4.3 Summary of results .............................................................................................................................. 28

4.3.1 Mission as a cultural trait ................................................................................................................. 28

4.3.2 Adaptability as a cultural trait .......................................................................................................... 28

4.3.3 Involvement as cultural trait ............................................................................................................. 28

4.3.4 Consistency as a cultural trait ........................................................................................................... 29

Chapter Five:Conclusion and Recommendation .............................................. 30


Feleke Yeshitila Habte Terefe Page v

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5.1 Conclusion............................................................................................................................................ 30

5.3 Recommendations ............................................................................................................................... 30

Lesson Learned ................................................................................................ 32

References ....................................................................................................... 33

Appendix ......................................................................................................... 34


Feleke Yeshitila Habte Terefe Page vi

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This paper presents an assessment of organizational culture. The aim of the research

was to assess the organisational culture of Yekatit 12 Referral hospital. For the purpose of

this study a quantitative methodology adopted. The sample (n =40) was employees from

health professional and administrative staff. To gather the necessary data, questionnaires

were distributed and interview was conducted.

The Denison Organisational Culture model was used to gather data for the study.

The Survey measures four culture traits, namely, involvement, consistency, adaptability and

mission. Descriptive statistics were used to analyse the data.

Results indicated that employees perceived involvement, consistency, adaptability

and mission negatively. All cultural traits have an impact on the hospital organizational

performance. There is also relationship on organizational culture and organizational

performance.

Organizational culture, Denison Organisational Culture Model, Organizational performance,

Cultural Traits, Involvement, Consistency, Adaptability, Mission


Feleke Yeshitila Habte Terefe

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The effectiveness of an organization is mainly depending on the skill, knowledge

and attitude of employees required by the job. Recruiting, selecting, orienting and then

placing employees by itself do not ensure organizational effectiveness. According to Kandula

(2006) the key to good performance is a strong culture. These days, Organizational culture is

becoming the most important factor for the success or failure of an organization performance.

Organizational culture is directly contributed towards the achievement of

organizational goal and objectives. Research conducted by D.R Denison and A.K Mishra

(1995) show that organizational culture is related to organizational success. Organizational

culture is a framework that guides day-to-day behaviour and decision making for employees

and directs their actions toward completion of organizational goals. The change in

technology, increasing complexity, instability and uncertainty requires different and greater

knowledge. Currently, organizational culture is vital in organization to shape employee’s

values, beliefs, assumptions and behaviours in order to accomplish successfully

organizational performance.

Yekatit 12 Referral hospital is one of the governments owned hospital established to

provide quality and equitable, preventive and curative health services to the inhabitants of

Addis Ababa. It also has mission to reduce mortality due to communicable diseases and other

health problems through active participation of the community and all partners in Addis

Ababa. To achieve these goal and objectives, the hospital must understand and manage the

effect of organizational culture on performance. It also should be linked with the hospital

strategies and missions.

It is well known fact that Yekatit 12 referral hospital invests much of the resources

to provide quality health service to people in Addis Ababa. Setting objectives and investing

much of the resource is not the end to bring quality service and effective organizational

performance. The hospital supposed to give great emphasis on organizational culture to shape

employees behaviour in order to provide quality health service to the people.

In Yekatit 12 referral Hospital where the research was conducted previously

attempted to introduce and implement quality improvement project such as Business Process

Reengineering (BPR). Based on unstructured interview with employees and patients, the

hospital did not consider the major and important determinant of organizational culture while



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they were doing the organizational transformational change. As a result of these the BPR has

been unsuccessful to provide quality health service to the people. In order to solve the current

problem, it is needed to understand the cultural traits that help the hospital to provide quality

service and determine which cultural trait should be promoted in the hospital to improve

quality service.

In the previous time, the hospital has conducted different research to improve the

service given by the hospital and customer satisfaction. As it is presented, all the researches

have been focused on work process, quality health service and organizational restructure of

the hospital. However, there is drawback on the understanding and managing of the effect of

organizational culture in the hospital. To fill the gap, this study will critically assess in detail

organizational culture of Yekatit 12 referral Hospital to improve the quality of health service

and the entire organizational performance of the hospital.

Yekatit 12 Referral hospital is one of the governments owned hospital in Addis

Ababa. It is found adjacent to Addis Ababa University, in front of Yekatit 12 commemoration

obelisk.

The hospital was established in 1915 E.C by Dr Hanar (Sweden citizen). It started its

function by 25 patient beds and 30 Ethiopian Nurses. During the invasion of Italy, the

hospital was a centre where the Ethiopian Patriot and the Italian prisoner in war had been

treated.

