Seven Action Items to Shift Your Culture Forward

Seven Action Items to Shift Your Culture Forward

Culture is at the heart and soul of every organization across the globe, and Human Synergistics’ 3rd Annual Ultimate Culture Conference examined this topic with the theme of Leadership and Culture—It’s a Two-Way Street. There were many executable learnings that came out of the event and here are six items that organizations can act upon to move their culture to a Constructive style—along with a seventh, personal favorite for each of us to remember.

1. Change the Climate

Dr. Robert Cooke had a fascinating presentation, discussing organizational climate and how shared “perceptions and attitudes” develop in an organization over time. Climate factors represent the tip of the iceberg; they are the things employees feel and sense in the environment in real time and that are visible to everyone in the organization—items such as encouraging real teamwork versus working in silos. Changing the climate factors has a greater impact on climate than actively pursuing the “ideal culture.” Therefore, change climate factors to change culture.


2. Lead and Be a Role Model

Dr. Peter Fuda shared tactics to make an impact, influence others, and transform results. He told the story of a daughter who has two apples, and her mom says, “Can I have an apple?” The daughter proceeds to take a bite of each apple; her mom is incredulous and can’t believe this “bad behavior.” The daughter looks at her mom and says, “Here, have this one—it’s sweeter.” The moral of the story is to always assume good and noble intentions. Dr. Fuda suggests we be a role model first and act out of only good intentions. We need to set the example for how we behave and how we expect others to behave. Set a higher standard and eliminate day-to-day frustrations by taking decisive action. Finally, inspire hope, not fear. Therefore, be the leader you want others to become and you will shift from awareness and acceptance to positive action and alignment.

Always assume a noble intention.
-Peter Fuda

3. Build Level 2 Relationships

Dr. Edgar Schein and Peter Schein spoke of the evolving culture of management to facilitate humble leadership. Many relationships in our organizations could be described as transactional. The objective is to get things done. Humble leadership is about “level two” relationships, which involve true caring and getting to know the person and not the role or title. Therefore, take the time to get to know the people in your organization as individuals instead of seeing only their role or title. You will become a more effective leader.

Humble Leadership

4. Change an Entrenched Culture

Right Reverend Jeffrey D. Lee and Reverend Gay Clark Jennings shared an amazing story about a deeply entrenched culture in the Chicago Diocese of the Episcopal Church. The Church is in the “caring and people” business; however, it was clear from the assessment that the culture was so entrenched it meant letting go of people. Painful decisions were made, and today the culture in the Episcopal Church is moving toward its ideal culture. Therefore, change an entrenched culture to create meaningful and measurable change. People will notice and applaud you for your efforts. They shared how the work expanded in the Episcopal Church to the church center as they worked with Human Synergistics to conduct a cultural assessment identifying both the ideal and current culture. This was another important lesson about how initial culture work doesn’t necessarily have to start at the top of the entire organization.

5. Break Old Habits

Dr. Marshall Goldsmith, the “World’s #1 Leadership Thinker,” listed some of the “transactional flaws” we need to lose. These lessons took place through active one-on-one audience participation. Dr. Goldsmith suggested we give more praise or “proper recognition” versus criticism. Stop sharing negative thoughts and stop explaining why something won’t work. Express gratitude versus trying to win too much. Not listening is a form of “disrespect.” So really listen! Therefore, if we break old habits, we also change climate and culture.


6. Measure Culture

Culture can be measured, and we know that there is a direct relationship between a Constructive culture and organization performance. All the speakers touched on this item in one way or another. Therefore, change your organization’s culture and change your performance.

7. Life is Short—Have Fun

Dr. Marshall Goldsmith mesmerized the audience by asking the question: You are 95 years old and about to die; what advice would you give yourself to be happy? This action item is personal for me and perhaps it holds meaning for you, too. Stop chasing what you don’t have, and if you have a dream, go for it. Life is short, so have fun!

Marshall Goldsmith at the Ultimate Culture Conference

I suggest leaders act on all six culture action items and simultaneously find out what brings joy and happiness in their lives.

If you attended the Ultimate Culture Conference, please share your favorite learnings below.

Organizational Culture Trumps Everything Else in Healthcare

The book I am writing1 is the result of an unpredictable journey in healthcare and my complete respect and admiration for the caregivers in healthcare organizations in the United States. I believe every organization has the capacity and potential to create a work environment that is purposeful, fulfilling, constructive, and fun. Yes, fun! It’s not strategy; not finance; not technology. It is organizational culture that trumps everything else in healthcare.

My Diagnosis and the Importance of Culture

On March 16, 2015, I got the diagnosis: malignant melanoma, right anterior distal thigh and left posterior shoulder. Just over 10 days later, I waited nervously on the exam table at the Massachusetts General Melanoma and Pigmented Lesion Center. Hensin Tsao, MD, Ph.D., Director of the Center and world-renowned skin cancer specialist, examined me and confirmed my diagnosis. Genevieve Boland, MD, Ph.D., surgical oncologist, consulted and recommended surgery on April 1. The entire process, from pre-op to discharge, took about four hours. My final pathology report on both sites, dated April 3, 2015, showed great news: no residual atypical melanocytic proliferation.

