Running head: HEALTHCARE 1 HEALTHCARE 3 Healthcare Yahima Montero Chamberlain University NR 534 Weeek 5 Healthcare The Analysis The paper explores and analyses how the culture and climate of at my workplace, Cleveland Hospital influence the provision of quality care services. The creation of a sustainable healthcare work environment in which workers and patients feel engaged, loyal, and satisfied remain as priorities of any organization. My organization culture makes the broader construct that covers every aspect of employees at work. The climate within the organization involves our shared perceptions among employees on the organization’s procedures, practices, policies, and the nature of the rewarding system. The summary of the assessment findings on my organization’s physical environment, organizational power and structure, social environment, environmental safety, professional and personal support, organizational communication, and organizational taboos form the critical aspects of the paper. Cleveland Hospital Organizational Culture and Climate Analysis Summary of Assessment Findings Physical Environment: How I experience the work environment at any given time, how it feels to work in the organization and to perform in the organization’s culture influences my mood. Within the facility, families visiting their patients have a well-furnished waiting bay with television in which they first rest before being allowed to see their patients. Those with cars can access marked parking lots that are enough. Since the organization is Christian-based, it has a chapel in which patients’ families can gather and pray for their loved ones undergoing medical treatment. Environmental Safety: As workers, we share values and beliefs that influence our behavior within the organization. It is through these share aspects in which the organization has identified to provide safety measures since the organization believes that healthy workers are essential assets in performance. As a result, environmental safety measures such as safety stickers on elevators, stairwells, passageways, and hallways are maintained. These stickers remind workers and other people that safety at the workplace is critical and that they should observe safety measures. Social Environment: The organization has maintained its annual event at the end of the year in which all workers and other senior employees converge to celebrate the achievements of that year. These internal social events have helped in strengthening interdepartmental socialization and making the organization one big family. As a result, the shared assumptions, values, and beliefs of the organization get enhanced to propel the achievement of goals and realization of the vision. Organizational Power Structure: Board of directors manages the facility. The executive management of the organization oversees daily operations. The chief executive officer remains the top boss responsible for all activi ...

1. Running head: HEALTHCARE 1
HEALTHCARE 3
Healthcare
Yahima Montero
Chamberlain University
NR 534 Weeek 5
Healthcare
The Analysis
The paper explores and analyses how the culture and
climate of at my workplace, Cleveland Hospital influence the
provision of quality care services. The creation of a sustainable

2. healthcare work environment in which workers and patients feel
engaged, loyal, and satisfied remain as priorities of any
organization. My organization culture makes the broader
construct that covers every aspect of employees at work. The
climate within the organization involves our shared perceptions
among employees on the organization’s procedures, practices,
policies, and the nature of the rewarding system. The summar y
of the assessment findings on my organization’s physical
environment, organizational power and structure, social
environment, environmental safety, professional and personal
support, organizational communication, and organizational
taboos form the critical aspects of the paper.
Cleveland Hospital Organizational Culture and Climate
Analysis
Summary of Assessment Findings
Physical Environment: How I experience the work
environment at any given time, how it feels to work in the
organization and to perform in the organization’s culture
influences my mood. Within the facility, families visiting their
patients have a well-furnished waiting bay with television in
which they first rest before being allowed to see their patients.
Those with cars can access marked parking lots that are enough.
Since the organization is Christian-based, it has a chapel in
which patients’ families can gather and pray for their loved
ones undergoing medical treatment.
Environmental Safety: As workers, we share values and
beliefs that influence our behavior within the organization. It is
through these share aspects in which the organization has
identified to provide safety measures since the organization
believes that healthy workers are essential assets in
performance. As a result, environmental safety measures such as
safety stickers on elevators, stairwells, passageways, and
hallways are maintained. These stickers remind workers and
other people that safety at the workplace is critical and that they
should observe safety measures.
Social Environment: The organization has maintained its

3. annual event at the end of the year in which all workers and
other senior employees converge to celebrate the achievements
of that year. These internal social events have helped in
strengthening interdepartmental socialization and making the
organization one big family. As a result, the shared
assumptions, values, and beliefs of the organization get
enhanced to propel the achievement of goals and realization of
the vision.
Organizational Power Structure: Board of directors
manages the facility. The executive management of the
organization oversees daily operations. The chief executive
officer remains the top boss responsible for all activities that go
into a hospital (Ramos, Franco-Crespo, González-Pérez, Guerra,
Ramos-Galarza, Pazmiño, & Tejera, 2019). The hospital has
departments headed by chief nursing officers, chief medical
manager, chief financial officers, and chief information
managers. These officers discharge their power in their
respective departments but follow the chain of command.
The hospital department administrators report to the
executive management and they are responsible for operational
service (Aarons, Ehrhart, Farahnak, Sklar, & Horowitz, 2017).
The direct oversee of patient care is under patient care mangers
whereby rehabilitation services’ directors and nurse managers
have employees under them who provide hand-on patient care.
All these leaders are addressed using their title within the
organization. The organization uses the cross as a symbol of
healing to enable patients to have hope after visiting the
facility.
Professional and Personal Support: The management
recognizes the fact that the healthcare setting is currently
evolving, thus it provides professional development to all
nurses and doctors. This supported supplemental training for
nurses and doctors promotes their value and ensures they remain
relevant in their career field to offer quality services. The
courses that the organization supports nurses and doctors
depend on their clinical relevance and applicability.

4. Organizational Communication: The most preferred way of
communication between the employees and management is
email. Each employee gets an email in case there is an
important communication either from the chief executive
officer, departmental leaders, or any other source within the
facility. The organization uses its staff lounge to communicate
crucial information that concerns all stakeholders of the
hospital.
Organizational Taboos: The current taboos in the
organizational influence workers interpret the medical field.
Male nurses and doctors do not attend to female patients,
especially in maternity or delivery unit. Currently, there is no
policy concerning such but male doctors have taken the issue as
taboo. Other existing taboo within the organization emerges
from the religious beliefs of healthcare practitioners and
patients. For instance, female Muslims patients discourage male
nurses or doctors from touching them.
Mission, Vision, and Goals
The organization's mission, vision, and goals provide a
roadmap toward the achievement of healthy, safe, and patient-
based care and work setting within the healthcare facility. The
culture and climate of the organization reflect these aspects and
determines the efforts needed for their achievement. The vision
of the facility forms the main hope for the future since it
inspires, futuristic thought of the organization. The vision is the
provision of unparalleled experience as the most trusted partner
for healthcare. On the other hand, the mission statement inspires
this hope and leads to health and well-being by offering the best
care to all patients. The goals include:
· Utilizing both formal and informal communication skills with
patients and families while illustrating respect and integrity
· Utilize clinical data to perform better diagnoses to provide
quality work
· Be proficient to obtain clinical data by physical examination,
patient interview, and precise interpretation of laboratory data.
Strengths and Opportunities for Improvement

5. Strengths: My organization has got some capabilities and
resources that give it a competitive advantage in the provision
of quality care services. The current strengths that the
organization can utilize to achieve its goals are extraordinary
reputation, functional safety committee, and strong employee
relationship. The reputation has made the facility famous as one
of the best hospitals that guarantee patient safety as well as
giving high-quality care services. Also, strong employee
relationships within and outside the facility can help in the
implementation of change for boosting the services offered
(Marquis, 2015). Good relationships ensure incidences of
resistance do not thrive. The third strength is the existence of a
safety committee. The hospital can use the committee in
identifying and analyzing aspects that contribute to healthy and
safe care.
Opportunity: The organization can exploit some of the
external aspects such as new technology and growing interests
in the healthcare setting to ensure continued improvements
toward its efforts in becoming a trusted partner in healthcare.
The new technology enables organizations to improve their
performance by having computerized healthcare systems. Also,
growing interests in healthcare provide an opportunity for the
organization to expand its care services by introducing a new
treatment to satisfy the needs of a growing population.
Climate Reflective of Culture
Organizational climate is an integral part of the culture.
Climate is about the mindset that facilitates efficient
organization structure and alignment (McDonald, Middleton,
Bassett, & Harris, 2017). A climate reflects culture through the
mindset in which healthcare workers approach to tackle their
work reveals the kind of practices and habits that exist. These
practices and routines form the organizational culture. Also,
emphasis on “victory” over others leads to unpleasant and cold
climate, in which employees develop a feeling of being
“threatened,” hence the need for protection. Such an atmosphere
reflects competition as part of organizational culture.