In1947 E.C, the hospital had been named by Emperor Majesty Haile Selassie. In

1967 E.C, it had changed its name as Yekatit 12 Hospital. The name was given to memorize

the indiscriminate massacre and imprisonment of Ethiopian by Italian Occupation Forces (led

by Rodolfo Graziani).

Yekatit 12 referral hospital is directly responsible to Addis Ababa city

administration health bureau. The organizational structure of the hospital is consists of two

operational staffs. The one is medical staff and the other is administration staff. Medical

service, Diagnosis and laboratories, Pharmacy and Nurse College are found under the

hospital medical provost. Human Resource management, Budget and Finance and General

Service and administration are belongs to the hospital administration provost.

Currently, Yekatit 12 Hospital has a total of 415 employees in medical staff and

administration staff. The medical staffs are 243 (59%) which includes medical doctors, health

http://en.wikipedia.org/wiki/Rodolfo_Graziani



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officers, nurses, laboratory technician’s pharmacist and other health professionals. The

administration staff are 172 (41%) that involve Human resource professional, accountant,

purchaser, janitor, guards, general service clerk and other administration employees.

According to Deal and Kennedy (1982), organization culture is the single most

important factor for success or failure. The success and failure of organization is mainly

depends on the effectiveness of organizational performance. Organizational performance is

the effectiveness and efficiency of an organization to achieve its goal and objectives. The

ultimate goal of the hospital is provide quality health service. Understanding and managing

organizational culture is one of the factors that improve organizational performance and

quality health service in the hospital. However, the hospital did not understand and manage

organizational culture. It focused on the day to day operation of the hospital.

Taking all these facts in to account, this study will intend to assess organizational

culture of the hospital and determine which cultural attribute used to improve the health

service and the entire organizational performance of the hospital.

These days, organizational culture becomes a strategic issue in any organization to

improve organizational performance. Deal and Kennedy (1982) argues that culture is the

single most important factor for success or failure. In this topic, Yekatit 12 referral hospital

did not conduct any research so far. This study looks the detail of organizational culture in

Yekatit 12 referral hospital. In this particular case, this research will contribute for the

improvement of health service. It also will be the starting point for further study on the

assessment of organizational culture and its attribute in Yekatit 12 referral Hospital.

The general objectives of this study will be to assess organizational culture of yekatit

12 Referral Hospital by using Denison’s organizational culture model. In addition, the

specific objectives of this study will be:-

To identify which cultural traits are positively perceived by the employees.

To determine which cultural dimension has a significant impact on the effectiveness

of the organizational performance in Yekatit 12 referral hospital

To identify which cultural attribute help to improve the entire organizational

performance of the Hospital



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Based on the objectives of the study, this research will be conducted mainly to

addresses the following questions:-

Which cultural attribute positively perceived by the employees?

Which cultural dimensions have an impact on the effectiveness of organizational

performance?

Are there any relationship between organizational culture and organizational

performance?

The study will focus on organizational culture and organizational performance in

Yekatit 12 Referral Hospital. The nurse college of the hospital will be excluded from

sampling due to the complex structure and broadness of the hospital. Two operational

directorates will be taken as a study sample. They are administration directorate and medical

service directorate.

Due to the financial constraints, fewer samples will be taken for the study. But this

does not affect the result of the research. Similarly, it is impossible to cover the whole

operational directorate of the hospital. By the reason of the complex structure and broaden of

the hospital, the study will cover only the current organizational culture, health service and

entire organizational performance of the hospital.

It is hoped that this study will contribute to advance the organizational performance

of the hospital. It will motivate the hospital leaders, administration staffs and health

professionals on how to improve organizational performance by understanding and managing

organizational culture of the hospital. Furthermore, it gives directions for other researcher

that need to conduct further study in this subject matter.

Organizational culture: - Shared values and beliefs that underlie an organization’s

identity

Denison Organizational Culture Model: - it is a model that highlights four key traits

(Mission, Consistency, Involvement, Adaptability) that an organization should master

in order to be effective.



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Organizational performance: The effectiveness and efficiency of organization

Mission: Defining a meaningful long-term direction for the organization.

Adaptability: Translating the demands of the external environment into action.

Involvement: Building human capability and creating a shared sense of ownership and

responsibility throughout the organization.

Consistency: Defining the values and systems that are the basis of the culture.



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This study will be survey in the form of cross sectional study in which data will

collect once across a population through sampling. Two operational directorates will be

selected. They are hospital administration directorate and medical service directorate. From

medical staff, 24 employees and from administrative staff, 16 employees will be selected

using random sampling techniques. The questionnaire will be administered personally by the

researcher to the respondents.

