Based on published articles and verbal communications with C-Suite teams,
it appears that a significant number of hospitals and health care systems
are either in or headed to a performance crisis. The leadership teams
and the members of their board are often lacking a clear understanding
of the roadmap to stability. Clearly, if successful turnarounds and adequate
response to today's changing environment are going to occur, everyone
working there must coalesce around a common vision and use their their
best efforts to reach common, agreed upon, improvement metrics. This ultimately
requires a common culture among all stakeholders which embraces high quality,
safety, affordability, accessibility, integrity and transparency.
In an April 2009 article published in Health Leaders magazine, entitled
"The Bumpy Road to Change", author Carrie Vaugh wrote that cultural
change is that "unambiguous phrase seemingly at the heart of every
hospital turnaround effort or quality improvement program or employment
satisfaction." Vaugh points out that because cultural transformation
is so difficult many efforts fail. We agree that the organization's
culture is the trump card!
How then do we build and sustain the culture required for a transformative journey?
Principally, the culture must have at its foundation the organization's
mission (who it is), its vision (where it is going), and its values (how
the organization lives and behaves). By communicating the mission, vision
and values frequently, their words increasingly become 'living'
documents guiding employees, physicians, trustees and volunteers in their
daily work related activities. By doing so, leaders become credible and
the entire organization becomes more authentic as the staff is seen to
Additionally, the culture must be built around a clear and understandable
strategic plan which drives measurable positive operational metrics to
which all are held accountable. This requires a cultural commitment to
to full and real-time transparency.
The Health Leader article, still pertinent today, listed four steps to
get cultural transformation off to a good start:
- Prepare Leaders - Insist that senior leaders are fully involved and take
responsibility for the culture change effort.
- Acknowledge that the Process Takes Time
- Don't Do Too Much At Once - Prioritize the most important items for
change, and make them happen first.
- Be Inclusive - Include all staff, both clinical and non-clinical, board
members and volunteers.
Knowing all the above, we certainly agree that cultural transformation
is not easy. As one health administrator said, "cultural change is
like stretching a rubber band. It can be stretched out, but it wants to
go back to its old shape and size." Because it is foundational to
success, cultural transformation must be worked on continuously. Creating
a strong culture is not an accident, it is the result of detailed and
intentional planning and effort.
Why? Because the organization's culture is the trump card for success!