Tip of the week: Develop the right culture

Last week, we discussed how to develop the right relationship between hospital leaders and physicians. That was number four of the “Seven Rs.” This week, the focus is how to align strategy and culture with hospital leaders and the medical staff.

There is great truth in the axiom “When strategy and culture are not aligned, culture eats strategy for lunch every time.” How would you describe your medical staff and hospital culture? The answer to this question is more important than you think. The true measure of an organization’s culture is how its members actually behave. Usually, behavior is consistent with the organization’s stated mission, vision, and values; but sometimes it is not. Accordingly, culture drives behavior, and behavior drives results. To develop a truly effective medical staff development plan, hospitals need to understand their current culture and establish the leadership necessary to change the culture if that is what is required to achieve physician and hospital success. In particular, when working with medical staffs around the country, The Greeley Company, a division of HCPro, Inc., based in Danvers, MA, has identified five underlying dynamic tensions that define the culture of the medical staff, sometimes referred to as polarities. They are:

• Collegiality and excellence
• Freedom and commitment
• Appropriate independence and mutual accountability
• Appreciation and continuous performance improvement
• Stability and change

An effective understanding of medical staff and organizational culture is necessary to create and implement a meaningful strategic medical staff development plan. Here are some steps to determine the right culture for medical staff development planning:

• Understand the role of culture: Don’t underestimate culture’s impact on strategic initiatives. Rather, gain an understanding of your medical staff’s culture and how it helps or hinders the hospital’s and physicians’ success.
• Measure your medical staff’s culture: Several tools exist to measure medical staff culture, including The Greeley Company Medical Staff Culture Survey. Measuring culture is a first step to managing and changing it.
• Change your culture: Understand the types of individuals you need in leadership positions to change your medical staff’s culture or implement strategic changes effectively given your current culture.

Culture change requires strong leadership. Leaders must espouse new beliefs and values (often in mission, vision, and values statements), “walk the talk,” and lead by example. They must reach out to their fellow physicians to communicate about the new culture and the reasons behind the change. Leaders must also build strong social capital and earn the medical staff’s respect to facilitate the necessary culture changes. In addition, leaders must hold fellow physicians accountable if they resist change. But with strong and effective leadership, slowly the change will come. Leadership’s job is to understand the current culture, define the desired future culture, and implement the changes necessary to shift the dynamic tensions favorable to the hospital’s and physicians’ success.

This week’s tip is from The Greeley Guide to New Medical Staff Models by Richard A. Sheff, MD; and William K. Cors, MD, MMM, FACPE. Check back next week to read about the next of the “Seven Rs.”