An interview will be conducted to gather information on the subject from the two

management of the Yekatit 12 referral hospital. It is used to ascertain the management view

on how organizational cultures enhance organizational performance. Documents on the

hospital health service will be reviewed. This will help the researcher to ascertain whether the

hospitals provide quality health service to the people and how it performs organizational

performance.

The target population of this study will include all levels of health professional and

administration employees who are working in Yekatit 12 referral hospital. The reason why

such employees are targeted is that the health professional are working in core business

process and the administration employees are working in support business process. As a

result of this, the researcher will compare the organizational culture and performance in both

businesses process.

The sample size will be 40. It will classify based on the professional level. Based on

this, the sample is made up of 24 health professional and 16 administration employees. The

sample size of 40 is small for this kind study intended. However, time and resources

constraints make it imperative to restrict the sample to this size. But it will not affect the

result of the study. Sample random sampling method will be used as a sample procedure.

The data for this research will be obtained essentially from primary and secondary

sources. The researcher will draw the effect of organizational culture organizational

performance from secondary source. The secondary data will be gathered from Yekatit 12



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referral hospital annual report on the performance of the hospital, books and journals on

organizational culture.

Primary data will be sourced from structured personal interviews conducted.

Furthermore, an extensive discussion will be held with the administration employees, health

professional and patients.

The research instrument will be a self administered questionnaire. The research

instrument will contain question which are closed ended. It will be developed from the

Denison Organizational Culture Model. Denison (1990) identifies four basic views of

organizational culture that can be translated into statements focusing on the cultural traits,

namely, that of involvement, consistency, adaptability and mission. The questions will be

measured by a four point Likert scale (Strongly agrees, Agree, Disagree and Strongly

disagree).

The collected data will be analyzed up on receiving the completed surveys. The

researcher will present the findings by using descriptive statistic percentage, graph, and table.

Survey results and recommendations will be presented in a report format with the data

graphically displayed where appropriate



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This section indicates conceptual frame work of organizational culture, health

service and organizational performance. The researcher used some different related books

and international journals.

Different writers defined organizational culture in different ways. A few definitions

on the term organizational culture are given in the following.

Organisational culture has been defined by Harvey and Brown (1996) as a system of shared

meanings, including the language, dress, patterns of behaviour, value system, feelings,

attitudes, interactions and group norms of employees within the organisation.

According to Denison (1990), organisational culture is referring to underlying

values, beliefs and principles that serve as a basis for an organisation’s management system.

Edgar Schein (1992) defines organizational culture as “a pattern of basic

assumptions – invented, discovered or developed by a given group as it learns to cope with its

problems of external adaptation and internal integration – that has worked well enough to be

considered valuable and, therefore to be taught to new members as the correct way to

perceive, think and fell in relation to those problems”.

From the above definitions it is clear that organization’s culture is the beliefs,

values, and behaviours that the organization has adopted over time as a way to be effective in


Denison’s organizational culture model is based on four cultural traits involvement,

consistency, adaptability, and mission that have been shown in the literature to have an

influence on organizational performance (Denison, 1990; Denison & Mishra, 1995). The four

traits of organizational culture in Denison’s framework are as follows:

Successful organizations have a clear sense of purpose and direction that defines

organizational goals and strategic objectives and expresses a vision of how the organization

will look in the future (Mintzberg, 1987; 1994; Ohmae, 1982; Hamel & Prahalad, 1994).

When an organization’s underlying mission changes, changes also occur in other aspects of

the organization’s culture.



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Ironically, organizations that are well integrated are often the most difficult ones to

change (Kanter, 1983). Internal integration and external adaptation can often be at odds.

Adaptable organizations are driven by their customers, take risks and learn from their

mistakes, and have capability and experience at creating change (Nadler, 1998; Senge, 1990).

They are continuously changing the system so that they are improving the organizations’

collective abilities to provide value for their customers (Stalk, 1988).

Effective organizations empower their people, build their organizations around

teams, and develop human capability at all levels ( Lawler, 1996; Likert, 1961). Executives,

managers, and employees are committed to their work and feel that they own a piece of the

organization. People at all levels feel that they have at least some input into decisions that

will affect their work and that their work is directly connected to the goals of the organization

(Katzenberg, 1993; Spreitzer, 1995).

Organizations also tend to be effective because they have “strong” cultures that are

highly consistent, well coordinated, and well integrated (Davenport, 1993; Saffold, 1988).

Behaviour is rooted in a set of core values, and leaders and followers are skilled at reaching

agreement even when there are diverse points of view (Block, 1991). This type of consistency

is a powerful source of stability and internal integration that results from a common mindset

and a high degree of conformity (Senge, 1990).

