Blog #2 on culture. Three simple ways in which healthcare leaders can begin to shape a new culture
The adage that the ‘best way to eat an elephant is one bite at a time’ applies when one is talking about changing an organization’s culture. In my first blog on this subject, I gave a simple and mostly symbolic example of how to take a bite. It was a look at the hierarchical structure that we have put in organizations that make it difficult to operate with purpose. I suggested that we could start with calling employees “colleagues”. This is one way of engaging them since we claim that “we are all in this together”.
Let’s back up. What is culture in the organizational sense? It is not necessarily the way sociologists and anthropologists define it, but one definition that I can relate to is “The original knowledge that people use to interpret experience and generate behavior” (James Spradley). In other words, those practices and behaviors that are “in the walls” and over time have become the norm. Culture is not usually codified. It develops over time and is seldom (albeit occasionally) generated by a single leader.
What are some of the things that a leader in healthcare can do to change culture? Currently, actions in this regard that do not impact their colleagues’ engagement are missing the mark. Some actions that show positive potential:
1. True open-door leadership- Making our colleagues know without a doubt that we are interested in what is on their minds. Symbolically, I tried this in the 90’s by keeping the door to my outer office open. The engineers told me that the door had to remain closed for fire safety. I had them install an automatic mechanism that would release the door when the fire alarm system was activated. Believe it or not, that word got around, and people knew that I was literally and figuratively accessible to them.
2. Quint Studer, the prolific writer, and sound thinker on servant leadership, talked about “rounding with reason”, making a mockery of leadership that walked around on the floors of a hospital and then retreated to their office with little more than a “hello” and “good-bye”. Rounding with reason is indeed valuable IF in the process, the colleagues are asked what could be done to make their jobs easier, what needs correcting, what problems they are encountering in doing their jobs and of course, what is going well. This is a good way to mine for things to celebrate. Learning about what is going on in colleague’s personal lives (within limits) also help in opening the lines of communication. It is particularly helpful the next time you are on the unit, to remember something about the colleague and mention it. Watch the results!
Caution: Colleagues who know that we are not serious about why senior leaders are on rounds will probably not let us know how they feel about people who are on their units for some other reason than to help them solve their problems. They will just put it in the “disrespect” column!
3. Standing meetings with teams are very useful, especially if the agendas for those meetings pertain to issues of importance to all or most of the group. Why not try to replace some of these with meetings around a single issue, with team-members who are most affected by the issue. Empower them with the ability to make decisions and implement action. Caution those teams with the reminder that they must communicate with those outside of their group when the decision affects a broader group. A leader can help in this process by recognizing that mistakes will happen. When they do, be quick to recognize them, celebrate them and allow the same team to change course.
These are just a few suggestions on the issue of culture change. Future blogs will address more. Including ways in which culture change can backfire if led by the wrong people. Just ask the folks that used to work for Enron!
Leaders don’t have all the answers. Or more correctly, they have them, but they are often deeply hidden in their life experiences. A good executive coach can be a trusted partner in helping a leader think in new ways in a totally safe and confidential environment.
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