Academic journal article Journal of Organizational Culture, Communications and Conflict

Organizational Culture on Community Health Outcomes after the 2009 H1N1 Pandemic

Academic journal article Journal of Organizational Culture, Communications and Conflict

Organizational Culture on Community Health Outcomes after the 2009 H1N1 Pandemic

Article excerpt

INTRODUCTION

Public health preparedness and response has been nominated as one of the ten great public health achievements of the first decade of the 21st century (CDC, 2011b). The 2009-2010 U.S. public health vaccination campaign has been presented in support of the nomination due to the 10,400 hospitalizations and 520 deaths that were averted by the campaign (CDC, 2011b; CDC, 2011c; Ohio Department of Health; 2011).

Four years after September 11, 2001, bioterrorism preparedness remained a high priority (Katz, Staiti, & McKenzie, 2006). From 2001 through 2005 the focus was on improving public health capacity and the second half of the decade focused on laboratory, epidemiology, surveillance, mass vaccination, prophylaxis, treatment distribution and administrative capabilities of the public health system (CDC, 2011b; Brannen & Stanley, 2004). Through flexible federal funding of bioterrorism preparedness, communities strengthened their ability to respond to public health emergencies (Cohen, Gould, & Sidel, 2004; Katz et al, 2006). Collaborative relationships developed for bioterrorism preparedness proved useful in addressing other threats, such as natural disasters and infectious disease outbreaks. However, ongoing challenges including funding constraints, inadequate surge capacity, and public health workforce shortages still persist.

Bioterrorism preparedness funding, crisis experience, and leadership have been noted as the most important determinants of local public health agencies' preparedness activities. (7) The Centers for Disease Control and Prevention (CDC) has played a mediating role by building capacity through funding key organizational leadership positions (Avery & Zabriskie-Timmerman, 2009; Katz et al, 2006). Public health has a defined leadership role at the local level in health and medical emergency support functions (CDC, 2011a; U.S. Department of Homeland Security, 2011). The key to effective public health leadership goes beyond managing within the organization. It must also invite shaping the organization's culture towards a health service of sustainability and change (Gray, 2009). Organizational performance varies with aspects of organizational culture and mixes of culture types (Reay, 2010; Singer et al, 2009). Public health related organizations can be guided through a successful cultural transition to enhance client safety, organizational adaptability, performance, and efficiency through the advocacy of their leadership (Singer et al, 2009; Stone, Bryant, & Barbarotta, 2009; Griffith, Yonas, Mason, & Havens 2010; Meagher-Stewart et al, 2010; Reay, 2010; Summerill, Pollard, & Smith, 2010;).

Given that organizational culture can be changed, the initial question should be: What cultural aspects are crucial to success during a public health emergency? To capture the essence of organizational performance; the focus should be on assessment of community level measures, establishment of targets, and utilization of available data to indicate areas directly linked to actions within the community where opportunities exist to improve the population's health (Gunasekaran, Patel, & Mcgaughey, 2004; Braz, Scavarda, & Martins, 2011; Erwin, Greene, Mays, Ricketts, & Davis, 2011). The 2009 H1N1 vaccination campaign presents an opportunity to explore the association of organizational culture aspects' to the health outcomes of the 2009 H1N1 post pandemic effect.

METHODS

The study design was a prospective and linked health outcomes study of organizations and their service areas as the unit of analysis. The sampling method was a two stage methodology with the first stage comprised of a judgment sampling of emergency exercises with the second stage comprised of a voluntary simple random sample of all participating organizations. All influenza related hospitalizations were enumerated during the 2010-2011 flu season. Culture in this study refers to the organization's members' fundamental ideology and orientation including the beliefs and values shared by all members. …

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