6 Necessities for Deliberate Culture Change in a Hospital

In a recent webinar hosted by Becker's Hospital Review, Rhonda Larimore, vice president and chief human resource officer with Children's Hospital of Pittsburgh of UPMC, and Ted Kinney, PhD, senior consultant with Select International, discussed key steps for hospital leaders who are trying to implement a culture change within their organization.

Ms. Larimore has overseen a multi-year cultural change at Children's Hospital of Pittsburgh with help from Select International. Two years later, the hospital has boosted patient satisfaction percentiles in every area except one, and the six-month employee turnover is "nearly non-existent," according to Dr. Kinney. Here, Ms. Larimore and Dr. Kinney discuss management techniques that drive, rather than hamper, cultural improvement initiatives.

1. Accept that culture change is a time commitment. Ms. Larimore said culture change is not quick, but is achieved through small steps and making the right, albeit difficult, decisions. Cultural improvement processes should be defined and included in hospitals' strategic plans and discussed in the long-term. The effort should not be made a "flavor of the month." For instance, Children's Hospital of Pittsburgh included cultural improvement in its strategic plan over a five-year time span, according to Ms. Larimore.

2. Define "culture" in your organization. Many healthcare organizations reach a plateau when discussing their visions of culture and don't define operational strategies to achieve it. Some hospitals may want to develop more patient-centered cultures, whereas others may be pursuing Lean cultures. Management needs to link behaviors to outcomes and distinguish the specific values and competencies that will drive the culture change.

3. Stress buy-in from leadership. Leadership has the ultimate accountability within the hospital, as management heads decisions affecting employee selection, retention and tenure. Dr. Kinney emphasizes ongoing education for leaders on what drives culture within the organization. "I'll frequently hold meetings with managers to let them know what we're looking for in the selection process, and how that links back to outcomes," he says.  

4. Make the change an inclusive effort within the organization. Some hospital cultures are mistakenly divided among the "haves" (medical professionals directly involved in patient care) and "have-nots" (other staff members), according to Ms. Larimore. Hospitals need to ditch that framework for true cultural change. Dr. Kinney also warns of what he calls the "cultural hourglass," where managers in the middle do not recognize frontline staff as contributors to patient satisfaction. "They're oftentimes led in a way that doesn't foster engagement," he says.

5. Develop and promote a set of core competencies. This might include values like collaboration, adaptability, dependability, customer-focused and accountability. These cornerstones should be factored into every aspect of the organization, including compensation, performance management, individual career planning and succession planning, among other facets. "I like competencies that are simple," says Dr. Kinney. He discourages lists of 30-something traits, as employees will forget them.  

6. Integrate employee assessments across the board. In the employee selection process, management needs to approach assessments as an integrated system.  "I want my interview, for example, to be built upon that same competency model as the assessment. It's all mapped back to the competency road map," says Dr. Kinney.

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More Articles on Employee Engagement:

5 Ways for Young Healthcare Leaders to Achieve Their Most Important Goals
Examining the Crossroads of Culture, Engagement and Patient Satisfaction
Patients Come Second, Employees Come First

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