An exploration of organisational culture in a regional trauma network, in Northern Ireland.

Background

Working directly with traumatised individuals can result in secondary traumatic stress and vicarious trauma in staff. Less research has been conducted into the impact of working with trauma on an organisation, including teams and structures. The population of Northern Ireland has a history of socio-political conflict, and trauma services may be uniquely impacted due to the dual personal and professional exposure to trauma. This research explores the organisational culture of a trauma service in Northern Ireland, investigating 'What are the tangible and intangible elements of organisational culture of the Regional Trauma Network?'

Methods

Semi-structured interviews (n = 10) were conducted with staff-grade and managerial Multi-Disciplinary Team staff across all five Health and Social Care Trusts. Reflexive Thematic Analysis identified three themes and respective subthemes that characterise the organisational culture of the service.

Results

Theme one: 'Vision vs Reality' with two sub-themes: 'Vision of Excellence' and 'Absent Strategic Direction'. Theme two: 'Together We Stand' with two sub-themes: 'Psychological safety' and 'You're more than just a number'. Theme three: 'Them and Us' with three sub-themes: 'Mirroring the Historical Context', 'Fragmented Services' and 'Fear of Consequences'. There is hope in the vision for an excellent service, and this is demonstrated in the cohesive local trust teams, yet feels absent within the fragmented regional service.

Conclusions

The history of the socio-political conflict may be mirrored within the Regional Trauma Network. Psychologically safe and close-knit local trust services work within a wider fragmented service, with limited communication between various parts. The cohesion and collaboration within the HSC Trust teams may help to inform regional service development going forward.