A Perspective onA Perspective on
Healthcare Culture ChangeHealthcare Culture Change
H S A 6939H S A 6939
Leadership Studie...
What Do We Mean When We SayWhat Do We Mean When We Say
“Corporate Culture? ““Corporate Culture? “
Corporate CultureCorpora...
What Do We Mean When We SayWhat Do We Mean When We Say
“Culture Change?”“Culture Change?”
Organizational TransformationOrg...
Culture Change ModelCulture Change Model
Preparation
Principles
HR and OD
Interventions
Managing
Barriers
Managing the
Mid...
PreparationPreparation
Culture Change=White Water Raft RideCulture Change=White Water Raft Ride
Study Organization’s Histo...
PreparationPreparation
Build a Case for ChangeBuild a Case for Change
– Current and Anticipated PainCurrent and Anticipate...
Principles of OrganizationalPrinciples of Organizational
ChangeChange
NONO Vision Realized Without CultureVision Realized ...
Management InterventionsManagement Interventions
(Human Resources)(Human Resources)
Human Resource PhilosophyHuman Resourc...
Management InterventionsManagement Interventions
(Organizational Development)(Organizational Development)
Organizational R...
Human Resource PhilosophyHuman Resource Philosophy
Largely Untapped Reservoir of TalentLargely Untapped Reservoir of Talen...
RecruitmentRecruitment
Warren Buffet Story: Integrity, Intellect,Warren Buffet Story: Integrity, Intellect,
and Energyand ...
OrientationOrientation
Leader’s Role During OrientationLeader’s Role During Orientation
Utility of Peer PressureUtility of...
LearningLearning
Foundation of Values, Trust andFoundation of Values, Trust and
EmpowermentEmpowerment
No Learning Without...
RewardsRewards
Performance Appraisal ShortcomingsPerformance Appraisal Shortcomings
Importance of Psychic IncomeImportance...
Organizational RedesignOrganizational Redesign
Management LayersManagement Layers Block, Distort, andBlock, Distort, and
F...
CommunicationCommunication
NO Beats UncertaintyNO Beats Uncertainty
Walk Your TalkWalk Your Talk
Keep Your Message Simple:...
Innovation EnhancementInnovation Enhancement
Focus on CustomerFocus on Customer
Constant, Incremental ImprovementsConstant...
Managing NormsManaging Norms
Unwritten Rules:Unwritten Rules:
Positive and NegativePositive and Negative
New Vision Requir...
Managing ValuesManaging Values
Leaders Promote & Protect ValuesLeaders Promote & Protect Values
GAP Between Values on Pape...
Barriers to ChangeBarriers to Change
Leadership BurnoutLeadership Burnout
Reluctant CEOReluctant CEO
Insular CultureInsula...
Barriers to ChangeBarriers to Change
Loss of Trustee Sponsorship and SupportLoss of Trustee Sponsorship and Support
Middle...
Managing the MiddleManaging the Middle
Basic Truth of Management is ThatBasic Truth of Management is That
Nearly Everythin...
Regional Medical Center CultureRegional Medical Center Culture
Audit FindingsAudit Findings
OLD CULTUREOLD CULTURE
People:...
Final ThoughtsFinal Thoughts
No Vision Realized Without CultureNo Vision Realized Without Culture
ChangeChange
Leadership ...
Final ThoughtsFinal Thoughts
Assess Readiness for ChangeAssess Readiness for Change
Be Clear Where You Are Taking PeopleBe...
Final ThoughtsFinal Thoughts
Management Transformation of HealthManagement Transformation of Health
Care Hasn’t Sufficient...
