Our response to this frequently asked question is always the same, whether we are in a 12-bed critical access hospital in Catalina Island, California, or a 1,000-bed urban hospital in New York City. The most critical item they will need to guarantee that change will occur in their organization at the bedside is a mirror. Every executive leader's first key to changing others lies in first looking at themselves.
To get started, an agreement that change must occur in order to achieve this new "Always Patient Experience" is needed. The individual and collective commitment of every member of the executive team is necessary to lead the change and achieve an Always Culture. How do we help leaders understand this?
Begin with a Culture Deep Dive
In coaching healthcare systems around the country, our first step in engagement is to lead the executive leadership team through a Culture Deep Dive. A Culture Deep Dive takes an organization and its leaders through a facilitated session that will help define structure and manage their culture in a way that achieves the organization's desired outcomes. The goal is to actively manage the culture to position the organization to effectively and consistently live out its mission and values, and to achieve the performance outcomes it desires.
A second component of the Culture Deep Dive consists of assisting executive leaders to create a journey that is strategic, tactical, and critical to the culture transformation process. Developing a journey message–a simple message that talks about why the change is occurring–is a key aspect of changing and sustaining the desired culture. We have to engage the hearts and minds of staff and help them understand why we are transforming their culture. Doing so is necessary before we can begin to address and explain the how and what of the process that will be required. To create this journey message, executives develop a short four to six sentence statement that answers the questions:
What will success look like?
What do I need from you?
The third integral step in a Culture Deep Dive is to work with the executive team to help them create their list of nonnegotiable items–the actions and behaviors that should be demonstrated by the executive leader at all times. These nonnegotiable items are the "Always" behaviors leaders need to identify as a team and agree to always demonstrate for their organization and each other. This step is critical for building and sustaining trust within the executive team.
Understanding the behaviors to which the executive team commits to hold themselves accountable can be a very powerful influence of a culture change. The evidence shown in an analysis of a recent HealthStream employee engagement survey noted that although "good relationships with direct managers remain very important to employees' job engagement, the actions of executive leaders and overall workplace policies play a greater role in driving organizational engagement."
The fourth and final step in our sessions with executive leaders is to teach them the tactic of senior leader rounding–a purposeful planned visit from a senior leader with staff and department leaders to build relationships and trust–and provide a forum for meaningful sharing of information. Getting commitments that all members of the executive team will begin rounding with departments throughout the organization and ensuring that all departments are visited by a member of the executive team at least three times a year is a powerful way to begin to build relationships, improve visibility, and communicate the consistent message about why we need to create an Always Culture.
Changing a culture cannot be delegated. Leading an organizational shift to an Always Culture begins with the executives.
This blog post is an excerpt from HealthStream's white paper, WANTED: The Always Experience, NEEDED: The Always Executive. Complete this form to download the white paper: