Perspectives on Perspectives on Healthcare Culture ChangeHealthcare Culture Change

Michael O. Bice©Michael O. Bice©

What Do We Mean When We Say What Do We Mean When We Say ““Corporate Culture? Corporate Culture? ““

Corporate CultureCorporate Culture– Shared Attitudes, Habits, Values, Social Shared Attitudes, Habits, Values, Social

ConventionsConventions– Stew of Rules, Mores, and Traditions Stew of Rules, Mores, and Traditions

Which Shape the Work ExperienceWhich Shape the Work Experience– ““The Way We Do Things Around Here”The Way We Do Things Around Here”

What Do We Mean When We Say What Do We Mean When We Say ““Culture Change?Culture Change?””

Organizational TransformationOrganizational Transformation– CoreCore Competence Change Competence Change

Drivers of Culture ChangeDrivers of Culture Change– Creating Successful New VenturesCreating Successful New Ventures– Managing Mergers & AcquisitionsManaging Mergers & Acquisitions– Coping With Innovation & ChangeCoping With Innovation & Change– Overcoming New Competitive PressuresOvercoming New Competitive Pressures

Leadership Leadership Organizational Organizational TransformationTransformation

Culture Change ModelCulture Change Model

Preparation

Principles

HR and OD Interventions

Managing Barriers

Managing the Middle

PreparationPreparation

Culture Change=White Water Raft RideCulture Change=White Water Raft Ride

Study OrganizationStudy Organization’’s Historys History

Describe Baseline CultureDescribe Baseline Culture– Values and BeliefsValues and Beliefs– Heroines and HeroesHeroines and Heroes– Rituals Rituals – CeremoniesCeremonies– Stories and Story TellersStories and Story Tellers

PreparationPreparation

Build a Case for ChangeBuild a Case for Change– Current or Anticipated PainCurrent or Anticipated Pain– Intellectual and Emotional ArgumentsIntellectual and Emotional Arguments

Vision: Sensible and Appealing Picture of Vision: Sensible and Appealing Picture of the Futurethe FutureCraft a Vision for the FutureCraft a Vision for the Future– Six Way Test: Imaginable; Desirable; Six Way Test: Imaginable; Desirable;

Feasible; Focused; Flexible; and Feasible; Focused; Flexible; and Communicable (Kotter)Communicable (Kotter)

Principles of Organizational Principles of Organizational ChangeChange

NONO Vision Realized Without Culture Vision Realized Without Culture Change Change

Commitment of Leadership Commitment of Leadership CommunityCommunity

Continuity of Leadership Continuity of Leadership

Flexible Execution PlansFlexible Execution Plans

Management Interventions Management Interventions (Human Resources)(Human Resources)

Human Resource PhilosophyHuman Resource Philosophy

RecruitmentRecruitment

OrientationOrientation

LearningLearning

RewardsRewards

Management Interventions Management Interventions (Organizational Development)(Organizational Development)

Organizational RedesignOrganizational Redesign

CommunicationCommunication

Innovation EnhancementInnovation Enhancement

Managing NormsManaging Norms

Managing ValuesManaging Values

Human Resource PhilosophyHuman Resource Philosophy

Largely Untapped Reservoir of TalentLargely Untapped Reservoir of Talent

Treat Employees Like Your Best CustomerTreat Employees Like Your Best Customer

PerPermission Statementsmission Statements

RecruitmentRecruitment

Warren Buffet Story: Integrity, Intellect, Warren Buffet Story: Integrity, Intellect, and Energyand Energy

Rule of ThumbRule of Thumb– % GO% GO– % GO, BUT% GO, BUT– % NO% NO

OrientationOrientation

Leader’s Role During OrientationLeader’s Role During Orientation

Utility of Peer PressureUtility of Peer Pressure

Forge Company TypesForge Company Types

LearningLearning

Foundation of Values, Trust and Foundation of Values, Trust and Empowerment Empowerment

No Learning Without Difficulty and No Learning Without Difficulty and FumblingFumbling

An Investment, Not An ExpenseAn Investment, Not An Expense

RewardsRewards

Performance Appraisal ShortcomingsPerformance Appraisal Shortcomings

Importance of Psychic Income Importance of Psychic Income

Growing compensation GAP between Growing compensation GAP between Leadership and direct caregiversLeadership and direct caregivers

Organizational RedesignOrganizational Redesign

Management Layers Management Layers Block, Distort, and Block, Distort, and FilterFilter

Low Corporate Overhead is a Low Corporate Overhead is a Competitive Advantage Competitive Advantage

Governance Culture ChangeGovernance Culture Change

CommunicationCommunication

NO Beats UncertaintyNO Beats Uncertainty

Walk Your TalkWalk Your Talk

Keep Your Message Simple: Avoid Keep Your Message Simple: Avoid Techno Babble and MHA-SpeakTechno Babble and MHA-Speak

