How can we heal the toxic culture in a medical center?

XYZ medical center, 400 beds, 5 thousands employees from more than 90 countries/ nationalities. CEO who joined the center 2 years ago from a UK healthcare system. Significant changes and replacements to the senior leaders across the organization. All corporate surveys and observations indicated the following:

  •      Lots of talk about values but not enough action
  •      A lack of employee engagement.
  •      Interpersonal conflicts and what’s in it for me rather than the organization interest first.
  •      Lack of psychological safety: employees do not trust and feel safe enough to speak out about significant problems.
  •      Performance issues, mediocracy is the norm and a high level of absenteeism.
  •      Lack of accountability and transparency is just a word widely used.
  •      Staff are blamed for mistakes based who they are or know.

Senior management justifies the above as industry norm for a newly established medical center and it will get improved with time. The average time of service for senior leader in the organization is 3 years.

What will you do to heal this culture;

  1.      If you join as CEO?
  2.      If you join as Chief – Medical Officer, Operating Officer, Audit Executive, Human Resources, Legal Counsel?
  3.      If you join as a board member?


Don’t just respond with I wont join 🙂



What is the optimal organizational/ leadership structure to oversee population health and post-acute care in a large health system?


Addressing Resiliency Factors Among Healthcare Providers

Participant comments on How can we heal the toxic culture in a medical center?

  1. Acknowledge directly the challenges org is facing rather than normalizing. Take ownership for lighting a path forward by example, accepting my role in healing and setting example. Work to inspire belief that can be part of something better and that input is valued, foster shared pride in what can achieve that will benefit us all.

  2. I believe this can not be accomplished without 1. A visionary and open leader who seeks and values feedback and input from any and everyone in the agency, 2. An all out, comprehensive assault on the organizational mentality that supports complacency, mediocrity and indifference. This assault includes the tedious and emotionally-exhausting work of incorporating staff and employees into the transformation process. Their buy-in and education are essential. Every person needs to own their piece of the change.

    In most health care organizations, many people don’t understand how or why their role is essential to the delivery of high quality health care. What if we educated all employees about high quality care and what that means in such a way they could recognize it…or not…and began to feel some personal connection between doing their job well and improving a patients experience?

    This transformation has to be brought about by a leadership team with the patience and long term commitment to staying the course …and figuring out how to collaborate with and get unions to care about patient safety, quality and outcomes.

  3. Very interesting place ! Also, an opportunity to establish a benchmark in leadership. In multi-cultural settings, getting a culture right is always a challenge. 5000 people from 90 countries is quite a challenge.

    There are three things people work for (and this is universal psychology):
    1. Purpose – the leadership has to set a sense of purpose which is very compelling and immediately gets sunk into the mind of all. That could be things like: Creating the best hospital in the region, Mission like statements (if its a not-for-profit)
    2. Appreciation – setting a culture of appreciating the high performers and acknowledging their good work .. there is nothing more demotivating for a high performer than to get buried amidst low performers; and maybe reward them with accolade, positions or such.
    3. Profit – link pay with performance. Give handsome raises to good ones and vice versa.

    Within a 2 year time frame, this unit can be a benchmark. Hence, the three year timeline would be enough to set this right.

  4. Fixing a broken culture requires significantly improving basic business performance. The big unknown is whether or not your demoralized employees will step up and join in the change. Corporate culture starts at the top.
    Here are some strategies to follow:
    1.) Define the culture. Improving your culture starts first with doing an honest assessment of who you are and then defining who you want to be. Since culture change starts at the top, ensure your leadership team can agree on the few words that describe the culture they want to build to turnaround business performance.
    2.) Plan the culture. Your culture plan should be in writing, with key initiatives spelled out and accompanied by targets, deliverables, milestones and key performance indicators. Establish a new cultural values framework. What does cultural progress look like? Can you come up with a theme or slogan that clearly articulates the new energy/direction of the company?
    3.) Communicate the culture. Every employee needs to know some key things: where we are, where we are going, why it matters, what’s my role, and what’s in it for me. Every leader needs direct engagement with employees – face to face is always ideal, but not practical, but try face to face town halls, video conference and small group discussions. Give a business update, talk about your culture agenda, trends in health care in the area, and seek honest feedback about your company. Be sure to ask for feedback after your engagements. Share what you learn from the organization, with the organization. Soon everyone will know that, yes, your feedback is being heard.
    4.) Amplify the culture. Continually take actions that amplify your culture change. The more you amplify, the quicker you can change your culture. For example, are your leaders credible? Is the company mission still suitable? Can you connect with employees on a more personal level? Are programs in place to praise and recognize excellence? Are your performance review and compensation programs aligned with your new culture?
    5.) Live the culture. Leaders must lead by example and ensure their words about the corporate culture match their actions. You can’t just speak about the cultural values, you need to live them. Then, it’s important to set the expectation that each employee is also going to be held accountable to cultural values, and it’s important to assess your progress. Show employees that you value and support them and they in turn, will give their best effort.

  5. Communicating better is the only way out. Listen to people to understand their feelings. That will let you diagnosis if hospital and staff are aligned or not in termos of identity or mission. If they are align the is about finding a road to change that is acceptable to all. Difficulties will come but if they are antecipated people will get over it. Each project should have a physician as an sponsor so they feel respected and they have some protagonism. Bring their ideas to the projects and they will also face the real challenges that administrators have when is time to change. Identify who is really connected to the institution, who is politically strong but not so aligned and listen to them. Try to find a common denominator in their speech to better plan the change. I am sure they all like the hospital and care about patients and hospital future. They want to be a protagonist of the change and not a passanger. Doctors were trained to act not to follow.

    We created a multidiscipplinary “Culture Team” in our hospital to discuss every other week about the changes we are facing and how they impact the people. People from different areas, some new in the hospital, some very old bring their thoughts and we discuss a common sense that they have to speak to people working close to them. That helped a lot.

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