Written By: Kristin Baird, RN, BSN, MHA

Culture, in its simplest definition, is “how we really do things around here.” Regardless of the written policies, codes of conduct, and wall-mounted plaques espousing values, it is the unwritten rules that, if left unchecked, quietly abduct the culture and hold it hostage. It’s the unwritten rules that form the cultural norms.

It is not uncommon for us to conduct in-depth culture assessments where we reveal unspoken rules that are light years away from stated values and strategic goals. It is then up to us to highlight the gaps and help leaders realign behaviors needed to close the gaps. In many cases, the leaders are unaware of the unwritten rules.

One example of unspoken rules that has stuck with me, years after a culture assessment, involved a highly specialized surgeon. He was rude to patients and verbally abusive to staff. Although the written policy was to report this type of behavior and embark on the disciplinary process, the unwritten rule became the norm. In this case, the unwritten rule was to tolerate his behavior because he would be too hard to replace and was the only one in a 40-mile radius who could perform certain procedures. If I were to translate this unwritten rule to a written one, it would read something like this:

Rude behavior, bullying, or any form of lateral violence will be grounds for disciplinary action unless you are a physician with a unique skill set, and who generates significant revenue for the hospital. 

In a recent article in Harvard Business Review, Why You Should Write Down Your Company’s Unwritten Rules, author Karen Niovitch Davis states, “But even in company cultures that are built around solid norms, it’s a good idea for leaders to assess the unstated rules, behaviors, and expectations from time to time.”

Davis goes on to explain, “By their nature, unwritten rules don’t exist anywhere but in people’s minds. Ask yourself what norms your employees are holding in their heads and get them on paper.” She states that “Until there is agreement on what perceptions exist, it’s impossible to address or change them.”

Not all unwritten rules are bad for the organization or misaligned with goals. I once interviewed the head of patient experience for an internationally renowned healthcare system that had enviable patient satisfaction scores across their system. Their unwritten rule was, “do the right thing.” Sounds vague and simplistic right? Yet it was an essential part of their culture. How did that become the unwritten rule? People constantly witnessed leaders going out of their way to help patients and staff because it was the right thing to do. They made it the norm.

What are your unwritten rules?

Baird Group conducts focus groups and in-depth interviews to help organizations reveal the unwritten rules currently shaping the culture. Let us help you gain a better understanding of your culture and the underlying beliefs and attitudes with a thorough culture assessment.  Contact us at info@baird-group.com