Detecting, and Doing Something About, Culture Disconnects

Written By: Kristin Baird, MHA, BSN, RN

The patient experience is a critical, and common, area of focus for healthcare organizations these days. Healthcare providers want to provide high quality, safe care for patients. Healthcare organizations want to be able to survive and thrive in an increasingly competitive market. And the patient experience is pivotal to both.Most, if not all, healthcare organizations espouse a focus on the patient experience. Many have invested time and other resources into improving the patient experience, including in some cases by creating a Patient Experience department or function, and appointing a Patient Experience champion to lead the effort. And most, if not all, healthcare organizations have values statements intended to ensure a patient-centric culture.
 But, as we conduct culture assessments at healthcare organizations around the country, we often see a disconnect between the stated culture and the day-to-day reality of interactions between patients and providers, and between employees. Patients see these disconnects as well. In fact, they’re on the front lines of the culture experience as they place themselves, and their trust, in your healthcare organization.
Consider this: if your organization is really, truly living its values, the patient experience will take care of itself! Think about it. If everyone is behaving, and acting in ways consistent with your values, a great patient experience is a natural outcome.
 Unfortunately, we observe disconnects in organizations where the values aren’t clear or well-articulated. We also see a misalignment when specific behaviors, essential to living out the values, haven’t been articulated or where there isn’t a process for really quantifying and providing feedback on the behaviors—in other words, holding people accountable for living the values.
 It’s that alignment with the values that will foster a culture that makes your healthcare organization one where patients want to receive care, where physicians want to practice and where employees want to work.
 Let’s look at some examples of the disconnects we’ve seen: 

  • Your values include collaboration and teamwork, but we see evidence of work being done in silos.
  • Your values declare a culture of trust and integrity, but we see blaming, finger-pointing, and gossip.
  • Your values espouse a culture of service and yet  many of your processes are provider-centric, not patient-centric.
  • Your values talk about shared governance, yet decisions are top-down and hierarchical or people don’t feel safe bringing their concerns, or their ideas, forward.
  • Your values include a focus on ownership, yet we observe people walking by call lights, stepping over garbage on the floor or walking past someone who looks lost.

If we spot these things during our culture assessments, it’s important to recognize that we’re not the only ones observing these disconnects. Your employees, patients, providers and visitors are observing them too.

You may have spent months creating your values statements, committing them to writing, having them expertly designed and framed in the most beautiful brass frame that hangs in a prominent spot in your hospital, but you’re not going to be judged on the beauty and presentation of your values statements—you’re going to be judged on your actions and behaviors.

What’s happening today in your organization is your culture, whether by design or default. Your culture in the very simplest form is – how things are done around here. If frontline staff don’t take ownership and are not being held accountable by their managers for specific values-driven behaviors, your culture will reflect that. If Managers don’t feel like owners and are not being held accountable by senior executives to live the values, then that’s the culture you have. And your patients and other customers know it. They can see it and feel it at every touch point.

I’ll say it again. If you’re behaving, and acting, in ways consistent with your values, the patient experience will reflect that.

When we report out to leaders on our culture assessments, our job is to give them the kind truth. We’ll always be respectful, but truthful. Sometimes the kind truth is hard to swallow, but we make it as palatable as we can. We never want to hold up the mirror to them and say: “This is how things are, and it’s a big problem.” Instead, we say: “This is how things are right now. It is a big problem, and here are some steps to fix it.” Experience has taught us that we can work with any organization whose leaders want to live out their values. With a foundation of strong values and a desire to fulfill them in every decision and every encounter, we’re well situated to help organizations to foster a culture of excellence. We work on steps that help them align values with actions—to create an exceptional patient experience.To learn more about the Baird Model for Service Excellence, employee engagement or leadership development workshops, or to sign up for her FREE newsletter, write to

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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 or call 920-563-4684

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