An organization with a strong external focus is focused on adapting and changing in response

to the external environment.

An organization with a strong internal focus is focused on the dynamics of the internal

integration of systems, structures, and processes. It values its people and prides itself on the

quality of services. A strong internal focus has been linked to higher levels of quality, fewer

defects and less rework, good resource utilization, and high employee satisfaction.



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A flexible organization has the capability to change in response to the environment. Its focus

is on its people. A flexible organization is typically linked to higher levels of product and

service innovation, creativity, and a fast response to the changing needs of customers and

employees.

A stable organization has the capacity to remain focused and predictable over time. A stable

organization is typically linked to high return on assets, investments and sales, as well as

strong business operations.

This research is mainly aimed to investigate the impact of organizational culture on

organizational performance in Yekatit 12 Referal hospital. Denison’s model proposes that

organizations with a higher combined measure of the four culture traits show higher levels of


Figure 1 Conceptual Model



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This chapter reports on the results from the culture assessment at Yekatit 12 referral

Hospital. The survey was distributed to 40 employees with 77.5% response rate. The

respondents provided information that assisted in meeting the objectives for the study. In the

assessment, section one questions were used to obtain demographic information and section

two questions were focused on the mission, adaptability, involvement and consistency of

organizational culture dimensions. To confirm the results which were collected by the

questionnaires, structured interview was conducted with two employees and three patients.

The researcher also used direct observation method to collect information.

This section summarises the results of the demographic variables which were

included in the assessment questionnaire gathered from the sample. From the total population

of the study, 10.37% was sample i.e. 40 employees from different department were selected

as a sample study.

Profession Frequency Percent

Medical Staff

General Practitioners 3 12.5

Health Officers 2 8.33

Nurses 9 37.5

Medical laboratory Technicians 4 16.66

Pharmacist 3 12.5

Other health Professionals 3 12.5

TOTAL 24 100

Administration Staff

Human resource management 7 43.75

Finance and budget 3 18.75

Purchasing 1 6.25

General service 5 31.25

TOTAL 16 100 Table 1 Professional Composition of sample

As the table indicated above, the nursing department was the largest representative

group of the sample (37.5%) from medical staff. 16.66% of the sample of the medical staff



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was medical laboratory technicians. The samples of medical practitioners, pharmacist and

other medical professionals comprised 12.5% each. Health officers were composed of 8.33%

from the sample of medical staff. From the administrative staff of the sample, 43.75% were

human resource, 31.25% and were general service and 18.75% were finance and budget.

0

5

10

15

20

Female Male

Health professional

Administrative staff

Figure 2 Gender Distribution of sample

The table shows that the majority of the sample (55%) was female, whilst the

remaining 45% comprised of male respondents. It is possible that the difference in gender

representation could be attributed to a larger number of females being employed at the

hospital.

0

2

4

6

8

10

12

14

High School

complete

College

Diploma

First degree Master Degree Doctorate

Degree

Figure 3 Educational background

As the graph indicated above that the educational background of the majority of the

sample was college diploma (32.5%). 20 % and 17.5% of the respondents have master degree



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and first degree respectively. The respondents who have doctorate degree were 15%. This

shows that the sample of the study was composed of all educational background.

0

2

4

6

8

10

12

Up to 2 years 3-5 Years 6-9 Years 10-15 Years Above 16 years

Figure 4 Work Experience of the sample

The majority of the sample 25% worked between 3-5 years at the hospital whilst

20% have between 6-9 years of service and above 16 years service. The rest worked between

10-15 years and up to 2 years. These indicate that the sample of the study covered all

employees who have long experience and least experience.

0

5

10

15

Below 20

Years

21-30 Years 31-40 Years 41-50 Years 51-60 Years

Figure 5 Age Distribution of the sample

From above figure it can be ascertained that the majority of the respondents 35% fall

between the age categories 31-40 years, followed by the age category 21-30 years were



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22.5% and 41-50 years which constitutes 20 % of the sample. The minority of the

respondents was 12.5% fall into the age category 51-60 and 10% was below 20 years.

Based on the questionnaires that were distributed to employees of Yekatit 12 referral

hospital, the result was analysed according to Denisons model of organizational culture

dimensions.

The following statements were used to determine if the employees understood and

believed in the strategic intentions of the hospital.

The results show that 9.7% of the employee respondents felt that the hospital

direction was clear to them, 38.8% feel that the hospital is competent in the sector, 28.9%

believe that the hospital has clear mission that gives direction to work, purpose and direction,

90.3% said that the hospital strategic direction is unclear for them. These results were

affirmed by the interview where the employees did not know clearly the strategic plan of the

hospital.

