It was the venerable Peter Drucker who said that “culture eats strategy for lunch.” Unfortunately, this little catchphrase is used as fodder to justify all sorts of actions and behaviors – some of which are questionable to say the least. In healthcare, it makes sense to say that an organization with a transformation strategy that isn’t aligned with its culture will fail. But digging deeper into the heart of the matter raises several questions:
- How do we design, foster, and nurture the right culture for our organization?
- How do we build the right organizational “habits” that create exemplify this culture?
- What steps do we take to translate our culture into the right outcomes in terms of performance?
- How do we align everyone – at all levels – in the organization? What’s our alignment model?
- How do we define what behaviors that are not culturally acceptable? What must change?
- Is our culture scalable and sustainable?
- Is our culture defined by our purpose and shared values, or is it vice-versa?
By providing compelling reasons for the organization’s existence, a leader builds a narrative that captures the imagination of all stakeholders – from the patients who are receivers of care, to the providers themselves – the clinical and nursing practitioners who serve the patient and society.
At the Physician Leadership Institute, we help organizations design or transform their culture by contemplating the following questions:
Mission: Why do we exist? What is the purpose of the organization? The department? The physician? The individual? Do we live by our mission in our day-to-day activities? Do we understand that the patient is our reason for existence? Profit, as Peter Drucker points out, cannot be a reason for existence. Instead, he says: “The customer is the foundation of a business and keeps it in existence. He alone gives employment. To supply the wants and needs of a consumer, society entrusts wealth-producing resources to the business enterprise.” [Management: Tasks, Responsibilities, Practices; Peter Drucker, p.61]
Values: What do we stand for? What do we hold in high esteem? What will we not do? Is how we do our work as important as what we do? Do we screen and hire to these values?
Behaviors: How will we know that we are living our values? What behaviors will we commit to? What are the non-negotiables? Do we have a clear COMPACT that outlines what is expected of each other? do we hire and evaluate our leaders to the behaviors?
Reward/Consequences: How will we know we are succeeding? How do we measure and reward right behaviors? How do we deal with the consequences of bad behaviors?
Leadership: Do our leaders have the courage to uphold the values, deal with the brutal facts and act when someone is not living the values and related behaviors?
Alignment and Shared Purpose: Does everyone in the organization believe, uphold, and act on the values of our organization? Do we share a common sense of purpose, responsibilities, and outcomes? Are we working collaboratively across departments and functions to achieve our common purpose?
A Physician Leader inspires team members to come together and solve problems in a collaborative way. A shared sense of purpose permeates the workplace environment. This shared purpose gives team members a sense of belonging and motivates them to act in order to achieve positive outcomes. Thus our Model of Physician Leadership is centered around organizational purpose:
Thus, culture can be designed anchoring it to a clear and shared purpose. Do our actions reflect our beliefs and our values? Are our organizational habits aligned with our stated intentions? How do we measure this?