6. Healthy, Safe, Person-Centered Care Environment Capacity
Organizational Culture's Capacity to Support
The organization's strong communication and collaboration
with other health stakeholders positively impact health
practitioners' ability to perform their role in the delivery of
compassionate quality care (Marquis, 2015). Regular
communication meetings conducted at the healthcare facility
staff lounge make workers updated with current trends in
healthcare settings since the management utilizes this
opportunity to brief the staff on what areas need improvements.
Further, the organization has taken physical safety measures for
patients and workers. The existence of a safety committee
ensures that people comply with health and safety measures
such as using the designated facilities such as hallways and
passageways. Also, elevators reduce incidences of patients or
workers fall within the healthcare facility.
Maintenance of equipment promotes the safety and
delivery of patient-centered care. The ability of the organization
to maintain equipment reveals a safe environment that reflects a
level of compassion and vigilance for the welfare of patients
(Trus et al., 2019). Patients' welfare is as critical as another
aspect of competent healthcare. Lack of treatment equipment
maintenance undermines improvement of facility safety thus
learning of causes of error and use of this knowledge in
designing safe healthcare systems becomes challenging. The
current teamwork and collaboration within the facility have
contributed to intensified efforts in understanding and changing
the conditions, components, and healthcare systems' processes
that relate to the safety of patients.
Institution's Culture to Attract Potential Staff
The current well-build culture of brand identity that is the
organization's unique quality care services delivered to patients
can attract and make staff want to work for the facility. The
brand identity is reflected in the organization's mission of
inspiring hope and leading to health and well-being by offering
the best healthcare to all patients (Trus et al., 2019). The efforts

7. and hard work of healthcare practitioners towards this mission
have resulted in a culture that continues to build facility
identity to the world society. Thus, the culture and quality care
services as a brand have given the facility a special edge that
attracts potential staff from other care organizations.
Nurse Leader's Role in Setting the Organizational Culture and
Climate
The role of the nurse leader is to ensure that their actions
and that of other nurses are in line with the facility’s mission,
vision, and beliefs. So, they assist in linking the crucial words
of the healthcare facility mission statement to action words to
assist staff model daily goals of the organization (Marquis,
2015). Also, they influence their followers to change
organizational culture to make it supportive for the achievement
of goals, hence making the working environment healthy.
Implications
Strategies for The Opportunities Improvement
Working on Quality Services: Despite patients playing part
in the effectiveness of a healthcare facility, an organization
must determine a suitable level of quality for the care services
offered. The critical focus is to balance service quality with
cost-effective solutions.
Using Technology: Technological equipment play a vital
role in healthcare efficiency and effectiveness of the hospital.
Computers and information technology, when used in areas such
as patients' record-keeping and diagnosis of diseases through
healthcare-based software, can bring a change in the entire
system.
Alignment of Personal Leadership Profile and Organizational
Culture and Climate
When personal leadership attributes are matched with the
culture and climate of the organization, there are high chances
of bridging the gap between building evidence-based health
practices and innovations and scientific discovery (Black,
2018). Good leadership within the organization, which is based
on an organization's culture, ensures effective and efficient

8. implementation and delivery of quality care services to those
who would most benefit.
Overall, the culture and climate of the healthcare
organization are core to the performance of the organization in
terms of innovation, quality care services, and management of
care systems based on health trends. Aspects such as social
environment, environmental safety, physical environment,
organizational structure, communication, and professional and
personal support environment are vital aspects that define the
nature of organizational culture and climate. These aspects
establish whether the healthcare facility can offer healthy, safe,
and person-centered care and work setting depending on the
beliefs and perceptions of healthcare workers on the
organization's culture and climate on their performance.
References