Figure 6 Strategic direction and intent

The following statement were used to identify that there are short-term goals that

help link what employees do on a day-to-day basis to the strategy and vision of the hospital.



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The results show that 9.7% of the respondents agreed that there is widespread agreement

about goals, 10.6% of the respondents believed that the hospital leaders set goals and

employees are on the track of stated goals, 9.7% agreed with the employees understand what

needs to be done.

Figure 7 Goals and objectives

The following statements were used to determine if the hospital has a shared view of

the stated purpose and desired future vision of the organization.

The results show that 19.4% of the respondents agree with the statement that the

hospital has a shared vision of what it will be like in the future, 38.8% of the respondents felt

that the vision is attainable, 61.2 % agreed that short term thinking compromise long term

vision, 9.7% agreed with the vision and mission created excitement and motivated

employees, 19.4% of the respondents said that the hospital is able to meet short term

demands without compromising long term vision. Based on direct observation of the

researcher, the hospital has not clear vision. No vision and mission which were posted in the

compound of the hospital.

19.40%

38.80%

61.20%

9.70%

19.40%

We are able to meet short term …

Our vision creates excitement and …

Short term thinking often …

The hospital leaders have a long …

We have a shared vision of what …

Figure 8 Vision



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The following statements were used to determine the behaviour of employees

regarding how employees respond and accept change within the hospital.

The results show that 16.1% of the respondents agree with the statement that the

way things are done is very flexible and easy to change, 9.7 % agree that the hospital respond

well to changes, 12.9% of the respondents agreed that new and improved ways to do work are

continually adopted, 42% said that there is resistance when attempts to create change, 42%

believed that different parts of the hospital cooperated to create change. It is confirmed by the

interview that the implementation of BPR faced challenge in the hospital.

Figure 9 Creating Change

The following statements were used to determine if the employees of the hospital

feel that they are meeting the needs and expectations of the persons for whom they are

performing their work.

The results show that 42% of the respondents agreed that customer comments and

suggestions often lead to changes, 19.4% agreed with the statement that customer input

directly influences our decision,19.4% of respondents agree with the statements that all

employees have a deep understanding of patients wants and needs,19.4% of the respondents

agree with the statements that the interest of the patient get ignored in the hospital decision,

19.4% agreed that the hospital members encourage direct contact with patients by the

employees. The researcher has seen patients who were complaining about the service of the

hospital.



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Figure 10 Customer Focus

The following statements were used to determine the organizational development of

the hospital.

The results show that 29.1% of the respondents agreed that employees view failure

as an opportunity for learning and improvement, 25.8% of employees feel that innovation and

risk taking are encouraged and rewarded, 48.4% said that learning is an important objective

in our day to day work, 9.7% respondents agree with the statement that we make certain that

the “right hand knows what the left hand is doing.

Figure 11 Organizational Learning



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regarding authority, initiative and ability to manage their own work. Empowerment creates a

sense of ownership and responsibility towards the organization.

The results show that 42% of the employee respondents felt that most employees are

highly involved in their work, 48.4% of the respondents agreed with the statements that

decision are made based on the best information,48.4% of respondents feel that information

is widely shared so that everybody can get easily, 48.4 % said that employees have a positive

impact on the organization, 16.1% of the respondents agree with the statements that

employees participating in every aspect of the hospital business process.

16.10%

48.40%

48.40%

48.40%

42.00%

Business planning is ongoing and

involves everyone in the process to …

Everyone believes that he or she can

have a positive impact

Information is widely shared so that

everyone can get the information he …

Decisions are usually made at the

level where the best information is …

Most employees are highly involved in

their work

Figure 12 Empowerment

The following statements were used to determine how well employees work together

as a team.

The results indicate that 9.7% of respondents agree that cooperation across different

parts of the hospital is actively encouraged, 19.4% believe that people work like they are part

of team, 38.8%% of respondents can agreed that teamwork is used to get work done rather

than hierarchy and teams are the hospital primary building block, 48.1% of the respondents

feels that work is organized properly in the hospitals.



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Figure 13 Team Orientation


towards development of skills. Competency and Capability Development relates to the

employee skills, training needs, and tools to do their job.

The results show that 12.9% of the respondents agreed with the statements that

authority is delegated so that people can act on their own, 38.1% of the respondents agreed

that the capability of employees is constantly improved, 38.1% feels that there is investment

in the skill of employees, 16.1% of respondents agreed with the statement that the capability

of employees are viewed as an important source of competitive advantage,38.8% of

respondents felt that problems arise because employees do not have the necessary skills to do

the job.

