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Culture in Health Care

Michael McConnell, BSHCM, PTA

 

In my 10-year career as a clinician, I have seen many changes in our health system. Changes powerful enough to see some organizations succeed and fail. The ones that ultimately failed all had something in common: they were bottom-line driven, didn't care at all for their employees, and finally did not have an established sense of culture. Let's look at that last one for a second; what does culture have to do with an organization failing? It's not a measurable outcome, and it's not something that can be seen or counted. The culture of an organization is the overwhelming feeling of comradery that motivates a returned feeling of employee dedication and empathy. Culture drives success, defines meaning, and rallies everyone behind a common goal.

Most of my professional career has been spent in South Bend, IN, and in surrounding health markets. Due to having difficulty finding a position in my immediate area, I decided it was best to travel until something became available. For three and a half years, I found myself traveling throughout Illinois, Indiana, and Michigan. I've had the opportunity to work for multiple therapy organizations and their outpatient/inpatient, acute care, and long-term care partners.

In healthcare, we find ourselves in a unique position. As licensed professionals, we can perform our specialized services, to collectively benefit and successfully heal our patients. We all bring something different to the table. Outside of the common goal for patient success, how are we similar, and what drives culture? We are all similar in that we want to work towards something higher than ourselves but may not necessarily know how to accomplish it. This desire to achieve something higher is where employees look to their organizations for a collective direction and leadership.

Practicing empathy is key to fueling culture, and this must start at the highest levels of the organization. Healthcare leaders that are seen working the floor alongside their teams on a regular basis are more respected and show a vested interest in the organization. It provides a feeling of comfort and relatability, or discomfort if you're not performing to expectation. As a leader, if you see someone not performing to expectation, dedicate the time to find out why. Are they having difficulty because of external obligations? Is it the job itself? You never know what a person is going through until you take the time to find out. Find common ground and build from there. Offer resources, establish improvement plans, and ultimately provide guidance; but it must be in person. When a leader shows empathy, it is guaranteed to be reciprocated. When clinicians begin to express empathy, it becomes more of a behavior.

Learning and understanding the behaviors of others is essential in finding a common culture. The challenge with healthcare is that we deal with a multitude of cultures and perceptions daily. Culture in healthcare is not limited strictly to organizational interactions. We all have different ideas of what is accepted and familiar. We have a saying in the therapy profession, avoid using the "Shotgun approach," when treating patients. Meaning, no one person we serve should be treated the same as the other and requires individual attention based upon their ailments, symptoms, and perceptions.

Culture can be positively changed or implemented by something as easy and straightforward as greeting everyone that crosses your path. Non-verbal and verbal cues need to be utilized, and they all need to be positive. Think about greeting one of your team members in the hallway in passing; you have 2-3 seconds at most to leave an impact. Positive or negative, it is entirely up to you. But think about this scenario, comparatively speaking. Which greeting do you think has a more lasting impression:

"As I proceeded down the hall, I observed Ashley walking towards me. She was easily 20-30 feet away, with the gap ever closing. Instead of looking down at the paperwork in my hand to avoid having to greet her or make eye contact, I do something different. I smile and make eye contact accompanied by the greeting for the time of day. (good morn., after., even.)"

VS

"I observe Ashley walking towards me in the hall, to prevent eye contact, I choose to look down at the paperwork in my hands. She has seen me see her, so she is probably going to be expecting a greeting. Without looking up from my paperwork, I managed to muddle out a simple, "hello." I could see out of my periphery that she seemed a little off-put by my greeting."

Societal and psychological norms encourage a reciprocating and typical response to human behavior. Simply put, human behavior is contagious! How do you think Ashley is feeling in the first scenario? I smiled, I made eye contact and maybe threw in a knuckle bump. Ashley feels happy to have been acknowledged, to be treated with respect, and sees that I am genuine in my greeting. How likely do you think she is in repeating my response? Very likely, and even if it is repeated only once, with Ashley greeting a patient or fellow clinician, the behavior remains contagious. This basic example is how culture is built.

Culture is not something that is practiced once and then obtained. It is ongoing and requires constant work. Practicing empathy should be an everyday occurrence. We are emotional beings at heart, and to be human, means to act with heart. Always remember that emotions and behaviors are contagious. If you facilitate the positive ones, we will live in a better world.