One of the first things I worked on in my five years at Tampa General Hospital (TGH) was an organizational change project to help a unit improve its culture. TGH CEO John Couris, David Howard, and I just published a paper (available here) in the New England Journal of Medicine Catalyst about this work. We use this healthcare case to explain how to change organizational culture.
What Is Organizational Culture?
There are lots of definitions of organizational culture, but they all come down to several basic elements about an organization’s social environment. Elements include:
- Behavioral Expectations: Within organizations there are shared norms that define how people are expected to behave. At TGH where this work was done, we adopted the AKTiVeSM model that says people need to be authentic, kind, transparent, and vulnerable with one another.
- Shared Language: Organizations have their own vocabulary to explain important concepts, like AKTiVe which is a term that employees all know at TGH.
- Shared Values: Organizations have foundational values that are shared with employees. Concepts such as ethics, innovation, and safety are common values that some organizations treat as non-negotiables.
- Symbols: Organizations adopt symbols that communicate who they are. There are many symbols that we associate with brands, such as the golden arches for McDonalds. These symbols are often used internally to give employees a sense of belonging to something bigger than themselves.
How To Change Organizational Culture
We applied behavioral science principles in our efforts to change organizational culture. This included survey feedback and team building exercises. We began by taking the pulse of the unit with a survey that went to all members of the team, including leadership, service providers (e.g., APPs, nurses, and physicians) and support staff. We chose a qualitative approach with open-ended questions to give us a deep understanding of their issues as they saw them. The results were compiled into a report that was distributed to everyone in the unit. A series of three retreats, run by facilitators, was held over about nine months. At the first, the team discussed the results and came up with a their own potential solution which was discussed and refined at the next two. A follow-up survey was conducted that showed considerable improvement. As one person noted, “no one is yelling at anyone anymore”.
Although this effort occurred in the healthcare industry, the methods we used are applicable to all industries. Applying them requires expertise in survey development/interpretation, and team facilitation which we had in-house. Organizations without such resources can enlist the help of external consultants, but to be effective, the approach needs to be customized rather than relying on a one-size-fits-all program. We chose our approach because it involved the unit in the change, and we merely guided them in finding their own solution. This maximized buy-in because we did not tell them what they needed to do–they figured that out themselves. Our article illustrates that how to change organizational culture is to rely on proven behavioral science methods that are customized to the situation at hand.
Image generated by Ideogram V3 accessed through BoodleBox.
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