ANALYSIS OF THE ORGANIZATIONAL CULTURE OF

HEALTH CENTER, FACTORS THAT INFLUENCE THE

ABSENCE OF STAFF MAKING DECISIONS.

Part 1. Background:

The type of services, Public Health Service.

The present study tries to discover which is the organizational culture of

the Health Center with special interest in human resources as its creative
element,to emphasize its importance in planning interventions for
consistent and contextualized changes. In addition, it tries, through said
analysis, to explain the factors that affect the participation of staff in the
organization's decisions. The organizational culture was analyzed from
the structural and qualitative point of view of the organization itself, in
relation to the health system and each of the jobs that comprise it. The
Health Center turned out to be a bureaucratic organization with political
configuration and jobs with deficiencies in the necessary specific
knowledge, a weakened internal communication system, and little
participation. Human resources do not have an optimal environment to
participate, several conflicts are generated that are not resolved and the
"dysfunctional" organizational culture follows a cycle that has become
static and that the bureaucracy prevents change.

DOCTORS, PERSONAL, SANITARY, CLEANING STAFF, DENTISTS,

BSTETRICES, STATISTICS, COLLECTIVE AGREEMENT, DEPT. OF HUMAN,
RESOURCES, DIRECTION
Part 2. Stage of Change: Action

THE ATTEMPT OF THE ACTION A training process was started in research

workshops to ensure that people know aspects of quality and
demonstrate its impact on the personal image and of the health center.
The doctors had a very negative attitude towards learning to research and
the most proactive people were the collective contract workers with an
attendance that exceeded 95%.

There was a radical change in attitudes, an environment of identification

of problems and of alternatives of change; feedback, positive attitude
towards constructive criticism; but the biggest obstacle that had to be
fought against is the director and the absence formal training structures
and political and anti-technical impediments to be able to exercise the
function of the first level as a health service that must teach and research.

ORGANOGRAM

Conflicts within the Health Service. Causes, reactions and flows

 ORGANIZATIONAL DIAGNOSIS

Technical indicators (3 points)

Quality of the medical attention

In hospital care, the quality and efficiency indicators serve as the basis for
measuring the performance of the services provided or should be
provided by the hospital and facilitate comparisons in space and time.

Human indicators (3 points)

Training is the acquisition of technical, theoretical and practical

knowledge for the development of professional activity.

Environmental indicators (3 points)

They refer to physical characteristics of the place where population

groups live or work. Some of these characteristics can be difficult to
measure (eg, exposure to air pollution, hours of sunlight per day, to
dengue vectors). They are factors external to the individual.

Space-time indicators (3 points)

Is more associated with the admission process, the waiting time for the
delivery of beds, the delay creates uncertainty and unsafely. Also to the
information about what to do and where to go, they need ask, because the
explanation of the procedures is not always clear, in addition, consider
that the largest hospitals do not have signage adequate.

Policy indicators (3 points)

Intervene to modify certain situations and factors generators of health

inequalities (relations of dominance - subordination related to health and
disease, the cause of the state of health of persons).
 CONCLUSIONS AND LESSONS

Human resources in this organization have an operational role, they do

not fulfill functions of change and innovation in the organizational
culture, they have not been empowered (political configuration and
vertical structure) of being an organization itself, nor of being public
administrators managing state resources.

Organizational Culture presents a Political Configuration, which is a

hostile environment to insert changes.

The vertical structure at the Area and health center level, the training of
human resources unrelated to jobs, the deficient internal communication
system, vision and problem solving.

Approaches and strategies to address the issue.

Prepare a Macro Action Research design whose objective is to influence

the organizational culture to create legal and legitimate spaces for
participation.

The possible participation in decision-making by non-professional

personnel will improve management quality, by comparing the problems
identified, actions carried out and management of director resources with
those proposed by non-professional personnel and in addition to the
criticisms of the latter towards management in general reflected superior
technical and practical characteristics that the management body did not
take into account.

Perhaps explained by the lack of knowledge and poor monitoring of all

the processes by the director and concentrating only on exhaustive
control of outdated standards and very far from context and quality.