Tell Stories; Give Examples; Paint a Tell Stories; Give Examples; Paint a PicturePicture

Innovation EnhancementInnovation Enhancement

Focus on CustomerFocus on Customer

Constant, Incremental ImprovementsConstant, Incremental Improvements

Exposure to People and Ideas that are Exposure to People and Ideas that are Foreign, Uncomfortable and ThreateningForeign, Uncomfortable and Threatening

Managing NormsManaging Norms

Unwritten Rules: Unwritten Rules: Positive and Positive and NegativeNegative

New Vision New Vision

Requires New Requires New

NormsNorms

BaselineBaseline

CultureCulture

Desired Desired

CultureCulture

ConformConform PerformPerform

HoardHoard

InformationInformation

Share Share

InformationInformation

AvoidAvoid

ConflictConflict

Confront Confront ConflictConflict

Managing ValuesManaging Values

Leaders Promote & Protect ValuesLeaders Promote & Protect Values

GAP Between Values on Paper and GAP Between Values on Paper and Values in PracticeValues in Practice

Litmus Test? Hold to Values When Times Litmus Test? Hold to Values When Times are Toughare Tough

Intervention RecapIntervention Recap

Human ResourcesHuman Resources– PhilosophyPhilosophy– RecruitmentRecruitment– OrientationOrientation– LearningLearning– Rewards Rewards

Organizational DevelopmentOrganizational Development– Organizational RedesignOrganizational Redesign– CommunicationCommunication– Innovation EnhancementInnovation Enhancement– Managing NormsManaging Norms– Managing ValuesManaging Values

Barriers to ChangeBarriers to Change

Leadership BurnoutLeadership Burnout

Reluctant Leadership CommunityReluctant Leadership Community

Insular CultureInsular Culture

Cycle of CynicismCycle of Cynicism

Physician RebellionPhysician Rebellion

Barriers to ChangeBarriers to Change

Loss of Trustee Sponsorship and SupportLoss of Trustee Sponsorship and Support

Middle Management ResistanceMiddle Management Resistance

Loss of Key Player(s)Loss of Key Player(s)

Events Outside Management ControlEvents Outside Management Control

Suffering Associated with Major ChangeSuffering Associated with Major Change Consider Mourning Ritual(s)Consider Mourning Ritual(s)

Managing the MiddleManaging the Middle

Basic Truth of Management is That Basic Truth of Management is That Nearly Everything Looks Like a Nearly Everything Looks Like a Failure in the MiddleFailure in the MiddleToolkitToolkit

– Celebrate Short Term WinsCelebrate Short Term Wins– Get Close to the CustomerGet Close to the Customer– MentorMentor– Run ScaredRun Scared– Culture AuditCulture Audit

Regional Medical Center Culture Regional Medical Center Culture Audit FindingsAudit Findings

OLD CULTUREOLD CULTURE

People: CommoditiesPeople: CommoditiesSocial EnterpriseSocial EnterpriseWeight of HistoryWeight of HistoryCynicismCynicismControl BehaviorControl BehaviorEntitlementEntitlementTotem: ElephantTotem: Elephant

NEW CULTURENEW CULTURE

People: Valued AssetsPeople: Valued Assets

Business EnterpriseBusiness Enterprise

Promise of the FuturePromise of the Future

TrustTrust

Enable BehaviorEnable Behavior

AccountabilityAccountability

Totem: EagleTotem: Eagle

Final ThoughtsFinal ThoughtsNo Vision Realized Without Culture No Vision Realized Without Culture ChangeChange

Leadership Community, NOT Heroic Leadership Community, NOT Heroic LeaderLeader

Treat Employees Like Your Best Treat Employees Like Your Best CustomerCustomer

Need for Energy, Passion, Sacrifice, Need for Energy, Passion, Sacrifice, Creativity and CommitmentCreativity and Commitment

Final ThoughtsFinal Thoughts

Assess Readiness for ChangeAssess Readiness for Change

Be Clear Where You Are Taking People Be Clear Where You Are Taking People and Why and Why

Walk Your TalkWalk Your Talk

Barriers to Change Are POWERFULBarriers to Change Are POWERFUL

Leadership Requires Disturbing People, Leadership Requires Disturbing People, But at a Rate They Can AbsorbBut at a Rate They Can Absorb

Final ThoughtsFinal Thoughts

Centrality of Values and BeliefsCentrality of Values and Beliefs

DonDon’’t Overlook Personal Transformationt Overlook Personal Transformation

Kubler-Ross and BridgesKubler-Ross and Bridges’’ Insights Insights

Communication Should Be Frequent, Communication Should Be Frequent, Consistent and ReliableConsistent and Reliable

Change is Ongoing, Endless, and ForeverChange is Ongoing, Endless, and Forever