Written By: Kristin Baird
Culture change is never fast. It’s never easy. It can, however, be controlled. Unfortunately, far too many CEOs and members of the leadership team abdicate their responsibility for controlling—or guiding—culture change because of their own behaviors, or lack thereof.
When I work with organizations on the behavioral expectations that go along with any desired culture change I’ll often ask them directly: “who is exempt from this change?” What I mean by that is who in the organization will not be held accountable to the new behavioral standard. Their first response is often a shocked: “Well, no one! Everybody will be expected to comply!” But then I’ll drill a little deeper. And, I’ll invariably find that there are one or more “important characters” in the organization who just might not be held accountable should they choose to flaunt or ignore the new behavioral expectation.
I’m guessing you’ve seen this same sort of behavior in your organizations. The problem is that when leaders let certain members of the organization resist the change and do nothing about it, a strong message is sent to the rest of the organization. That message is: “This change really isn’t all that important and I won’t be held accountable if I choose to just keep doing things the way I’ve always done them.”
It’s not that you won’t face resistance. You will. What’s important, though, is how you handle that resistance. Let’s take a look at “3 Tips for Dealing with Resistance.”
1) Reflect on situations—and individuals—that have caused issues in the past. Who will be exempt from the new expectations? Get real. Be honest. You know who the resistors have been in the past and you can be pretty confident that they’ll continue to resist in the future. These are the “sacred cows” in your organization that, for whatever reasons, the culture has accepted as above reproach or beyond the rules. If you’re serious about making a culture change, now, you need to identify who these individuals are so you can proactively prepare to manage their resistance. During this process stay constructive, keep the conversations blame-free and focused on behaviors not personal character. This can be a significant learning opportunity for your leadership team.
Here’s an example of someone who became exempt. My firm worked with an organization that had very limited parking and ultimately made the decision that employees—and physicians—would be required to park in a back lot. One physician—a very hard-to-recruit type of physician—threatened to resign if he couldn’t park closer to the entrance. After all, he was a very important, and very busy, man and he needed to be able to get to the surgical suite quickly. He put up a big fight and seemed serious about “taking his ball and going home” if he didn’t get his way. So, the CEO backed down. It may have seemed like a small thing, but that decision sent a clear message out to the entire organization – the expectations don’t apply to everyone, especially those sacred cows.
So, who are the people in your organization who may think they’re exempt? You may want to make a list because chances are, you’ll have to prepare for how you’ll deal with them.
2) Prepare talking points that can be used to bridge from resistance back to a patient-centered philosophy. Based on the individuals and situations you’ve identified think about how you will respond to any expressed, or exhibited, resistance. Focus on creating messages that clearly tie behavioral expectations back to what’s important for your patients and visitors. This can be framed as a “what would you do” exercise. Based on situations you can anticipate, quiz each leader about “what would you do” if Dr. X does Y. Then practice your responses and, again, focus your messaging at moving away from the resistance and building a bridge to focus on your patient-centered philosophy. It becomes, then, not about Dr. X, but about the patients and visitors.
3) Stay the course! This is the toughest of these steps because it is obviously much easier to cave in to strong resistance than it is to stand your ground in support of the culture change and related behaviors. But that’s exactly what you must do if you want to see real change occur. Here’s an example that a colleague told me about recently. A high-level surgeon who brought in a great deal of revenue to his organization was not on board with the behavioral changes expected and flat-out refused to make those changes. When the CEO met with this surgeon and conveyed that not complying wasn’t an option, he threatened to leave. The CEO stood firm. The doctor left. And, despite significant wailing from other members of his team who declared he was “a brilliant surgeon” (he was) and “we’re going to lose so much revenue and so many patients,” the CEO accepted the surgeon’s resignation and he went to practice in another state. And guess what? The organization didn’t fall apart, the patients didn’t go away, and most importantly the cultural change continued to be fueled by a very strong message that nobody was exempt.
As these types of tough situations emerge—and they will—stay the course by leaning on each other, talking to each other and supporting each other in the decisions that must be made.
The bottom line: keep your eye on the prize. You’re working hard to create a culture where patients want to come for care, where providers want to practice and where employees want to work. It’s fairly simple—it’s just not easy.
Want to use this article in your e-zine, newsletter, or on your Web site? You may, as long as you include the following statement:
Nurse, author, and consultant Kristin Baird, “Healthcare’s Customer Service Guru,” is the author of Raising the Bar on Service Excellence: The Health Care Leader’s Guide to Putting Passion into Practice (Golden Lamp Press, 2008), Reclaiming the Passion: Stories that Celebrate the Essence of Nursing (Golden Lamp Press, 2004), and Customer Service In Healthcare: A Grassroots Approach to Creating a Culture of Service Excellence (Jossey Bass, 2000). The Baird Group provides consulting, mystery shopping, and training services for improving the patient experience. To learn more, please visit https://baird-group.com or call 920-563-4684.