For many leaders and organizations, embracing and implementing a culture of Belonging requires a transformation of their leadership culture and broader culture(s). In this article, the fourth in a series, we hear from retired health care CEO and expert in cultural transformation, Deborah Proctor, on how she led successful and sustainable organizational culture transformations.
Moderator: Deborah, you have successfully led many organizations through cultural transformation. How do you define culture?
Deborah: My definition of culture is, "The way we do things around here." In practical terms, this means, how do you integrate new people? Celebrate success? Identify new leaders? Direct your people? When you can articulate how these are done, you can understand the culture of an organization.
Strong cultures start with values. Values are our underlying belief systems that shape how we behave. If we value the dignity of all individuals, for example, we behave in such a way that supports that dignity and ultimately creates a culture of belonging, a culture where I bring my whole self to the organization and feel seen for who I am.
Moderator: I've been trying to reconcile the relationship between leadership culture and the broader organizational culture, especially for large organizations. How do they interact, and how do we get things done?
Deborah: A leadership culture is precisely what it sounds like…. how we behave when leading people to achieve the mission. It shouldn’t be that different from the overall culture, but it might have more detail. For example, in a health care delivery system, we want to eliminate error and manage risk to our patients. That may call for more “command and control” behaviors. Leadership, however, might want to encourage innovation and transformation of our thinking, allowing room for failure.
Moderator: So a culture of Belonging is a component of culture, correct?
Deborah: Yes, Belonging is a single cultural characteristic, but you may have many other characteristics too. When Ascension Health developed out of an affiliation of Catholic health systems one of the first things we did after naming the values, was to select the cultural characteristics we wanted for the organization. I think there were between nine and twelve different characteristics. We didn’t ask people to memorize these becausee no one can remember all that. But whenever we developed a new business or leadership process, we asked ourselves if the process we defined supported these characteristics. If we want a culture of Belonging, do we bring people into our organization in a way that they feel seen for who they are? Do we inclusively engage people? Do we exit people from the organization in such a way that they feel willing to come back at a later time? How do we work with vendors and others outside of the organization, so they have a sense of our belonging culture?
Moderator: What else is necessary to build a strong culture?
Deborah: Once you identify your values and your cultural characteristics, one of the best ways of embedding them is to recognize and celebrate the people who live them. This really helps everyone understand the expectations.
Moderator: This is what we do at our firm. We highlight somebody exemplifying a value and living a value. Tell me more.
Deborah: When I worked at St. Joseph Health System in a leadership development role, not as the CEO, I was part of a team that helped the organization develop its four fundamental values: dignity, service, excellence, and justice. Once the values were established, we developed the Values in Action awards, where we nominated people who represented those four values. Anyone could nominate a peer or a leader for one or more of the values awards. A local team then selected the individuals who most closely represented each of the four values. Those individuals were celebrated locally but were also put forward at the system-wide level where only four were selected to represent the entire system. This program was started in 1987 and I left the system in 1990 to pursue other career opportunities, then returned fifteen years later as the CEO. I was thrilled to learn the program was still in effect but not surprised because it was so deeply embedded in the organizational culture.
We made sure to honor the people who were selected for the system. We invited them to our system-wide trustee meeting. They could be from housekeeping or engineering, nurses, or physicians, and they had some of the most incredible stories. We would film a video of each honoree. These were phenomenal stories of how people represented dignity in our organization, along with excellence, service, and justice.
Moderator: Just speaking specifically about St. Joseph Health and the work you did to set the culture before and especially when you became CEO, was the example that you just shared part of a broader initiative?
Deborah: When I came to St. Joseph Health, the board desired to strengthen the “systemness” of the organization. At the time, the individual hospitals functioned more independently and sometimes at cross-purposes. To define systemness, we started by clarifying our mission and vision and reinforcing the commitment to our four values.
The next question was, how would we know we were achieving our mission and progressing toward our vision? We decided on three outcomes that would be our measures: 100% of patients would receive perfect care, 100% of all encounters would be perceived as sacred encounters, and 100% of our communities would be the healthiest in the U.S.
What followed was the strategy to achieve those outcomes.
And what helps or hinders you from accomplishing the strategy and achieving the outcomes is all culture. … leadership styles, infrastructure, technology, incentives, etc. Once we focused on these outcomes everything else developed as a result. Once we defined perfect care it became clear that different hospitals shouldn’t be measuring different clinical outcomes and a system standard was developed. On the other hand, the needs of one community in becoming healthy might differ from another so this was best dealt with locally.
Moderator: So, to recap can you tie all these concepts together for us?
Deborah: Culture is quite broad and encompasses all the ways we do things in an organization. Organizations can determine what cultural characteristics will best help them achieve their mission and live their values.
Moderator: Thank you, Deborah, for this insightful discussion on cultural transformation and its relationship to Belonging.
Deborah Proctor has over 40 years of leadership health care experience and is the Chair of the Board for THEO. THEO is a trusted Transformation Advisory firm working with enterprise leaders and entrepreneurs at the forefront of the well-being movement. Their uniquely human approach transforms the Talent, deploys Culture as a strategic advantage, and guides the Enterprise across the entire transformational journey. They ensure worthy organizations fulfill their Vision and meet their potential in time for it to matter.