Great leaders intentionally define, articulate, and model the culture they want for their workers.
In 2013, Google—noted for hiring the best and brightest—embarked on an effort to take stock of the company’s ability to create a culture that inspires excellence. Through its initiative, dubbed Project Oxygen, the company scoured its own data for patterns in hiring, firing, and promotions since the company’s incorporation in 1998. The internal study’s findings surprised just about everyone involved: Soft skills, such as communication and emotional intelligence, made the biggest impact on an employee’s success. a
For a data-driven company like Google, the importance of soft skills—and the value of hiring people from disciplines outside the STEM world—was a revelation. b Google has since expanded upon the seven soft skills initially cited in its Project Oxygen findings as being most important attributes of a successful manager, and a builder of culture, into the following 10 key attributes: c
- Is a good coach
- Empowers team and does not micromanage
- Creates an inclusive team environment, showing concern for success and well-being
- Is productive and results oriented
- Is a good communicator—listens and shares information
- Supports career development and discusses performance
- Has a clear vision/strategy for the team
- Has key technical skills to help advise the team
- Collaborates across the company
- Is a strong decision maker
Strong leadership is becoming increasingly important as health care moves from volume to value. With a growing emphasis on precision medicine, data-driven treatment protocols, and an aging population in need of more medical options than ever before, healthcare practitioners are facing some of the highest levels of stress of any industry. According to a 2014 survey, 69 percent of workers in health care report feeling “stressed,” with 17 percent saying they were “highly stressed.” d
Although patient care will always be the primary focus, healthcare leaders would could benefit from following the lead of companies noted for putting employees first, including Zappos, Southwest Airlines, The Container Store, Ritz Carlton, and Google. And although patient care—not employee needs—tends to stand at the forefront of most healthcare organizations’ missions, it stands to reason that medical professionals can provide the best care only if they are mindful of—and supported in—safeguarding their own mental and physical health.
The business and financial impact, not to mention the human toll, of not creating a healthy culture is also considerable. A recent study concluded a healthcare organization loses $58,000 with the turnover of one nurse and $1.3 million with the turnover of one primary care physician. e Of the healthcare companies surveyed, 86 percent cited company culture and engagement as top management issues.
Workplace Trends in a Rapidly Changing World
A culture shift in any workplace requires not only strong leadership but also the ability of leaders and employees to recognize the changes in their environment. In health care, the major change is the shift from volume to value, which acts as a catalyst to bring about even more change and the need for organizations to adjust.
The chaos norm. Along with identifying the necessary internal changes needed to strengthen culture, effective leaders must recognize the changes happening in the external world that make internal adjustments necessary. First, the very nature of change is redefined with shifting circumstances and is quite different today from how it was experienced in the past. In health care today, as in many industries, organizational change is constant, relentless, and continually accelerating. With heightened competition, increasingly sophisticated (and demanding) consumers, and rapid advances in technology, leaders must create an environment in which people trust their colleagues, collaborate across business units, and give and receive feedback freely.
In such an environment of change, the downside of ignoring the importance of culture can be devastating in terms of employee disengagement. According a 2017 report from Gallup, 85 percent of workers worldwide are not engaged in their work, costing the global economy of approximately $7 trillion per year in lost productivity. f Among those employees, 18 percent are actively disengaged, meaning that they may actually harm the organization through mistakes or malfeasance, while 67 percent are “not engaged.” Although the latter group may be less inclined to harm the organization, either intentionally or unintentionally, many employees clearly are not giving their companies their best performance.
Function fluidity. Leaders and managers, especially those with hiring power, have long thought about employees in terms of track record. This strategy is not necessarily a bad way to judge; past behavior often is the best indicator of future behavior. But now leaders must begin to look at employees in terms of potential to ensure they can flow with change and growth. Leaders should expect workers to be in a state of constant training as they are assigned to teams and projects based on their ability to learn, grow, problem solve, and lead others. Tasks should be assigned on what a professional can be trained to do rather than what they have done in the past.