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Perspective On Culture Change

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  • Retrospective look at 25 years of culture change experience, during which I witnessed, practiced, and studied culture change. I’ve been the Acquirer, and I’ve been acquired. The former condition is a lot more fun. I will share what I believe to be some enduring lessons with you tonight. An appreciation for the dynamics of culture change generally occurs in the trenches, not in the classroom. It’s not that you can’t teach culture change to the uninitiated—you can. It’s just that the topic gets a better reception after you’ve had some real world experience. My journey began in 1981: New job with LHS in North Dakota (turnaround); doing everything that made me successful up to that time; yet having major job frustrations. At the same time, I was serving as a Kellogg National Fellow 1980-83. Prep for Colombia trip; Importance of honoring Colombia’s culture; Proverbial light went on; I was not paying much attention to LHS culture, and when I did, it was to overpower it: led to lifelong fascination and study Latest Revision: Thursday, January 10, 2008
  • Perspective On Culture Change

    1. 1. A Perspective onA Perspective on Healthcare Culture ChangeHealthcare Culture Change H S A 6939H S A 6939 Leadership StudiesLeadership Studies University of FloridaUniversity of Florida
    2. 2. What Do We Mean When We SayWhat Do We Mean When We Say “Corporate Culture? ““Corporate Culture? “ Corporate CultureCorporate Culture – Shared Attitudes, Habits, Values, SocialShared Attitudes, Habits, Values, Social ConventionsConventions – Stew of Rules, Mores, and TraditionsStew 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”
    3. 3. What Do We Mean When We SayWhat Do We Mean When We Say “Culture Change?”“Culture Change?” Organizational TransformationOrganizational Transformation – CoreCore Competence ChangeCompetence 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 LeadershipLeadership  OrganizationalOrganizational TransformationTransformation
    4. 4. Culture Change ModelCulture Change Model Preparation Principles HR and OD Interventions Managing Barriers Managing the Middle
    5. 5. PreparationPreparation Culture Change=White Water Raft RideCulture Change=White Water Raft Ride Study Organization’s HistoryStudy Organization’s History Describe Baseline CultureDescribe Baseline Culture – Values and BeliefsValues and Beliefs – Heroines and HeroesHeroines and Heroes – RitualsRituals – CeremoniesCeremonies – Stories and Story TellersStories and Story Tellers
    6. 6. PreparationPreparation Build a Case for ChangeBuild a Case for Change – Current and Anticipated PainCurrent and Anticipated Pain – Intellectual and Emotional ArgumentsIntellectual and Emotional Arguments Craft a Vision for the FutureCraft a Vision for the Future – Kotter’s Six Way Test: Imaginable; Desirable;Kotter’s Six Way Test: Imaginable; Desirable; Feasible; Focused; Flexible; andFeasible; Focused; Flexible; and CommunicableCommunicable
    7. 7. Principles of OrganizationalPrinciples of Organizational ChangeChange NONO Vision Realized Without CultureVision Realized Without Culture ChangeChange Commitment of LeadershipCommitment of Leadership CommunityCommunity Continuity of LeadershipContinuity of Leadership Flexible Execution PlansFlexible Execution Plans
    8. 8. Management InterventionsManagement Interventions (Human Resources)(Human Resources) Human Resource PhilosophyHuman Resource Philosophy RecruitmentRecruitment OrientationOrientation LearningLearning RewardsRewards
    9. 9. Management InterventionsManagement Interventions (Organizational Development)(Organizational Development) Organizational RedesignOrganizational Redesign CommunicationCommunication Innovation EnhancementInnovation Enhancement Managing NormsManaging Norms Managing ValuesManaging Values
    10. 10. Human Resource PhilosophyHuman Resource Philosophy Largely Untapped Reservoir of TalentLargely Untapped Reservoir of Talent Treat Employees Like Your BestTreat Employees Like Your Best CustomerCustomer PerPermission Statementsmission Statements
    11. 11. 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
    12. 12. OrientationOrientation Leader’s Role During OrientationLeader’s Role During Orientation Utility of Peer PressureUtility of Peer Pressure Forge Company TypesForge Company Types
    13. 13. LearningLearning Foundation of Values, Trust andFoundation of Values, Trust and EmpowermentEmpowerment No Learning Without Difficulty andNo Learning Without Difficulty and FumblingFumbling An Investment, Not An ExpenseAn Investment, Not An Expense
