How culture shapes room for manoeuvre in hospital reform

Professor Pieter Degeling with Imperial's Vice-Provost for Education Professor Debra Humphris

Professor Pieter Degeling hosts seminar on how culture interacts in hospitals

Imperial’s Institute of Global Health Innovation (IGHI) and the Centre for Global Health Research were delighted to host an evening lecture with Professor Pieter Degeling on how culture interacts in hospitals across the world.  The event was chaired by Professor Debra Humphris, the Vice-Provost for Education at Imperial. 

Professor Degeling is Emeritus Professor of Health Management at the University of Durham and Visiting Professor in Health Policy and Management at the University of Technology Sydney.  He has published extensively on health care reform, clinician management, clinical pathway development and implementation and clinical governance.

His seminar presented the findings from a cross-national study that involved 2637 hospital-based medical, nursing and managerial staff in China, Australia, New Zealand and England. The idea was to find out how hospital culture differs throughout the world and drew on Dr. W. Edwards Deming’s famous 14 Points, which serve as management guidelines with the aim to increase workplace productivity.

The data from the study was gathered via a closed ended questionnaire that was structured to map the stances of doctors, nurses and managers on issues and matters that are the focus of reform. The study documents the ways in which the stances of Chinese medical, nursing and managerial staff differed from those of those located in Commonwealth countries. Whereas the results obtained from Commonwealth hospitals showed a marked division between clinicians and managers about (i) clinical autonomy and (ii) the prerogatives of management, this was not the case in Chinese hospitals. The study traces these differences to a range of cultural, organisational and policy based factors and demonstrates how (in often unforeseen ways) these factors may shape room for manoeuvre in hospital reform.

More information about the study can be found here.  

“What being a Doctor means in the UK is not the same as what being a Doctor means in China.  Culture is highly resilient. Getting over key cultural divides in hospitals and involving staff at the frontline of care is key to empowering hospital workers to help systems run more smoothly and efficiently” said Professor Degeling. 

“We were delighted to welcome Professor Degeling to Imperial.  His lecture allowed us to look at the different ways of thinking about the cultural construction of healthcare and the best ways to systemise care around specific care pathways” said Professor Debra Humphris. 

Reference: Degeling P, Zhang K, Coyle B, Xu L, Meng Q, Qu J and Hill M, (2006) “Clinicians and the Governance of Hospitals: A cross-cultural perspective on relations between profession and management” ,  Social Science and Medicine (63) 757-775