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Table 1 Indicative types of data ( and methods for collecting data) for each level and domain of culture in a hospital change programme

From: Patients-people-place: developing a framework for researching organizational culture during health service redesign and change

Level/Domain of culture Patients People Place
Observable behaviour and artefacts (audits, surveys, patient satisfaction monitoring, observation of activities undertaken as part of a redesign programme, content analysis of information and communication) Patient information leaflets/posters; lay members of boards; methods for consultation/involvement in redesign initiatives Frequency and extent of consultation with or full involvement of stakeholders in decision making; modes and content of communication about potential and actual changes to the service; management structures New building layout and facilities; reallocation of services between primary, secondary, tertiary or community health spaces; development of day surgery units; tension between consolidation and decentralization of services
Values and habits of social actors (phenomenological interviewing, participant-observation) Value statements from staff and patients about initiatives to involve patients; ways of talking about everyday practice and change Value statements from senior and frontline staff; deployment of ‘change agents’ to show where perceived barriers to change are; views on role of government policy Associations made between buildings and quality; views on community; co-design practices for new clinical space
Basic assumptions (theory, discourse analysis, ethnography) Power relations between staff and patients; professional and organisational structures; ideologies of care Power relationships between clinicians and management; organisational hierarchies; professional divisions of labour Ideologies of progress, technological development and modernization; communities of practice