The Evolution of Organizational Culture: First Generation - Patient Experience
I’ve been in healthcare long enough to recall the first discussions about “culture” and “the patient experience” some 20 years ago. The first generation of these discussions led to basic training programs that went beyond clinical and technical skills, trying to learn from other industries to build a service culture focused on patients. For an industry steeped in clinical and technical expertise, it all felt quite strange.
Second Generation - Employee Engagement
Then, a few years ago, I attended ASHHRA, the big healthcare HR conference. The theme was “employee engagement,” theorizing that if we are successful in engaging hospital staff in the organization’s mission so they feel like they are integral to its success, then it will result in better patient care and organizational outcomes. Now it felt like we were evolving from simple service-orientation training to something different.
There’s some evidence that this approach makes sense. Last year, we interviewed Mark Sevco, the President of the University of Pittsburgh Medical Center’s newest hospital. His team started with employee engagement, theorizing that it would build the foundation for success. It worked. They have an outstanding culture and outstanding employee engagement and patient satisfaction scores.
Our role in helping organizations prioritize a culture of engagement has been to build a healthcare hiring strategy, including an approach to interviewing and the use of scientific behavioral assessments to identify candidates who are most likely to have the attributes to thrive in and contribute to this type of culture.
Third Generation - Love
Last month, I saw the next generation of this culture evolution at the LEAP HR Healthcare event held by Hanson Wade in Chicago where several healthcare HR leaders talked about their efforts to build their culture around “love.” Yup, love. Some cynics might ask if this goes too far. Their sentiment is that a hospital is a complex organization; a business whose purpose is to provide highly sophisticated care to sick patients - a business that requires a large, educated workforce with specific and demanding job responsibilities. And while these employees care for patients, and we expect a sense of compassion and “patient-centeredness,” they are employees, and it is a business.
A 2014 Harvard Business Review article, Employees Who Feel Love Perform Better, explored “companionate love” in the workplace. This is love based on warmth, affection, and connection. Think about it - it makes sense. If everyone, from the C-suite to the environmental service worker and valet, aspires to the goal of most schools of spiritual thought: to love those around us and act from that love, a lot of behavioral expectations and culture goals take care of themselves, don’t they?
Managers can expect a lot from employees but still care for them, even when they don’t meet those expectations. One speaker explained that they’ve moved away from the language of performance reviews and progressive discipline, and on to “professional expectations,” i.e., we hold our professionals to a high standard. When they don’t meet those expectations, we let them know and help them to improve, but out of love. We want them to succeed. We want them to provide the best care possible for the patients because we care deeply about every patient and family member.
What an amazing, aspirational culture. Is it realistic? We’ll see. I hope so. There is evidence that it can work: the Harvard study cited above found that healthcare staff perform better when they perceive greater affection and caring from their colleagues and managers. The research also demonstrated that this type of culture related directly to client outcomes, including improved patient mood, quality of life, satisfaction, and fewer issues requiring ER visits (it was a long-term care facility).
This was not an isolated finding. A follow-up study showed similar results in seven different industries.
Wow! Who would have thought that with all of the research and discussion on human management strategies and tools, culture, and organizational performance, that the key to success is something we all should already know? Treat colleagues, employees, and patients and their families from a place of love. Of course, the presentations at LEAP HR outlined some very specific changes, strategies, language, and programs that communicate and support these efforts.
The HBR article outlined a few important strategies but concluded:
“Most importantly, though, it is the small moments between coworkers — a warm smile, a kind note, a sympathetic ear — day after day, month after month, that help create and maintain a strong culture of companionate love and the employee satisfaction, productivity, and client satisfaction that comes with it.”
Your Healthcare Hiring Strategy can Help Build a Culture of Love
We haven’t yet integrated “love” as a behavioral competency in our hiring tools, but the "companionate love" referenced in the article is clearly related to personality attributes that we do measure. People with high levels of compassion, empathy, and service orientation are far more likely to be able to bring love to their work every day. It will be interesting to watch how these programs perform and whether, as an industry, healthcare is ready and willing to start talking about love as the basis of success.