Many organizations that have been successful at culture change describe the culture of today as continuing to evolve and clearly a long-term investment.  Many admit the journey will never end and "it becomes a way of life".  Change resolves old challenges and inherently creates new ones, which in turn create opportunities for growth.  In the ongoing cycle of renewal, when new challenges arise, a values-based culture has a touchstone reflecting the communal destiny.  

Rituals of public celebration and storytelling help weave and embellish the tapestry of shared assumptions, attitudes, values, beliefs and collective memories that become the cherished customs of an organization.  Imbedded in the concept of cultural sustainability is the pattern of succession:  passing the passion and leadership from generation to generation.  Patients and families who serve as volunteer advisors willingly share their stories and time.  Their motivation comes from wanting to give back to those who cared for them, and their insights, perceptions and suggestions provide reinforcement for sustaining and continuously improving the evolving culture.

Health care organizations are unique.  They exist to provide care and services to people during some of life's most vulnerable moments.  Because culture is a community affair, investing in and caring for the organization's people is the core of sustainability.  When seeking and welcoming new members and guiding and empowering the next generation become time-honored community norms, the cycle of renewal pulses its rhythm at the heart of the organization.  Everyone's role holds meaning and promise.  Unspoken truths are honored.  Like the emotion that arises when hearing a beautiful song, culture is internal, yet palpable as it becomes as an instrument of healing  (Kimball, 2005).

(Kimball, 2005)

When we use creative thinking to develop changes, we think outside our normal thought pattern to develop new ideas. New ideas for us, though, could already be standard practice for someone else. One hospital may experience long waits to transition patients while another hospital of similar size uses better scheduling, resulting in few delays.  We should be drawn to examples of a high level of performance in areas we are trying to improve. 

Wouldn't we want to learn more about a hospital with low waits for patients if that was our problem? Reading journals, visiting other similar sites, or talking with colleagues could generate new ideas. There are also existing models (for example, the Chronic Care Model for care of patients with chronic illness) that have been shown to improve performance. As with any new idea, we often cannot just copy it but need to adapt the idea to our situation by testing.  

To improve, it is not sufficient to just develop a change. One must also test, implement, and if needed spread the changes. These skills are defined below and will be explored briefly in the next several newsletters

* Testing a change: Running trials to adapt ideas to a local situation

* Implementing a change: Making a change part of the day-to-day operations

* Spreading improvements: Having the change adopted beyond the initial locations.  

Langley, Gerald J.; Moen, Ronald D.; Nolan, Kevin M.; Nolan, Thomas W.; Norman, Clifford L.; Provost, Lloyd P. (2009-06-03). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (JOSSEY-BASS BUSINESS & MANAGEMENT SERIES) (Kindle Location 1048). Wiley Publishing. Kindle Edition.

Contact

Tammy.Haithcox@pqcnc.org