Health promoting hospitals: a typology of different organizational approaches to health promotion

This paper draws on a review of the literature about the types of health pr omotion activities conducted by health promoting hospitals and an observati on of how some Australian hospitals have structured the organizational arra ngements to be more health promoting. This paper also draws on the experien ces of one of the authors (A.J.) in managing and evaluating an organization al change process at a major specialist hospital in Adelaide, South Austral ia, that sought to re-orientate the hospital towards placing more emphasis on health promotion. From these three sources, a typology of four approache s of organizational arrangement to health promotion is presented. These app roaches are: 'doing a health promotion project, 'delegating it to the role of a specific division, department or staff'; 'being a health promotion set ting; and 'being a health promotion setting and improving the health of the community'. For the re-orientation of the specialist hospital to occur and be sustainable, the research indicated that over the case study period of 1994-1998 there had to be strong organizational commitment to change, suppo rted at multiple levels of the organization, and reflected in policy and pr actice change. The paper concludes that more evaluative research of this ty pe will be important if the rhetoric of healthy settings is to become a rea lity.