    14. 14. RewardsRewards Performance Appraisal ShortcomingsPerformance Appraisal Shortcomings Importance of Psychic IncomeImportance of Psychic Income Growing compensation GAP betweenGrowing compensation GAP between CEO and direct caregiversCEO and direct caregivers
    15. 15. Organizational RedesignOrganizational Redesign Management LayersManagement Layers Block, Distort, andBlock, Distort, and FilterFilter Low Corporate Overhead is aLow Corporate Overhead is a Competitive AdvantageCompetitive Advantage Governance Culture ChangeGovernance Culture Change
    16. 16. CommunicationCommunication NO Beats UncertaintyNO Beats Uncertainty Walk Your TalkWalk Your Talk Keep Your Message Simple: AvoidKeep Your Message Simple: Avoid Techno Babble and MHA-SpeakTechno Babble and MHA-Speak
    17. 17. Innovation EnhancementInnovation Enhancement Focus on CustomerFocus on Customer Constant, Incremental ImprovementsConstant, Incremental Improvements Exposure to People and Ideas that areExposure to People and Ideas that are Foreign, Uncomfortable and ThreateningForeign, Uncomfortable and Threatening
    18. 18. Managing NormsManaging Norms Unwritten Rules:Unwritten Rules: Positive and NegativePositive and Negative New Vision RequiresNew Vision Requires New NormsNew Norms BaselineBaseline CultureCulture DesiredDesired CultureCulture ConformConform PerformPerform HoardHoard InformationInformation ShareShare InformationInformation AvoidAvoid ConflictConflict ConfrontConfront ConflictConflict
    19. 19. Managing ValuesManaging Values Leaders Promote & Protect ValuesLeaders Promote & Protect Values GAP Between Values on Paper andGAP Between Values on Paper and Values in PracticeValues in Practice Litmus Test? Hold to Values When TimesLitmus Test? Hold to Values When Times are Toughare Tough
    20. 20. Barriers to ChangeBarriers to Change Leadership BurnoutLeadership Burnout Reluctant CEOReluctant CEO Insular CultureInsular Culture Cycle of CynicismCycle of Cynicism Physician RebellionPhysician Rebellion
    21. 21. Barriers to ChangeBarriers to Change Loss of Trustee Sponsorship and SupportLoss of Trustee Sponsorship and Support Middle Management ResistanceMiddle Management Resistance Suffering Associated with Major ChangeSuffering Associated with Major Change Loss of Key Player(s)Loss of Key Player(s) Events Outside Management ControlEvents Outside Management Control
    22. 22. Managing the MiddleManaging the Middle Basic Truth of Management is ThatBasic Truth of Management is That Nearly Everything Looks Like aNearly Everything Looks Like a Failure in the MiddleFailure in the Middle ToolkitToolkit – Celebrate Short Term WinsCelebrate Short Term Wins – Get Close to the CustomerGet Close to the Customer – MentorMentor – Run ScaredRun Scared – Culture AuditCulture Audit
    23. 23. Regional Medical Center CultureRegional Medical Center Culture Audit FindingsAudit Findings OLD CULTUREOLD CULTURE People: CommoditiesPeople: Commodities Social EnterpriseSocial Enterprise Weight of HistoryWeight of History CynicismCynicism Control BehaviorControl Behavior EntitlementEntitlement Totem: 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
    24. 24. Final ThoughtsFinal Thoughts No Vision Realized Without CultureNo Vision Realized Without Culture ChangeChange Leadership Community, NOT HeroicLeadership Community, NOT Heroic LeaderLeader Treat Employees Like Your BestTreat Employees Like Your Best CustomerCustomer Need for Energy, Passion, Sacrifice,Need for Energy, Passion, Sacrifice, Creativity and CommitmentCreativity and Commitment Beware of “Merger of Equals”Beware of “Merger of Equals”
    25. 25. Final ThoughtsFinal Thoughts Assess Readiness for ChangeAssess Readiness for Change Be Clear Where You Are Taking PeopleBe Clear Where You Are Taking People and Whyand 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 Absorb.But at a Rate They Can Absorb. Change is Ongoing, Endless, and ForeverChange is Ongoing, Endless, and Forever
    26. 26. Final ThoughtsFinal Thoughts Management Transformation of HealthManagement Transformation of Health Care Hasn’t Sufficiently Reduced Costs,Care Hasn’t Sufficiently Reduced Costs, Enhanced Quality or Improved AccessEnhanced Quality or Improved Access Current System of Health Care DeliveryCurrent System of Health Care Delivery and Financing isand Financing is NOTNOT SustainableSustainable Profound and Wrenching CulturalProfound and Wrenching Cultural Changes Yet To ComeChanges Yet To Come Transformational Leaders Needed!Transformational Leaders Needed!

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