Actions speak louder than words: the importance of aligning hospital culture with expectations

Posted on: 7/23/21

If you were asked to explain your hospital’s culture, could you? This does not mean the values that make up your ideal culture posted around the hospital and listed on strategic plans. Specifically, do you have real-world examples of how your culture reveals itself in everyday operations? Do you think individual departments and employees would say the same thing? Why or why not?

These are important questions to reflect on because a hospital’s culture permeates everything a hospital does. From common language and behavior to standards, values, and processes, a hospital’s culture shows what it stands for and how it achieves its purpose. Culture is more than a sum of communicated strategic initiatives; it is a way of operating. It dictates how employees respond to situations with no blueprint, which pervades the complex and ever-adapting hospital environment. 
 
Culture is a product of intention. Importantly, hospital leadership must provide support, resources, and education that align with the desired culture. For example, do you encourage speaking up about concerns or asking questions yet enable power dynamics to inhibit communicating concerns and curiosity? Without regularly asking employees about their comfort level in speaking up, it is difficult to determine if the promoted culture plays out in daily operations. 

Another consideration – do you promote a learning environment yet penalize reported errors or near misses? A team that feels psychologically safe to report medical errors or near misses and discuss solutions may outperform other departments overall because of a learning-oriented culture. If a leader reviews only specific performance metrics without gaining a cultural perspective, the opportunity for positive operational change is lost. Further investigation may show that these departments create an environment of learning from even small failures by reporting and discussion, thus avoiding potentially catastrophic errors down the road. 

It is vital to focus on hospital culture, especially during a major change, unprecedented crisis, and health care worker shortage. Unclear expectations and incongruence of culture and practice add stress to an already drained workforce, increasing the risk of burnout and decreased quality care. Involving health care workers in cultural direction and expectations gives a voice to those who impact culture the most and creates accountability and commitment to fulfill a shared vision. 

For more resources on creating a thriving workforce, visit the WorkHealthy Hospitals’ (WHH) Thriving Workforce Hub. Additionally, the WHH team, a grant program of TSET, is available for further discussion and resource support. You can contact the team at [email protected]. (Sydney Tomlinson)