But are you sure? Do you really know how you do things?
When you ask healthcare leaders to describe their culture, they’ll often give a lofty definition. I define it as, “Culture is how we do things around here.” Jeff Bezos said, “Your brand is what other people say about you when you’re not in the room.” Your brand is directly tied to your culture. That certainly makes sense from the point of view of patients and visitors. How you do things is how they determine who you are and what you value.
But, do you really know how you’re doing things? Because that’s what your culture really is.
Not the mission statement on your wall. Not the values on your website. But how you actually do things and what your customers experience.
When I walk into an organization to do a culture assessment, I’ll walk in and start observing. I’ll see someone on their phone not making eye contact as I approach the desk. I’ll ask for directions and someone will point but not offer help.
How you do things is on display during everyday interactions. A patient gets their meal delivered and tells the person delivering it that it’s not right. The response? “I just deliver what’s on the cart.”
That’s probably not how you think you do things. But what you think and what your patients are actually experiencing are often very different.
When I bring these observations to executives, though, I often get pushback. “Oh no, that’s not who we are. That’s not our culture.”
So I ask: “When should I come so that I get what you promise? What day of the week? What time of the day? Who should be working? When is it that I’ll find your staff aligned with what you believe your culture is?”
And that’s when the real conversation starts.
The Accountability Illusion
Leadership rounding is a great way to learn about how things really are done around your organization. It’s long been embraced as a leadership best practice. But accountability for effective rounding is often an illusion. I’ll often hear from executives: “Oh, we have impeccable rounding.” One CEO was so proud of her leaders’ rounding, she shared the color-coded spreadsheets indicating a detailed schedule. That was the plan, not the reality.
Detailed spreadsheets, unfortunately, don’t tell the full story.
When I explored the reality of what was really happening, I found something much different than what the spreadsheet showed. I found that rounding simply wasn’t occurring, or not with the frequency expected. Her spreadsheet created an illusion of accountability.
Is rounding a white glove inspection or an opportunity to connect?
I was rounding with a manager one day who pointed down the hall to where the CEO was standing with his arms crossed. After a moment he left the unit. The manager said, “In the next 20 minutes, I’m going to get a call or an email or both from him.” What she predicted would happen next (and she was right) was a phone call outlining everything that was wrong on the unit.
They called it his “white glove test.” The CEO appears on a unit. He looks around. He doesn’t say anything. Then he leaves.
And what follows is a call or an email listing everything that’s wrong.
Think about what that signals to people. It signals: “The CEO is coming to find what you’re doing wrong.” Not to thank you. Not to interact with you. Not to ask: “Do you have what you need to do your work today?” It’s an inspection; a judgment. That speaks volumes about the culture the CEO is creating.
That’s not what rounding should be. Rounding should be a validation. Constructive feedback when necessary. And recognition of staff efforts.
The Real Diagnostic
When we conduct culture assessments, there’s often a gap between what the C-suite thinks is happening and what people on the units are actually experiencing.
The executives have one perception. The directors have another. The managers have yet another. Nobody is aligned.
When there’s lack of alignment in the culture, you can’t deliver on your brand promise consistently.
You can’t say you have a patient-centered culture if your patients experience indifference. You can’t say you value people if your managers experience a white glove inspection instead of support.
Culture isn’t an aspiration. Culture is what people experience when no one is watching.
So the real diagnostic question isn’t: “Do we have the right values?” The question is: “When your staff, your patients, and your visitors interact with your organization do they experience what you promised them?
If the answer is no, then you have a culture problem. When you’re ready to do something about it, give us a call. The first step: a mystery shopping assessment to provide insights into what’s really happening around your organization.
Tags: Brand promise, Culture Assessment, Culture Matters, healthcare leadership, leadership development, Leadership Rounding, Organizational Culture, Patient Experience