The language of leadership. Leaders must learn to be as skilled in communication and people as they are in processes and systems. For some leaders, and for some employees, this process will not come easily. For others, it will be an exhilarating invitation to master new skills as they take on additional functions. Following are some recommendations on where leaders should focus their efforts to become great communicators.
Share your vision. Leaders should share with their teams their vision for growth and their perspective on the competitive landscape. Although there certainly will be some proprietary and confidential matters that cannot be discussed, transparency and inclusion are integral to effective organizational communication. When leaders are open and inclusive, employees rightly feel that trusted and valued.
Be clear about goals. In planning, leaders should look one year (or more) ahead and start working backwards, quarter by quarter, month by month, week by week, to determine goals. Organizational leaders should be clear and concise about anticipated outcomes by sharing high-level objectives, critical tasks, milestone markers, and project ownership.
Stay connected. It is important to check in with team members regularly to ensure employees are on task and on time. Good leaders know what their people do well and tap into their talents. It also is important to find out what team members need, either directly or through their managers. Conflicts should be resolved quickly and feedback given frequently.
Foster a team approach, and be part of it. Modeling an attitude of continuous improvement will encourage everyone to regularly contribute strategies and suggestions to improve the workplace. Encouraging workers at all levels to offer ideas for increased quality and productivity will help make ongoing improvement part of the organizational culture.
It also is important to celebrate success along the way and recognize the outstanding efforts of employees. Institutionalize celebrations that fit your unique culture and create new ones as occasions arise. After Abbott Medical acquired St. Jude Medical and the staffs were merged (yet another example of change), Gray Fleming, the head of Midwest sales, celebrated his team for their dedication and agility—as well as a successful sales season—in an unforgettable manner. When the team arrived at the sales banquet for a surprise excursion around Lake Michigan, Fleming and his senior staff greeted them dressed as waiters and bearing trays of wine and champagne. Their goal was to honor their team members for a job well done as not only servant leaders, but also as server leaders.
Move from a corporate to a community mindset. Paradoxically, as changes are implemented more and more swiftly, leaders will need to loosen their hold on the workforce. Through transparency of mission and constant communication, effective future leaders will foster trust and collaboration, encouraging employees to create deep and meaningful relationships with coworkers. With the right mindset, these relationships can flourish in shared physical space or virtually as improved technical connectivity continues to place colleagues face to face across the hall or across the globe.
With flextime policies (and changing attitudes about people using them without penalty), global teams, and 24/7 accountability, leaders can avoid costly burnout and turnover. By creating avenues for engagement such as intranet portals, company-supported volunteer activities, and training programs, leaders can replace bureaucracy with flexibility and hierarchy with collaboration.
The Hope-Driven Culture
One of the best ways to create a more effective organizational culture is to understand what employees truly want. Although much of the culture and leadership literature is focused on what leaders can and should be doing—such as articulating a vision, setting strategies, and monitoring the bottom line—it can be extremely helpful to see what leadership looks like from the other side of the desk. A study of data from Gallup involving polls of more than 10,000 people revealed four key themes that emerged most frequently as the attributes that followers desire in their leaders: trust, compassion, stability, and hope. g
The science of hopefulness, or hope theory, stems from a body of research from the medical and positive psychology communities that tells us that hope is specific, situational, and future-focused. The concept was pioneered by the late Charles R. Snyder, PhD, a professor of psychology and, from 1974 to 2001, director of the graduate training program in clinical psychology at the University of Kansas at Lawrence. Snyder said the concept of hope is based on both “willpower” and “waypower,” where one is able not only to create the pathways to realizing a vision, but also to sustain the mental energy and perseverance to travel those pathways effectively. h He likened this process to the saying “Where’s a will, there’s a way,” citing both elements as critical to success.
Today, with the world and workplace focused on ideas and innovation rather than output alone, the most successful people often are the most hopeful because they see multiple pathways, rather than just one way, to arrive at a successful outcome.
