HCS 370 Week 4 Positive Organizational Culture Example

Taking Down the Error Whiteboard: Assessing and Rebuilding the Culture of a Hospital Pharmacy Department Toward Positive Practices

[Student Name]

University of Phoenix

HCS/370: Organizational Behavior

Week 4 Assignment

[Instructor Name]

[Date]

The hospital, the pharmacy department and its culture findings are composites written for a model paper; theories and findings come from the sources listed.

New technicians in the composite hospital pharmacy department notice the whiteboard on their first day. It lists each technician's name and a tally of errors caught by pharmacists this month. The department's values poster, three feet away, lists teamwork, respect and excellence. This paper assesses the department's culture and plans how to move it toward positive practices.

What Culture Is

Schein (1990) defined culture as a pattern of basic assumptions that a group has learned as it solved problems, which have worked well enough to be taught to new members as the correct way to perceive, think and feel. He described culture at three levels: artifacts, the visible things; espoused values, the stated beliefs; and basic assumptions, the unspoken beliefs that actually guide behavior.

Level One: Artifacts

The whiteboard. Corrections written on notes attached to preparations. Closed-door meetings after serious errors. A break room used by pharmacists and technicians at different times.

Level Two: Espoused Values

Teamwork, respect and excellence, printed on the poster and repeated at orientation.

Level Three: Underlying Assumptions

The artifacts reveal assumptions the poster does not: that errors reflect individual carelessness, that public counting deters mistakes and that pharmacists check technicians rather than work with them. When espoused values and underlying assumptions disagree, new employees learn the assumptions within a week, because they watch what happens after an error rather than what the poster says.

Evidence From Staff

A short anonymous survey of 44 staff found that 71% of technicians agreed that mistakes are held against them, compared with 25% of pharmacists. Exit interviews described fear of the whiteboard. Pharmacists said the board was meant to track patterns, not shame anyone.

Subcultures

Pharmacists and technicians experience different cultures in the same department. Pharmacists see a culture of vigilance; technicians see a culture of blame. Both are real, and change must address both.

What Positive Culture Means

Cameron et al. (2011) studied positive practices, including caring for colleagues, providing compassionate support, forgiving mistakes, inspiring one another, emphasizing meaningful work and treating people with respect, integrity and gratitude. In studies of financial services units and of health care units, positive practices were associated with organizational effectiveness, including, in the health care setting, outcomes such as lower turnover and better climate for patients.

Why This Is Not Soft

Positive practices are not the absence of standards. Forgiving a mistake does not mean ignoring it; it means responding without contempt while fixing the cause. Excellence and kindness can coexist.

A Just Approach to Errors

The department will adopt a just culture approach. Human errors, such as selecting the wrong diluent from a similar-looking shelf, receive support and a system fix. At-risk behavior, such as skipping a barcode scan to save time, receives coaching and an examination of why the shortcut seemed necessary. Reckless behavior, which is rare, receives discipline. The same approach applies to pharmacists and technicians.

Practices to Adopt

Replace the whiteboard with a monthly review of error patterns by product and process, without names. Give corrections privately with the reason. Start each shift huddle with one thing that went well. Share a monthly story of how the department's work helped a patient. Hold joint breaks and a quarterly lunch for pharmacists and technicians.

The Leader's Role

Culture changes when leaders change their own behavior. The pharmacy director will announce the whiteboard's removal in person and explain why. She will attend error reviews and ask what about the system made the error likely. She will publicly thank people who report their own mistakes.

Supervisors and Pharmacists

Shift supervisors and pharmacists will receive training in the just culture approach and in giving feedback. Their annual goals will include team climate results.

What the Pharmacists Gain

The change is not only for technicians. Pharmacists described feeling like inspectors rather than colleagues. Working with technicians on system fixes, rather than tallying their errors, gives pharmacists a role closer to why most entered the profession: using expertise to keep patients safe.

Aligning Systems

Policies must match the new culture. Performance reviews will stop counting individual errors and instead assess safe practices, such as scanning compliance. Recognition will reward reporting near misses.

Onboarding as Culture Transmission

Culture is taught most intensely in an employee's first weeks. New technicians currently learn the department's assumptions by watching what happens after errors. Under the plan, orientation will include a conversation with the director about the just culture approach, a mentor for 90 days and a first-month check-in asking what surprised them. New employees will hear the new assumptions from the start rather than absorbing the old ones.

Celebrating Meaning

Pharmacy staff rarely see patients. Once a quarter, a nurse or physician will join a huddle to describe a patient whose care depended on the department's work, a practice meant to connect daily tasks with their purpose.

Resistance

Some pharmacists worry that removing the whiteboard will lower vigilance. The director will track error rates alongside culture measures to show whether safety holds or improves.

Measures Over a Year

Repeat the anonymous survey at six and twelve months, aiming for fewer than 30% of technicians agreeing that mistakes are held against them. Track near-miss reports, which should rise as fear falls. Track first-year turnover, aiming below 20%. Monitor dispensing errors reaching patients.

Early Signs

In the first quarter, near-miss reports doubled, which the director presented to staff as a sign of trust rather than a sign of more errors. Reporting one's own near miss is an interpersonal risk, and people take such risks when they believe the team will not punish them (Edmondson, 1999).

Conclusion

The department's values poster described a culture its practices contradicted. Reading culture through artifacts, values and assumptions showed a blaming culture beneath the stated respect. Positive practices, a just approach to errors and leaders who model the change can bring the culture in line with its words, with effects on retention and safety that can be measured.

References

Cameron, K., Mora, C., Leutscher, T., & Calarco, M. (2011). Effects of positive practices on organizational effectiveness. The Journal of Applied Behavioral Science, 47(3), 266-308. https://doi.org/10.1177/0021886310395514

Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350-383. https://doi.org/10.2307/2666999

Schein, E. H. (1990). Organizational culture. American Psychologist, 45(2), 109-119. https://doi.org/10.1037/0003-066X.45.2.109