A Key Strategy to Create and Sustain a Great Culture

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Great cultureCULTURE. If you are anyone working in healthcare, you’ve been hearing that word a lot. It seems to be the current buzz word. Every other day there’s a new study, report, article – you name it – revealing the “shocking effects” of toxic cultures on human beings and how leaders, executives, organizations, etc., need to focus on creating healthy work cultures. But what does that even mean? What is a great culture?

I’ll tell you what culture is NOT. Culture is not about the fluff. It’s not about the soft and gooey. Culture IS about how employees behave and interact with each other based on the organization’s values, beliefs, and organizational policies. Culture is what you create and what you tolerate.

Great cultures set you apart from other organizations. It’s your competitive advantage.

What does the evidence say about great cultures?

  • In 2020, the Nurse Leader Magazine did a survey and discovered that only 2 in 10 leaders strongly agreed that senior leaders live and breathe their cultures. Meaning, they walk the talk.
  • In a recent survey, less than half of nurses in the US say that they are fully engaged, and 14% are unengaged. Disengaged employees are 3.8 times more likely to cite organizational culture as a reason for leaving.
  • After a recent bi-monthly leadership meeting with a President and CNO, they shared the #1 reason people left the organization in the last year was not pay. Pay was at the bottom of the list. The #1 reason related to culture.

What is culture?

In his book, “The Florence Prescription”, the author, Joe Tye, mentions that culture is to the hospital what personality and character are to the individual. Your culture is defined by what you permit and what you promote.

John Eades, a leadership development coach, defines culture as the shared values and beliefs that guide thinking and behavior. It’s how you behave on a daily basis.

And finally, Peter Drucker’s famous saying, “culture eats strategy for breakfast.”  You can have the most beautifully articulated strategic plan but if culture isn’t on it, you will never succeed.

Great cultures aren’t built overnight. They take time, patience, and constant attention.  Where do you begin?

All great cultures start with core values.

At a leadership conference, the speaker asked attendees to name their core values. People stopped looking at the speaker and did that “side-eye” look at each other. It was obvious that they didn’t know.  

How can your employees be expected to honor your values if your leaders don’t know what they are?

Core values can’t just be words on a piece of paper or a plaque on your lobby wall. They need to become a mantra – a living and breathing set of behaviors that define the way we “do business” here.

It starts during the interviewing process and needs to be embedded in your onboarding process with new employees, should be incorporated into your strategic plan, meetings, annual competencies, and in any recognitions.

For example, let’s say your core values are…

  • Assume positive intent
  • Respect for all
  • Commit to continuous learning
  • Do the right thing
  • Work as a team

Then, on a regular basis, recognize your employees and your leaders for honoring your core values. Celebrate your core values more than tenure.

You want to talk about your core values so that every human in you organization can immediately recite them – anytime – anywhere.

What if your employees aren’t honoring your core values?

All of us know how hard it is to create and sustain a healthy work culture. Once you make your core values a living and breathing set of “rules”, what do you do when some employees struggle to honor those values? Do you kick them to the curb? Do you ignore their direct violation of your values? What do you do?

At least initially, be curious, not judgmental. This is your opportunity to remind them of your values and how they didn’t honor them. It’s your opportunity to coach them.

A nurse manager hired a clinically excellent nurse, but it wasn’t long before she realized there were “opportunities” in terms of behavior. There were no clinical issues, but he was somewhat short-tempered, a bit abrasive, and overreacted to benign situations.

However, he was extremely coachable. Over time, she talked to him and gave him feedback on his behavior and how he wasn’t honoring their values. Over time, even his teammates noticed an improvement.

She was patient – not judgmental. He was able to step up and become a well-respected team member.

Remember, the goal is not perfection. It’s improvement.

The performance and engagement of our teams reflects the cultures that we as leaders create. We are responsible for creating that tone.

Can leaders influence culture?

In closing, there’s a book, “The Leadership Challenge” where the authors say there is a hundred percent chance that you can be a role model for leadership. There is a hundred percent chance that you can influence someone else’s performance. And there is a hundred percent chance that you can affect someone else on what they think, what they say, and what they do. And there’s a hundred percent chance that you can make a difference in other people’s lives.

Culture is driven from the top down, and to be successful in sustaining that great culture, we must look at our leadership as a personal philosophy, with a commitment to serving others through our examples and the expectations that we set. We set this tone, and the key in sustaining a positive culture is creating a community of people who encourage each other and work towards a common goal.


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