Taking Your Culture From Good to Great

I recently had a discussion with the CEO of a large East Coast hospital system. She was relatively new in the job and was lamenting that her prior organization, where she had been the COO, seemed to have operated much more effectively than the one she had taken over. 

As we began drilling down into the issues she was experiencing, she noted that employee morale was low and patient satisfaction was only average (as identified through surveys), and there seemed to be a general lack of concern from key employees that these were important issues. Additionally, she observed the creation of silos and a CYA mentality, in which a culture of blame existed, rather than one of mutual problem-solving. 

One example she provided was how nurses on one of the nursing stations were blaming housekeeping for the general untidiness of the area, but doing little on their watch to make things better. It was easier to blame than to problem-solve. This blame, and counter-blame, was unproductive, yet no one was taking responsibility or ownership to make the environment better for employees or for patients. Furthermore, she was alarmed that a few good employees had recently left the system for jobs elsewhere. It was clear to the new CEO that she was navigating through a depressed culture—a result of the absent accountability.  

Everyone wants to be associated with a winner, not a whiner. When differentiating between winners and whiners, the most important differentiator is also the simplest: accountability! 

When problems arise, and persist, it is common to hear employees say that “no one is being held accountable.” This is often perceived in a punitive sense, with the assumption that there must be someone to blame for problems not being solved. This attitude is one in which employees are always looking outward, rather than inward, for solutions. While the process of creating a culture of accountability can be arduous, the steps to be taken are easy to understand and are generally related to leadership. 

As we explored the creation of a culture of accountability with the CEO, we discussed the necessary steps that leaders must take to be successful. These are, in order: 

  1. Leaders must themselves have a clear understanding of the mission and goals of the organization. 
  2. Leaders must have the authority to create a culture of accountability in their department or organization. They must also have the support to make the changes necessary to transform the culture.
  3. Leaders must have the right people in the right positions. Changing a culture is not easy; not everyone has the courage, nor skill set, necessary to drive change.
  4. Leaders must clearly articulate their expectations and create an environment in which the goals of their department align with the goals of the organization. These expectations include standards related to the quality, quantity, and timeliness (QQT) that leaders expect, and include metrics for measuring success. 
  5. Leaders must identify owners of the goals and objectives.
  6. The goals must be communicated throughout the department or organization.
  7. Owners of goals must have a cadence of meetings for regular review of goal accomplishment, relative to expectations, and revise goals when necessary.
  8. Rewards and recognition must become part and parcel of the process.

In our discussions with the CEO, we noted that the most important aspect when creating a culture of accountability is to sustain the effort until it becomes institutionalized. Too many organizational initiatives begin with a bang and end with a whimper, as poet T.S. Eliot famously wrote. Finally, while accountability is often associated with some kind of punitive action, efforts to instill accountability in the culture are much more likely to be successful by having the right people in the right places, and rewarding behavior that approximates the desired results. The new CEO is currently in the process of implementing our recommendations. We are confident that she will be successful!

For information on how we can assist your team, contact us at: MyronBeard@BeardExecutiveConsulting.com