Among the advantages of having a high level of hope (not to be confused with optimism, which a generalized outlook on life independent of one’s actions and circumstances), Snyder’s research showed that hopeful people are more likely than unhopeful people to:
- Set a high number of goals
- Have goals that may be more difficult to attain
- Reach their goals
- Have less distress and greater happiness
A culture of hope can help an organization and its leaders shape its strategy for change. Here are a few ideas to help leaders who are looking to deepen employee engagement and develop organizational culture.
Share your purpose. The why behind a team, division, or organization may be obvious to a leader, but do not assume that everyone else understands it. Every employee in the organization should be able to accurately describe the organization’s mission.
Find the formal and informal change agents. Do not succumb to the notion that only the senior leadership team or human resources department can manage change. Find those influential people at all levels of the organization who others listen to, respect, and follow. Instill them with hope about the future—as well as the realities of the business— and enlist their help in easing others through change.
Be open and transparent. Have a common language around shared values and predetermined standards. Don’t fall into corporate slogans or platitudes that would be better posted in the employee cafeteria or embroidered on a pillow. Instead, share real, honest, down-to-earth talk about what the company stands for and what is expected of its employees. For example, at the San Juan Regional Medical Center in Farmington, New Mexico, the team routinely discusses what they call their “sacred trust” to do the right thing, and “personal reverence” for the value of every patient, patient family, and staff member. i
Offer information freely. Information is the organizational lifeblood on which decisions are made in every company. Effective leaders honor people with their trust and willingness to give them the facts. Although some things must remain confidential, most information can and should be shared readily up and down the pipeline that can help others make timely decisions.
Avoid micro-managing. Hire the right people, know what their skills and strengths are, and monitor them as necessary without undermining their confidence or ability to take calculated risks. People who are charged with mastering new skills and taking ownership of projects are likely to be far more engaged.
Embrace your frontline. Do not forget about the people who are out front doing hard duty with patients, patient families, vendors, and more. When you flip the conventional wisdom and think about leaders as working for their followers, and not the other way around, you are building a hope-driven culture.
Know your people. This advice may seem obvious, but it is not intuitive to everyone. Employees spend most of their waking hours at work, so leaders should take the time to get to know their employees as people—discover their passions, learn their children’s names, and know their hopes and dreams for the future.
Paint a vivid picture of the future. Building culture is about looking toward a better future. Employees need to understand where the organization is heading and what that means to them individually. A good leader will communicate the vision so fully and frequently—through town hall meetings, internal newsletters, and one-on-on conversations— that everyone has a clear vision about where the company is headed.
The most effective leaders understand that, as rapidly as our world is changing, they also must adapt and change. By creating a highly engaged culture of employees who look at change not as overwhelm but as opportunity, healthcare leaders will be well positioned to effect meaningful change in their organizations.
a. Strauss, V., “The Surprising Thing Google Learned About Its Employees—and What It Means for Today’s Students,” Washington Post, Dec. 20, 2017.
b. STEM = Science, technology, engineering, and mathematics
c. Harrell, M., and Barbato, L., “Great Managers Still Matter: The Evolution of Google’s Project Oxygen,” re: Work, Feb. 27, 2018.
d. Ricker, S., “Stress Is Part of the Job for Health Care Workers,” CareerBuilder, Feb. 12, 2014.
e. Fish, T., “Culture: The Heart of a Successful Healthcare Organization,” Ita Group, July 18, 2017.
f. Gallup, State of the Global Workplace , 2017.
g. Rath, T., and Conchie, B., Strengths Based Leadership: Great Leaders, Teams, and Why People Follow, New York: Gallup Press, 2008.
h. Snyder, C.R., The Psychology of Hope: You Can Get There From Here, New York, The Free Press, 1994.
i. Gill, L., Capture the Mindshare and the Market Share Will Follow, Palgrave Macmillan, 2013.