9. Aarons, G. A., Ehrhart, M. G., Farahnak, L. R., Sklar, M., &
Horowitz, J. (2017). Discrepancies in leader and follower
ratings of transformational leadership: relationship with
organizational culture in mental health. Administration and
Policy in Mental Health and Mental Health Services Research,
44(4), 480-491.
Black, J., & La Venture, K. (2018). The Human Factor to
Profitability: Leveraging People-Centered Cultures as
Meaningful Organizations. Public Integrity, 20(5), 444-458.
Marquis, B.L., & Huston, C.J. (2015). Leadership roles and
management functions in nursing: Theory and application (8th
ed). Philadelphia, PA: Lippincott, Williams & Wilkins.
McDonald, A. R., Middleton, J., Bassett, D. M., & Harris, L.
(2017). Organizational Culture and Climate factors Impacting
Forensic Interviewers’ Experiences of Vicarious Trauma.
Forensic Res Criminol Int J, 4(4), 00118.
Trus, M., Galdikiene, N., Balciunas, S., Green, P., Helminen,
M., & Suominen, T. (2019). Connection between organizational
culture and climate and empowerment: The perspective of nurse
managers. Nursing & health sciences, 21(1), 54-62.
Ramos, V., Franco-Crespo, A., González-Pérez, L., Guerra, Y.,
Ramos-Galarza, C., Pazmiño, P., & Tejera, E. (2019). Analysis
of organizational power networks through a holistic approach
using consensus strategies. Heliyon, 5(2), e01172.
LUGO
1
LUGO
3
Diana Lugo
Profesor Deva
ENGL-1302
10/22/18

10. Research Report
The topic I chose to do my research paper on is a subject
that is not freely spoken about in the states. It’s on whether or
not the United States is truly democratic. With this being said, I
am planning to use current and unconventional ideas to convey
my position. Such as, researching Russian meddling, totalitarian
elements within the government, and comparing U.S laws to
dictatorships around the world. I’ve concluded that our nation is
not the as perfect and heavenly as we describe it to be. The
reality is the United States, ironically, has contributed towards
many of the actions they’ve condemned in the past. Like,
putting in place legislation for personal gain, the act of getting
rid of multiple ethnicities in the name of “peace”, and finally
the discreet collaboration with Russia. In all, the more we dive
deeper within the walls of the government, we are awoken to the
truth. Which is the United States in theory is democratic
however, there are elements of totalitarianism within our
society that should be brought to light.
To begin, my research topic is centered around the idea of
whether or not the United States is truly democratic or are we
seeing a gradual change in characteristics that will end up being
catastrophic. When researching I found various articles that
believed the U.S is not the nation we make it out to be due to
the Electoral College. To clarify, the Electoral College is
subgroup of representatives that vote on a President or Vice-
President. The catch is that this group of representatives can
overrule popular vote. To put this in perspective, in 2016
Hillary Clinton won the U.S popular vote but, Donald Trump
won the electoral college. Thus, he is now president.
Ultimately, we know that this is unfair towards the masses.
Therefore, I decided not to go with the mainstream answer
towards this prompt. I wanted to push the boundaries of what is
acceptable to say about the government. As a result, I was able
to find elements of totalitarianism within the nation. In my
research I'll demonstrate the similarities between Nazi Germany
and various actions taken by President Roosevelt, Clinton, and

11. Trump. Along with the horrible conditions Latin America and
the middle east was left with due to America's involvement,
which they did in a effort to spread democracy.
As with everything controversial, this topic has two sides
of the story. In particular, there is a strong urge to terminate
anything that is not related to western traditions. Especially, if
the subject matter is closely related to the 1930’s and 40’s Nazi
Germany. Keeping this in mind, one of the biggest reasons for
denouncing this form of government is because totalitarianism
has been proven not to work. For example, we’ve seen USSR,
Mao Zedong, and Hitler all fail miserably in there efforts to
construct a totalitarian government. To make matters worse,
after the democratization of these countries corruption was wide
spread within the land therefore, democracy failed. To this day
we’ve not seen the complete transformation of Russia whose
government is claiming they are following democratic rules
but, this is the same country whose president has been serving
in office for 10 years and has government owned television
along with censorship of the media.
With all this being said, some people say that switching
over towards a dictatorship would be beneficial to the country.
In all honesty, there were not many arguments favoring this
type of transition. Nevertheless, the articles I did find and read
argued that the U.S democratic system will ultimately come to
an end due to its constant racism, uneven wealth distribution,
and over arching patriotism. Hence, the idea that totalitarianism
could be savior the United States since it does not have classism
which would “theoretically” solve racism therefore, ending the
unfair distribution of money. Furthermore, another explanation
for switching political systems is that the birth of democracy
was totalitarianism. It’s for this reason many Americans are
rooting for their return to its original government. In all, the
arguments for totalitarianism is based on a hypothetical ending
of racism, social classes, and a closing of the wealth gap.
To conclude, my research report is consisting of various
examples of current and past events. My goal is to unveil a new

