getting your culture right for healthcare transformation

Getting Your Culture Right for Healthcare Transformation

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Panel Members

• Reginald W. Coopwood, MD, FACS– President and Chief Executive Officer

Regional Medical Center, Memphis TN

• Lisa E. Harris, MD– Chief Executive Officer and Medical Director

Wishard Health Services, Indianapolis IN

• Anna Roth, RN– Chief Executive Officer

Contra Costa Regional Medical Center, Martinez CA

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Breakout Session Objectives

• Learn a simple framework for understanding culture and the importance of getting it right for organizational transformation

• Compare your organization’s culture to a healthcare industry benchmark

• Learn about ways that leaders can change culture to support organizational transformation

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Corporate Values

• Communication• Respect• Integrity• Excellence

Do these look familiar?

They were Enron’s (espoused) Corporate Values!

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Culture is Often Hidden

Norms, Behaviors & Artifacts

Personal Values & Attitudes

Cultural Values & Assumptions

Visible & Tangible

Less Visible butTalked About

Not Visible andRarely Questioned

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What is Culture?

Culture is the shared set of beliefs, values, and behaviors that have contributed to the

organization’s success in the marketplace over time. It is a powerful yet invisible force that fosters cohesion, reinforces organizational

identity, and pervades every aspect of how the business is run.

“It is the way we do things around here.”

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Some Examples of Culture (Positive)

• The vision of the organization is widely shared and it provides meaning and direction to the work of staff.

• There is clear agreement on the right way and wrong way to do things.

• Different parts of the organization often cooperate to create change.

• Authority is delegated so that people can act on their own.

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Why is Culture Important

“Any competitor can duplicate our putting satellite TV’s in every seat, any competitor can duplicate our larger overhead bin space, any

competitor can duplicate our extra leg room, any competitor can duplicate our roomier leather

seats, but NO competitor can duplicate the culture and leadership we’ve created that

delivers the JetBlue experience to our customers.”

David Neeleman, CEO, JetBlue Airways

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Changing Perceptions of Business Culture

Behaviorally based, measurable, and manageable via deliberate leadership.

Result of thoughtful leadership, values orientation, and involvement of the entire organization in a focused direction.

Have strategic impact that must be managed to preserve business value and ensure success.

Intangible, esoteric, and difficult to manage.

Just happens.

Luxury when there is time

From… To…

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Why Address Culture Now?

The Opportunity:

Never Waste a Crisis - Great leaders knowthat significant opportunity liesin a world turned upside down.

Dr. Saj-nicole Jonichief executive of Cambridge International Group

The Approach:

Culture will have a significant impact on theorganization’s ability to effectively transform itself

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A Framework for Understanding Culture

Translating the demands of the business environment into action

Defining a meaningful long-term direction

for the Company

Building human capability, ownership, and responsibility

Defining the valuesand systems that are the

basis of a strong culture

© Denison Consulting, LLC. All Rights Reserved

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Does Culture Matter? – Links to Performance

Innovation &Customer

Satisfaction

StablePerformance

Over TimeProfitability

ROI, ROE

Operating PerformanceQuality

Employee Satisfaction

GrowthMarket Share


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Composite for US Healthcare Organizations

Percentile is the composite score as a

percentage benchmarked against the average of other

organizations.


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Dynamic Tension

Dynamic Tension:

Linking the purpose, direction, and goals of the organization (top - down) to a shared sense of responsibility, ownership and commitment with all employees (bottom - up).


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Dynamic Tension

Dynamic Tension:

Successful organizations learn how to cope with the dual problems of external adaptation (stimulate progress) and internal integration (preserve the core).


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Changing the Culture Example – HealthPlus of Michigan*

• Core Business – provider of HMO and point-of-service health plans• Employees – 400• Opportunity – Stability in the industry in 1997 provided chance to focus

on internal infrastructure and monitor/measure an environment that could be continuously improved

• Results:– Below the 25 percentile for most all of the culture traits– Chose to focus on Mission first – strengthening the vision, developed a

strategy, communicated it to staff, and set individual performance goals for staff tied to the company plan

– Suffered a setback in 2001 from the pressures of intense competition– Continued the process with focus on specific areas such as Core Values and

Capability Development– By 2007, company was scoring higher than 85% of all benchmarked companies

* Published by Denison Consulting, Volume 3, Issue 2, 2009

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Changing the Culture Example – University of Maryland Medical Center*

• Core Business – Healthcare facility, 700 beds, 1,000 attending physicians, 300,000 patients per year

• Employees – 6,600• Opportunity – Poor financial and operating performance in late 1990’s led

senior leadership team to believe that culture change was needed• Results:

– Initially received low results on culture and leadership surveys– Goal – help leaders develop the skills and relationships needed to make

culture stronger and healthier– Implemented a comprehensive leadership development program– Organization needed to learn a new level of empowerment – authentic and

truthful conversations with viewpoints respected by senior leaders– Culture survey scores increased on 11 of 12 traits and net income increased

150%

* Published in the Organization Development Journal; Winter 2007, page 63

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Creating a Master Plan for Change

• Gain a full understanding of the current reality – what aspects of culture need to be strengthened to improve the success of the organization

• Determine the best place to start, typically Mission and Involvement

– Mission – shared vision for the organization of the future, with ambitious but realistic goals, that motivates staff and gives meaning and direction to their work

– Involvement – Accomplishing the shared goals and objectives in the organization through information sharing, cooperation, and empowerment

• Design the right programs and interventions to improve the culture

• Broaden the ownership of the transformation to all internal and external stakeholders

• Execute the plan and monitor results

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Your Assignment – Analyze Your Organization


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How did you go bankrupt?

Two ways. Gradually, then suddenly.

Ernest HemingwayThe Sun Also Rises

Getting Your Culture Right for Healthcare Transformation

getting your culture right for healthcare transformation

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