Figure 14 Capability Development



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The following statements were used to determine if members of the organization

share a set of values which create a sense of identity and a clear set of expectations.

The results show that 9.7% of the respondents agreed with the statements that the

leaders and managers practice what they preach and there is distinct set of management

practice, 38.8% of the employee respondents felt that there is a consistent set of values that

govern the way business is done, 38.8% agreed that ignoring core values will get you in

trouble, 19.4% of the respondents said that there is an ethical code that guides our behaviours.

Figure 15 Core Value

The following statements were used to determine if members consensus in the

hospital when they are working together.

The result shows that 38.8% of respondents feel that when disagreements occur, the

hospital members work hard to achieve “win-win” solutions and there is strong culture in the

hospital, 19.4% said that in the hospital it is easy to reach consensus, 29.1% of the

respondents agreed with the statements that we often have trouble reaching agreement on key

issues, 19.4% of the respondents believed that there is clear agreement about the right way

and the wrong way to do things.



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Figure 16 Agreement

The following statements were used to determine if the behaviour of members of the

hospital on coordination of work and consistency.

The result shows that 38.8% of the respondents feel that the approach to do business

in the hospital is very consistent and predictable, 9.7% said people from different parts of

the hospital share a common perspectives and it is easy to coordinate works,38.8% agreed

with there is good alignment of goals across levels in the hospital.

38.80%

19.40%

9.70%

9.70%

38.80%

There is good alignment of goals

across levels

Working with someone from another

part of this hospital is like working …

It is easy to coordinate projects

across different parts of the hospital

People from different parts of the

hospital share a common perspective

Our approach to doing business is very

consistent and predictable

Figure 17 Coordination and Integration



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In the summary, the average score of each dimension of culture were presented in

the following manner:-

Dimension of Culture Average

Score

Dimension of Culture Average

Score

MISSION ADAPTABILITY

Strategic Direction and intent 34.7 Creating change 24.54

Goals and Objectives 10.24 Customer focus 23.92

Vision 29.7 Organizational learning 32.28

INVOLVEMENT CONSISTENCY

Empowerment 40.66 Core Values 23.8

Team orientation 30.96 Agreement 29.1

Capability development 28.8 Coordination and Integration 23.8

Table 2 Summary of results

The results of this study indicate that the cultural trait mission (strategic direction and intent,

goals and objectives and vision) was negatively perceived by employees of the hospital.

According to these findings, the employees were unclear about goals and objectives required

to drive the achievement of the mission and vision.

The results of the study show that the cultural trait adaptability (creating change, Customer

focus and organisational learning) was negatively perceived by employees of the hospitals.

The hospital has weak adaptability cultures that stress employee innovation, risk-taking,

internal flexibility and entrepreneurialism.

The results of this study show that employees of the hospital perceived the cultural trait

involvement (empowerment, team orientation and capability development) negatively.



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According to the results from this study, the cultural trait consistency (core, values,

agreement and co-ordination and integration) was negatively perceived by employees of the

hospital.



`

The objective of this study was to assess the organisational culture at Yekatit 12

Referral Hospital in Addis Ababa.

The findings of this study indicate that employees perceived all organizational

culture dimensions negatively. All organizational culture dimensions were scored below

average. The very lowest rated dimension was goal and objectives (10.24). From the result of

the data, the highest rated dimension was empowerment (40.66). With regard to profession of

employees, there was no significant difference regarding the perception of organizational

culture traits. The health professional and administrative staffs perceived all the dimension of

culture negatively.

Denison’s research has demonstrated that effective organizations have high culture

scores in all four traits. But this research found that all dimension of organizational culture

have low culture score in Yekatit 12 Referral Hospital. These dimensions of culture have an

impact on the hospital quality health service and the entire organizational effectiveness.

Because of the weak organizational culture of the hospital, the hospital could not be

successful on the entire organizational performance. The hospital does not focused on the

adapting and changing in the response of the external environment. It also does not focused

on dynamics of the internal integration of systems, structures, and processes.

According to the result of the study, all cultural traits have direct relationship with

organizational performance of the hospital.

Based on the conclusion of the study it is recommended that:-

The hospital leaders should build a culture as a clear role with a set of objectives. In

order to build culture, the hospital should create awareness. To create awareness of

the hospital culture, it is advised that the hospital provide training to employees. The

hospital leaders also should discuss with employees concerning the organizational

culture.



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Make the employees in the hospital familiar with the hospital’s strategy and vision.

Everyone in the organisation must be able to define their goals in terms of the overall

mission, vision and strategy of the hospital. Strategic direction must be supported at

all levels. The hospital should develop its own mission and vision and posted to the

hospital in order to create consensus.

The hospital should build cultural trait of adaptability to recognise and respond to its

external environment and internal environment. This helps the hospital to motivate

and encourage innovation, risk-taking, internal flexibility and entrepreneurialism.

Employees should be involved in decision-making, as it will make them to be

committed to the achievement of the decisions taken. Employee involvement creates a

sense of ownership and responsibility towards the organization. Employees are more

committed to a decision or course when they are involved in the decision- making

process. Involved and committed employees work hard to ensure the achievement of

hospital goals.

Organization’s values should be shared amongst employees as it will enable them to

act in the interest of the organization at all times. Shared values (consistency) provide

the central source of integration, coordination and control. Consistent organizations

have highly committed employees and are more effective in its organizational

performance.

Finally, the hospital should perform a culture assessment survey to identify the

hospital weak culture and improve them. In order to improve the culture of Yekatit 12

Referral Hospital, all employees must understand what culture is and how it and their

actions affect the hospital performance. In addition, all level of the hospital leaders

must make a long term commitment to its improvement and efforts made to do so.



`

By conducting an assessment of organizational culture, we have got opportunity to learn

How to diagnose organization using organizational culture assessment model

Bottomless understanding of concepts on organizational culture and human relations

Linking different theories with the different practical situations

About Denison Organizational culture assessment model

Besides to these,

working as a group and develop team sprit

Collaborative learning (one from the other)

communicating with other person

Develop skill to conduct research



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DavenportT.O(1998)“The Integration Challenge: Managing Corporate Mergers”

Management Review 87 (Jan) pp 25 - 28.

Deal, T., & Kennedy, A. (1982). Corporate cultures. Reading, Canada: Addison- Wesley.

Denison, D. (1990). Corporate culture and organisational effectiveness. New York: John

Wiley & Sons.

Denison, D., & Mishra, A. (1995). Toward a theory of organisational culture and

effectiveness. Retrieved December 21, 2004, from http:

www.denisonculture.com/articles/toward_theory.pdf

Harvey, D., & Brown, D. (1996). An experiential approach to organisational development

(5th ed). New Jersey: Prentice Hall.

Kandula, S. R. (2006). Performance Management. New Delhi: Prentice Hall of India private

limited.

Lawler, E., & McDermott, M. (2003). Current performance management practices. Worldat-

Work Journal, 12(2), 49-60.

Likert, R. 1961. New Patterns of Management. New York, NY: McGraw-Hill.

Nadler, D. & Nadler, M. B. (1998). Champions of change: How CEOs and their companies

are mastering the skills of radical change. San Francisco: Jossey-Bass.

Ohmae, K. (1982). The mind of the strategist: The art of Japanese business. India: McGraw-

Hill Professional.

Schein, E. (1992). Organisational culture and leadership (2nd ed.). San Francisco: Jossey-

Bass.

Saffold, G. (1998). Culture traits, strength and organisational performance: Moving beyond

‘strong’ culture. Academy of Management Review, 13(4) 546-558.

Spreitzer, G. (1995). Psychological empowerment in the workplace: Dimensions,

measurement and validation. Academy of Management Journal, 41(5), 511-525.

Stalk, G. (1988). Time - the next source of competitive advantage. Harvard Business Review,

1988, Jul-Aug, 41-51.



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Dear;

This study is being conducted by a graduate student in the Department of Educational

Planning and Management under Educational and behavioural studies in Addis Ababa

University.

The purpose of this study is to assess the current organizational culture of Yekatit 12 Referral

Hospital.

You have been selected randomly by your profession. You feel assured your responses will

be confidential.

In advance, I wish to thank you for taking time to complete this questionnaire. The input you

provide will be used for my study. Please complete the following questionnaires as much as

possible.



`

SECTION ONE

Please make a (X) in the appropriate box.

