Staff evaluations and perceptions of organizational culture: Implications for performance improvement and mental healthcare service evaluation

摘要

The researcher studied staff perceptions and evaluations regarding the provision of adult outpatient mental health services at a county medical center. Methods to improve the quality of adult outpatient mental health services were examined. Qualitative methods were employed to conduct a process and cultural assessment. The researcher addressed: (1) staff evaluations of crucial issues regarding performance improvement, (2) cultural issues relating to organizational change and development, (3) the interventive impact of focus group involvement, (4) the utility of qualitative methods for data analysis, (5) specific considerations for mental healthcare staff, and (6) how the evaluative process of a specific service and/or program impact the greater organizational system. All facets of service provision except confidential information expressed within the confines of the therapeutic relationship were examined;Results yielded six themes indicating cultural, system and leadership issues that compromise the quality of service provision. The final themes include: (1) understanding the entire process of service provision, depends on which roles staff occupy, (2) focus groups are helpful as they validate participants, enhance understanding of staff interdependency and emphasize the need for effective communication, (3) staff perceive upper administration as non supportive and out of touch with their needs and concerns, (4) other than serving patients better, staff perceive \u22performance improvement\u22 as ambiguous and/or not relevant, (5) staff recognize the complexity of change as an emotional process resulting in frustration, isolation and compromised quality of service to patients, and (6) attaining important information for quality service is compromised by both the unique challenges inherent with mental healthcare and the frustrating complexity of the system. Implications from this study support the salience of qualitative process research to develop strategies for change in mental healthcare organizations. In addition, the study outlines creative strategies for family therapists to apply clinical training, systems theory and qualitative methods to work with larger systems.