Culture, Strategy, and Operations – You Can’t Separate Them

Culture is a Top Concern for Department Leaders

As Alan Friedman noted in a recent blog, citing a survey by the Academic Orthopaedic Consortium, many Department Chairs identify “culture” as their most pressing leadership concern.

Why?  Because they understand, intuitively, that culture impacts everything they do.  Often, though, when someone says they want to improve their culture, they can’t put their finger on exactly what they’d like to see change. Alan’s blog does a great job making culture more concrete, and outlining how to move toward the culture you aspire to.

Leaders see disappointing scores on a culture or engagement survey and believe they need to dig into purely cultural variables. That's a mistake.

The Link Between Culture, Strategy, and Operations

Culture does not stand alone as a performance variable.  It is inextricably linked to both strategy and operations.  It’s why you can’t change culture with a “culture” program or training.  To understand your current culture, and how it's impacting performance, you MUST explore strategy and operational challenges.

See, Change Culture by Focusing on the Work!

Leaders see disappointing scores on a culture or engagement survey and believe they need to dig into purely cultural variables. That's a mistake.

Bryan Warren, Executive Advisor

First, particularly in healthcare, many people do NOT respond well to an initiative focused on something so ambiguous and ill-defined as culture. 

Second, there may, indeed, be issues with how people interact, communicate, and behave, but these interactions and behaviors often, arise from strategy and operations challenges.

For our purposes, let’s define:

• Strategy as your overall plan to realize your vision and achieve the defined goals;

• Operations, as simply the structures and processes by which you get things done. Things like: What needs to be done? Who does what? When does it get done? How will it get done; and

• Culture as the sum of the beliefs and behaviors your people bring to work every day.

Examples

How do strategy and operations impact culture?  Let’s look at a few examples:

The Department’s vision and goals, and the plan to get there, are not clearly defined, and communicated – or key leaders don’t fully support them . . .

This will cause frustration, or lack of confidence in the future. Teams often struggle to discuss this disconnect in a productive, meaningful manner. It may never be aired among the leadership group, or  when they do come to the surface, it’s late in a strategic initiative, or simply done in a manner that causes strife. 

When this happens, this group needs to work on how to have difficult conversations, the core issue is really a strategy problem!

Your organizational structure is not right for your goals. . .

This makes it impossible to make progress on key initiatives, causing frustration.  Again, this frustration may manifest itself in what feels like cultural issues - A seeming failure of people to take accountability or step up and lead, or simply lack of progress on key initiatives, etc. 

These issues are a manifestation of a lack of clarity of roles and responsibilities. This can cause confusing and ineffective communication and messaging – which feels like culture.

Operational and process challenges that SEEM solvable AREN’T being solved.

If operational processes don't work, they cause inefficiency, reduce productivity, and become barriers to individual and organizational success.

This causes frustration, and sometimes even a sense that people aren't valued. Their perspective is, "If the organization can't do the work to help me succeed, they must not value me or my contribution!"

In reality, even this can be a structural/strategic problem, at its core.  Do you have the right structure, the right people, in clearly defined roles, with the authority to solve these persistent process issues? 

Collaboration, Communication, Accountability, etc.

[A]l of the metrics that matter - Quality, Patient Experience, Growth, Academic Performance, Engagement, Wellness, Retention, Productivity, and Physician Career Success - are interrelated.

These situations all contribute to poor collaboration and communication, what seems like a lack of accountability, and people not feeling valued, heard, or connected.

Certainly, sometimes, the problem is that leaders need to work on their effectiveness - or teams need to understand why team behaviors like psychological safety matter - and develop effective communication skills.

Improving these might change how people interact, but you won’t have a culture of effective collaboration that moves the metrics you care about!

In reality, all of the metrics that matter - Quality, Patient Experience, Growth, Academic Performance, Engagement, Wellness, Retention, Productivity, and Physician Career Success - are interrelated.

Leadership Styles can Play a Key Role in Department Success, and Culture - See our Blog Regarding Leadership Myths.