I tell this story not for sympathy, but to share how positive my experience was from my initial clinic visit through surgery. Having started my career at a large academic medical center, I was expecting the impersonal hustle and bustle that we assume comes with large organizations, as well as the resulting sterile personal experience. Surprisingly, I was overwhelmed with optimistic feelings and knew it was because of my many caregivers, including those in environmental services and food services to board members, managers, nurses, physicians, and many others. On my final visit with Dr. Boland, I shared my positive experience. She responded that this was “our culture and we do these things automatically.”

While my personal experience was positive, not all healthcare organizations share the Constructive culture exemplified by Massachusetts General. However, if culture could drive my positive experience as a patient, could it also drive positive organizational results and a great experience for caregivers?

Let’s talk about organizational culture and how that same positive example could become a reality for others.

Culture Trumps Everything Else

After working in healthcare for over 35 years—25 years in hospitals and 10 years providing advisory services to over 500 hospitals across the United States—I learned that culture trumps everything else in healthcare. This is not a gut feeling—both research and my own professional experience suggest that  Constructive norms and expectations lead to better execution of strategy, better quality and patient satisfaction, improved financial performance, and greater levels of employee engagement.2

Some Early Evidence

I contacted Human Synergistics over 10 years ago, after I had completed strategic plans for 100 healthcare organizations. Ten of these organizations had not made any progress one year after adoption of the strategic plan in a number of essential areas, including employee and provider engagement; financial health; market share; strategy execution; quality; and patient/provider/employee satisfaction. The other 90 organizations made great strides.

What was the difference between the organizations that improved and those that stagnated? Once again, it comes down to culture. The Human Synergistics Circumplex details the three general types of culture we find in all organizations, including those in healthcare:

  1. Constructive: Cultures that promote effective goal-setting and achievement, growth and learning, and teamwork and collaboration.
  2. Passive/Defensive: Cultures that lead to conformity, rigidity, and lack of team member accountability and initiative.
  3. Aggressive/Defensive: Cultures that lead to internal competition, management by exception, and short-term emphasis as opposed to long-term effectiveness.2

When I surveyed the cultural styles of the 10 underperforming healthcare organizations, eight had Passive/Defensive styles and two had Aggressive/Defensive styles. Since then I have learned that, like organizations in other industries, healthcare organizations with Constructive styles generally produce higher quality results, better financial performance, greater patient satisfaction, and higher employee and provider engagement.3

Future Research and the Culture Map

Because culture is directed from the top of an organization, I am now curious about hospital governance and whether the cultural style of a board leads to increased organizational performance. I am presently conducting research related to performance and board cultural style. Specifically, in collaboration with Human Synergistics, I will survey several hospital boards to measure cultural styles and determine their impact on hospital effectiveness. I anticipate that this work will be completed by early 2016. My hope is that the development work and research in this area will resonate with the healthcare workforce and that the resulting culture map will lead to a more Constructive, productive, and happy work environment.

How would you describe your organization’s culture? Does it share a Constructive, optimistic way of operating? Does it have the capacity and potential to become a purposeful, fulfilling, Constructive, and fun work environment?

I look forward to your comments and thoughts on LinkedIn and Twitter. Thank you!


1 This post is excerpted from Scott Goodspeed’s upcoming book, The Culture Map: Why Organizational Culture Trumps Everything Else in Healthcare (working title).

2 Cooke, R. A., & Szumal, J. L. (2000). Using the Organizational Culture Inventory to understand the operating cultures of organizations. In Ashkanasy, N. M., Wilderom, C. P. M., & Peterson, M. F. (Eds.), Handbook of organizational culture and climate. Thousand Oaks, CA: Sage.

3 In addition to the research articles and books listed on Human Synergistics’ web site, many other articles have been published in specialized journals summarizing studies on the importance and impact of Constructive cultures.  Examples related to healthcare and social service organizations include:

Agbenyiga, D.L. (2011). Organizational culture-performance link in the human services setting. Administration in Social Work, 35 532-547.

Gillett, E. & Stenfert-Kroese (2003).  Investigating organizational culture: A comparison of ‘High”- and a ‘Low’- performing residential unit for people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 16 279-284.

Guidet, B. & Gonzalez-Roma, V. (2011). Climate and cultural aspects in intensive care units. Critical Care, 15 312.

Minivielle, E., Aegerter, P., Dervaux, B., et al (2008). Assessing organizational performance in intensive care units: A French experience. Journal of Critical Care, 23 236-244.

Pelieu, I., Djadi-Prat, J., Consoli, S.M., et al (2013). Impact of organizational culture on preventability assessment of selected adverse events in the ICU: Evaluations of morbidity and mortality conferences. Intensive Care Medicine, 39(7) 1214-1220.