Physician Leadership in Driving Culture Change

Getting your organization aligned with your vision and plan

Whether you are a physician leader in industry or clinical practice, you know you need to get your organization to a new place.  The way everyone in your organization works, thinks, and behaves may (or may not) be okay—but to achieve your aspirations for the future, you are going to need a better approach.  Your challenge is to move your organization from where it is today—to where it needs to be in the future.   And you need to do it before the future runs over you like an avalanche. 

No matter where you wish to take your organization, you will need the support and commitment of your colleagues—if you are to succeed.  However, getting your people unstuck—getting them not only to embrace your vision, but to change the way they work and think to achieve it—is often more challenging than defining the goal or objective. 

The key to achieving meaningful change in your organization is to align every thought, action, and behavior (the expression of an organization’s culture) with a clearly defined and well-communicated vision.  While this can seem to be a daunting task, you can achieve alignment if you break the process down into manageable steps.      

Know where you want to go

The first thing you need to do is be clear.  Create your leadership team and mutually define where your organization is going and why.  Work with this team to clearly and unambiguously justify the decision for change.

Avoid the “anywhere but here” cop-out

Clearly identifying and communicating the need for change is not the same as knowing where you want your organization to be in the future.  Some leaders initially convey their objectives in terms of what is not working in their organizations today.  The focus should instead be on where you are trying to take your organization.

Once you start the “makeover,” people need to know where they are going if they are to focus their energy and sustain the momentum.  Otherwise, they will continue to drift or, even worse, return to the old ways you are trying to escape.

Your team: don’t leave home without it

There is probably no group in your organization more emotionally invested in the old ways than your leadership team.  The process of getting this team fully committed to a shared vision can be messy and slow.   If the team is not on board regarding the vision, the rest of the organization will be left in the dark regarding the direction and benefits of future change efforts.

If your leadership team is not aligned with your vision, you either have the wrong vision, the wrong team, or you have not effectively communicated your perspective.  In the early stages, some will line up along one side or the other.  Focus on those in the center; this is where the leverage for change lies.  If you can move the majority of these team members to your point of view, the few on the other side will either move to the middle or move on.

Use the vision as a filter for decision-making

Ideally, your vision—along with other descriptors, such as the mission (or purpose) and values of the organization—would serve as a template or “filter” for making decisions.  Some refer to this as the “social architecture” of the organization.  What’s important, however, is not what you call it—but how you use it. 

The description of your organization’s future goals and plans is critical; it is the highest level template for the many decisions made in your organization every day.  The most effective models are clear and concise statements that can be fleshed out with open dialogue to ensure that everyone shares the same understanding of their meaning.

Create, communicate, and translate

The process of establishing a clear vision and direction for your organization is as much about internal communication as it is about planning. The challenge is not in formulating a vision; it is in making it meaningful to everyone in your organization every time they must make a choice.

Communicating your vision is as important as the vision itself—and believe it or not, you cannot over-communicate your vision.  A well-communicated but poorly translated vision is just noise.  On the other hand, a well-communicated and well-translated vision has a good chance of influencing behavior.  Many of the vision statements on plaques on waiting room walls probably don’t lend themselves to easy communication and translation.  Because your vision is the heart of your change communication strategy, it must be crisp and concise.  There can be a lot of supporting language, but the statements themselves—and what they stand for—should be accessible to everyone in the organization for every decision that needs to be made.  

If you aren’t going to measure, then don’t bother

You’ve heard it before: “what gets measured gets done.”  It’s still true.  An effective measurement system that scans both the lagging and leading indicators should become the framework for managing change.  It can also allow for course corrections.   Since you can’t make every decision yourself, your measurement system will become one of you most critical tools for communicating what is important—and should be considered in every decision. 

The best measurement systems are those that are simple and have the most impact.  After clarifying the desired destination, the leadership team creates a “dashboard” of the few, critical performance indicators.  This provides a framework for monitoring the progress of change and making course corrections as necessary.

Some management teams tend to focus on a litany of financial measures.  While financials are important, they are also retrospective—like looking in your rear-view mirror.  They can only tell you where you have been, not necessarily where you are going.  It’s also important to ensure that these measures are cascaded and aligned throughout the organization.  So, if what gets measured gets done, then what’s getting done must be aligned with what you are trying to achieve. 

Stop talking about change

Getting everyone to align their behavior with your vision for the future usually means they will need to change, at least in part, the way they work and think.  And most people seem to resist change.  But then, what they  really resist is the loss of control over their work lives—and the resulting uncertainty about the future.

If this is the case, then it is not a stretch to figure out how you, as a leader, can help your people begin to retool and regain control.  Of course, the starting point is an effective two-way dialogue.  Present the case for change in such a way that helps everyone envision the future while developing a picture of their role in it.   

As physician leaders, we need to stop talking about managing change—and focus on helping our organizations reestablish control over their lives.  If we could do this, the challenge of aligning our organizations becomes much less formidable.

Comments

[Deborah Munhoz]

Working with leaders in and outside of healthcare, what I know is –these principles are tried and true across industries. My clients tell me, “decision making is easier” when they are clear about their vision and values. Why? Because they can more readily sort what meets their criteria and what does not. Result- faster, easier and better choices!