1. Your age:

A. 20 years and below ( )

B. 21 to 30 years ( )

C. 31 to 40 years ( )

D. 41 to 50 years ( )

E. 51 to 60 years ( )

2. Your Sex:

A. Male ( ) B. Female ( )

3. Your profession belongs to :

A. Administration ( )

B. Health ( )

C. Others ( )

4. How many years have you been working in this hospital including this years?

A. Up to 2 Years ( )

B. 3 up to 5 years ( )

C. 6 up to 9 years ( )

D. 10 up to 15 years ( )

E. 16 years and above ( )

)

5. What is the highest qualification which you have attained?

A. High school complete ( )

B. College diploma ( )

C. First degree ( )

D. Masters degree ( )

E. Doctorate degree ( )

F. Others ( )


Feleke Yeshitila Habte Terefe Page 20

`

SECTION TWO

To what extent are you agreed with the following statement? Please make (X) mark in the

space given in front of each statement. The choices are given below

1. strongly disagree

2. Disagree

3. Agree

4. Strongly Agree

No Statements Choices

1 Mission 1 2 3 4

Strategic Direction and Intent

1.1.1 There is a long term purpose and direction in the hospital

1.1.2 The hospital strategy leads other organizations to change the way they compete in the health sector

1.1.3 There is a clear mission that gives meaning and direction to the work

1.1.4 There is a clear strategy for the future

1.1.5 The hospital strategic direction is unclear to me

1.2 Goals and Objectives

1.2.1 There is widespread agreement about goals

1.2.2 The hospital leaders set goals that are ambitious, but realistic

1.2.3 The leaders has gone on record about the objectives we are trying to meet

1.2.4 We continuously track our progress against our stated goals

1.2.5 People understand what needs to be done for us to succeed in the long run

1.3 Vision

1.3.1 We have a shared vision of what the hospital will be like in the future

1.3.2 The hospital leaders have a long term viewpoint

1.3.3 Short term thinking often compromises our long term vision

1.3.4 Our vision creates excitement and motivation for our employees

1.3.5 We are able to meet short term demands without compromising our long-term vision

2 Adaptability

2.1 Creating Change

2.1.1 The way things are done is very flexible and easy to change

2.1.2 We respond well to competitors and other changes in the business environment

2.1.3 New and improved ways to do work are continually adopted

2.1.4 Attempts to create change usually meet with resistance

2.1.5 Different parts of the hospital often cooperate to create change



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Statement Choices

2.2 Customer Focus 1 2 3 4

2.2.1 Customer comments and recommendations often leads to changes

2.2.2 Customer input directly influences our decision

2.2.3 All hospital members have a deep understanding of customer wants and needs

2.2.4 The interest of the customer often get ignored in our decision

2.2.5 We encourage direct contact with customers by our people

2.3 Organizational Learning

2.3.1 We view failure as an opportunity for learning and improvement

2.3.2 Innovation and risk taking are encouraged and rewarded

2.3.2 Lots of things fall between the cracks

2.3.4 Learning is an important objective in our day to day work

2.3.5 We make certain that the “right hand knows what the left hand is doing”

3 Involvement

3.1 Empowerment

3.1.1 Most employees are highly involved in their work

3.1.2 Decisions are usually made at the level where the best information is available

3.1.3 Information is widely shared so that everyone can get the information he or she needs when it’s needed

3.1.4 Everyone believes that he or she can have a positive impact

3.1.5 Business planning is ongoing and involves everyone in the process to some degree

3.2 Team Orientation

3.2.1 Cooperation across different parts of the hospital is actively encouraged

3.2.2 People work like they are part of a team

3.2.3 Teamwork is used to get work done, rather than hierarchy

3.2.4 Teams are our primary building blocks

3.2.5 Work is organized so that each person can see the relationship between his or her job and the goals of the hospitals

3.3 Capability Development

3.3.1 Authority is delegated so that people can act on their own

3.3.2 The “bench Strength” (capability of people) is constantly improving

3.3.3 There is continuous investment in the skills of employees

3.3.4 The capabilities of people are viewed as an important source of competitive advantage

3.3.5 Problems often arise because we do not have the skills necessary to do the job



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Statements Choices

4 Consistency 1 2 3 4

4.1 Core Values

4.1.1 The leaders and managers “practice what they preach”

4.1.2 There is characteristic management style and a distinct set of management practice

4.1.3 There is a clear and consistent set of values that governs the way we do business

4.1.4 Ignoring core values will get you in trouble

4.1.5 There is an ethical code that guides our behaviour and tells us right from wrong

4.2 Agreement

4.2.1 When disagreements occur, we work hard to achieve “win-win” solutions.

4.2.2 There is a “strong” culture

4.2.3 It is easy to reach consensus, even on difficult issues

4.2.4 We often have trouble reaching agreement on key issues

4.2.5 There is a clear agreement about the right way and the wrong way to do things

4.3 Coordination and Integration

4.3.1 Our approach to doing business is very consistent and predictable

4.3.2 People from different parts of the hospital share a common perspective

4.3.3 It is easy to coordinate projects across different parts of the hospital

4.3.4 Working with someone from another part of this hospital is like working with someone from a different organization

4.3.5 There is good alignment of goals across levels

Thank you

Organizational Culture and Human Relations

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