12. way of perceiving the United States. Personally, I’ve come to
the conclusion that the U.S is a democracy, on the surface level.
However, when diving deeper into the semantics of the
government's whereabouts we can see Americas true colors
unfold before our eyes. Due to the facts given to me by the
databases. In the end, it is up to the audience to decide what to
believe about the nation.
Holguin 1
Holguin 2Lucia HolguinDeva1302-5100829/10/2018Notecards:
20 Quotes
1. “Since Medicaid pays for only about two-thirds of the usual
fees that health providers expect, it is likely that services are
not as readily available to Medicaid recipients as they might be”
(Kenny 109).
2. “These gaps are likely to continue into the future, given the
trade-offs that many states have had to make to exchange state

13. dollars for maternity services with state dollars for Medicaid
expansions” (Strobino 288).
3. “The demand for prenatal care at their clinics, the
administrators say, stems in part from the growing tendency of
physicians to close their obstetrics practices because of high
malpractice insurance rates and to refuse to accept Medicaid
patients because of low reimbursement rates” (Donovan, 128).
4. “Several administrators note that a pre- natal program can
enhance the public image of a clinic and, if the clinic also
offers abortion services, help deflate charges leveled by right-
to-life groups that the clinic encourages pregnant women to
have abortions” (Donovan, 127).
5. “All clinics have made arrangements with a private
obstetrician or with staff physicians at a local hospital for them
to see each prenatal care patient at least once-and usually twice-
during her pregnancy” (Donovan, 128).
6. “Poor rates of participation in prenatal care reveal that the
American maternity care system is fundamentally flawed,
fragmented and overly complex, particularly for low -income
women, women who are uninsured or underinsured, teenagers,
inner-city and rural residents and newly arrived immigrants”
(Brown, 79).
7. “First, there are not always enough health department clinics,
community health centers or similar facilities in every
community to provide prenatal care to those unable or unwilling
to use the private health care system, and the waiting time for
appointments in facilities that do exist is often long” (Brown,
75).
8. “It could be argued that the stresses and constraints of living
in poverty and the inner city not only affect some fetuses
adversely (via variables not available for analysis, such as
consumption of an inadequate diet, smoking, drinking, drug
abuse, and other mechanisms as yet unexplored), but also affect
maternal motivation to seek prenatal care” (Gortmaker 656).
9. “There appears to be a U-shaped association between
recommended visits received and low-birthweight rates; both

14. women with Inadequate ratings and those with Adequate Plus
ratings had increased low-birthweight rates” (Kotelchuck,
1487).
10. “Their high proportion of low-birthweight births should
make us somewhat sanguine about proposals to improve US
infant mortality rates that simply recommend more prenatal care
visits generally or for high-risk women only” (Kotelchuck,
1488).
11. “Prenatal care is one of the most widely used preventive
health care services in the United States” (Alexander, 307).
12. “The most recent study of trends in health insurance among
American women showed an increasing rate of uninsurance,
growing from 11.7% in 1980 to 18.2% in 2005 among women
ages 25 to 64” (Kozhimannil , 136).
13. “Income eligibility levels for pregnant women are
determined by states and have generally remained steady or
increased slightly over the past decade. Eligible women are
required to enroll in Medicaid to receive benefits, and some
states have recently created policies to simplify enrollment
procedures for pregnant women” (Kozhimannil, 139).
14. “However, the number of states that have increased outreach
efforts and/or offered enhanced maternal benefits packages has
declined slightly since the 1990s” (Kozhimannil, 139).
15. “Only 56 percent of the respondents said they received all
of the recommended procedures in the first two visits, and only
32 percent of the respondents said they received advice in all of
the areas” (Kogan, 637).
16. “There is scant literature on the relation between ethnicity
of the practitioner and patient satisfaction, although it is
sometimes suggested that obtaining care from practitioners of
one's own ethnic back- ground may be desirable because these
caregivers may be better able to deliver culturally competent
care” (Handler, 692).
17. “Another way to improve prenatal care is to identify
practices, the benefits of which seem suspect or uncertain, and
to try to answer these questions by doing research” (Hemminki,

