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How Healthcare Executives Can Support Their Leaders Who Are Trying to Change Culture

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An epidemic of bullying and incivility exists in healthcare that affects employee morale and turnover. Bullying also affects patient outcomes. The problem is that front line leaders do not always understand how to deal with the bad behavior of their employees, especially the employees who are so clinically competent. Therefore, they often do what’s comfortable – they do nothing.  As a result, we are hemorrhaging really great employees and harming the very patients whom we’re serving.

45% of nurses have been verbally harassed or bullied by other nurses, according to a 2017 survey by employment agency RNnetwork.

More than half of the nurses who reported work harassment indicated they were considering leaving the profession all together!

We can no longer afford to use silence as a strategy.

A Better Approach

Over the years, I’ve transitioned from doing keynote presentations and workshops to comprehensive consulting and online interactive programs. My approach has been referred to by my clients as a “top-down; bottom-up; and everything-in-between” approach.

Because I know that cultivating a culture of professionalism where any incidents of bullying or incivility are immediately rejected and respect and kindness become the new norm needs to involve for everyone.

However, changing culture first starts with the top – the executive leaders.

I recently had a conversation with a leader who reached out for help. His frustration was that he was trying so desperately to create a culture where employees felt safe to speak up (psychological safety), however, every time he tried to get the executive leadership team on board, they disengaged. He said, “They talk the talk but don’t walk the walk.”

When the executives (VPs, Directors, etc.) aren’t engaged, most initiatives will fail. Therefore, to reinforce executive commitment and support, it’s important that they are visibly involved.

My team and I currently work with healthcare department leaders and their employees through our Department Culture Change Initiative. This comprehensive program focuses on equipping the front line leaders with the skills and tools they need to transform their work cultures from disruptive and disrespectful to collaborative, professional, and respectful. A key strategy in this culture transformation is getting the employees involved.

In addition to the front line leaders and their employees, we also involve the executive leaders as an additional visual support.  Even if you’re not involved in our Department Culture Change Initiative, you can still benefit from a few of the strategies we share with our clients.

After all, walking the walk is way more important than talking the talk!

Ways executives can support front line leaders with culture change:

Schedule monthly meetings with front line leaders

The purpose of meeting is to build relationships with your leaders; reinforce your commitment to supporting them; and to keep your fingers on the pulse of what’s happening in their department. Use this opportunity to strengthen your commitment to them.

Conduct biweekly/monthly rounds

It’s important the employees know you are investing in them because you see great potential in their ability to become the role models for professionalism. They need to SEE you so that they know you are involved in their success.

Host coffee & conversation meetings with employees

Host a “coffee & conversations” meeting with the employees. The purpose is to engage them in a conversation about their culture and the opportunity they have to make their department an amazing place to work. Order coffee and sit with them in their conference or break room. Rotate these “conversations” to ensure you connect with all departments over a period of time.

Share the intent with your physician partners and ask for their support

Although front line leaders should be engaging their physician partners, as the executive, you should also communicate the intent to cultivate a professional culture with physicians and other executive leaders. Communicate your intent with your CEO, COO, CMO, etc. Ask for their support.

Highlight a department in an organizational circular

Many organizations put together a newsletter or some other announcement that is distributed among all employees. Ask for space in such circulars and highlight a department that is working on improving their culture. Employees LOVE to be acknowledged!

Invite leader to attend executive leadership meeting

Once a department is showing improvement, invite the front line leader to an executive meeting to share the initiative and “brag” about their improvements. This reinforces the importance of a healthy workforce culture.

The key is to be present and involved in the initiative so that the principles, tactics, and strategies are reinforced until they become a habit and the “way we do business here”. As the late Albert Einstein so wisely said, “Setting an example is not the main means of influencing others; it is the only means.”


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