15. 209).
18. “The costs of the care may be an important factor in
determining which source of care is sought, and perhaps when
and how often visits are made. Thus, maternity benefits beyond
basic health insurance may be necessary” (Hemminki, 344).
19. “The report also notes that Medicaid eligibility expansion
does not guarantee that providers are available, able and willing
to offer the medical and psychosocial services that pregnant
women need, in ways that are convenient and acceptable to
them” (Witwer, 35).
20. “The Maternity and Infant Care Projects, initiated by the
federal government in 1963, often involved opening clinics
where none existed or expanding existing facilities, so they
could accept more indigent patients” (Brown,179).
Organizational Culture and Climate Assessment
A thorough, evidence-based analysis of organization culture and
climate begins with a thorough, evidence-based assessment.
You will use this tool to assess the culture and climate of your
institution. Take a tour of your organization. Complete each
item with the seven categories of the assessment tool for the
organization, not just your unit. There are no right or wrong
answers and some will be as varied as the types and numbers of
organizations represented by the class. Your answers shoul d
reflect the data you collect, not just what you think is the case.
Therefore, if there are areas you are unsure about, make contact
with the best resource you have at the organization to obtain the
best evidence. Using this assessment tool assumes observations
are being completed on “normal” days, not one consisting of
extreme circumstances or situations. In other words, don’t
choose a day to observe when a crisis is occurring. Upon
completion of the tool, you will have the information needed to
analyze the culture from various evidence points and to reflect
on congruence between the climate and culture of your
organization.
Remember to include the completed tool with your analysis

16. paper.
Please remember this is an individual assignment. While you
might happen to be taking this course at the same time as
someone else that works with you at the same or nearby
organization, this is not a group assignment. If you have any
questions about completing the assignment, reach out to your
instructor or course leader.
Organizational Culture and Climate Assessment Tool
(Adapted from Marquis, B., & Huston, C.J. (2017). Assessing
the organizational culture, in Leadership Roles and Management
Functions in Nursing: Theory and Application, 9th ed.
Philadelphia, PA: Wolter-Kluwer, p. 307).
1. Physical Environment
a. What is the visual appeal of the environment
b. Is the environment guest friendly?
e.g. access to different locations within the facility, treatment
areas clearly marked, waiting areas/lobbies are well furnished
and welcoming, spaces large enough for groups (families,
patients, and providers) to meet in privacy or quietness, dining
facilities adequate for usage, etc.?
c. Sufficient space for colleagues, team, interdepartmental
meetings?
d. Designated chapel or worship space?
e. Other observations of physical environment?
2. Environmental Safety
a. Hallways, passageways, elevators, stairwells clean, free from
clutter, and well illuminated.
b. A safety committee exists and is actively engaged
c. Security services needed and provided?
d. Equipment maintained in good working order?
3. Social Environment
a. Organization-wide social events held periodically, especially
around holidays or professional days?
b. Organization events well attended?
c. Interdepartmental socialization is positive?
d. Any departments preferred or disliked?

17. e. Evidence of colleague or employee socialization outside of
work?
f. Staff and colleagues appear to like each other
g. How are interactions between staff and visitors?
4. Organizational power structure
a. Where is the seat of power within the organization?
b. What is the balance of power seen between departments?
c. Is special treatment/perks given to some, i.e., parking
preferences, dining perks,
d. What symbols of importance or power are visible/obvious?
e. Are some referred to or addressed always by their surname or
title
f. Are lines of authority clear and followed?
g. How is informal power managed?
5. Professional and personal support
a. Provisions for professional development of staff available
and supported?
b. Educational reimbursement for degree work?
c. Recognition awards and perks?
d. Adequate staff lounge or gathering areas?
e. Organization supports social functions/holiday parties
financially
6. Organizational communication
a. How does communication most frequently occur?
i. Eg, email, unit-wide postings, verbally, snail-mail, etc
b. Does informal communication exist?
i. e.g. grapevines, water-cooler discussions, texting,
ii. How reliable is informal communication?
c. Where does important information get communicated?
i. Staff lounge, physician’s ready rooms, parking lots, during
procedures?
7. Organizational taboos
a. Are there any topics off limits for discussion?
b. Do “unofficial rules and policies” that can never be broken
exist?
c. Do cliques exist that can never be questioned or disrupted?

18. NR 534 Organizational Culture and Climate Assessment Tool
9.1.18nhs