The secret sauce of great health care organizations

Greg Smith, formerly of Goldman Sachs, has described a positive organizational culture as being the “secret sauce of greatness.” What is the nature of this secret sauce? A simple, popular definition is that “organizational culture is the way we do things here.”

The relationship between organizational culture and organizational success is unassailable. In our commercial dealings, has not each of us easily recognized when a business culture is truly customer-focused, and when it is not? And as potential customers, are not the choices we make – choices that will ultimately result in business success or failure – significantly influenced by what we have observed?

The same applies to healthcare institutions. Yet in this time of health industry turmoil, as tremendous energy is expended on hot trends, new mandates and crisis management, is sufficient attention being paid to the less dramatic task of ensuring the existence of a strong, positive organizational culture? There are examples of resounding success, but they are far from universal. Honestly, how much ongoing thought do most of us give to the health of the organizational culture of the clinic or hospital or health care system in which we work, and the manner in which this influences all attitudes and activities?

Each health care institution’s culture is destined to be unique, and will be manifest by various signs and symptoms – positive or otherwise – expressed in ways too numerous to mention; however, one characteristic will be evident in every health care organization with an optimized culture: engaged, satisfied physicians and staff, observably proud of their institution and eager to serve.

What paths ensure the development of a preferred organizational culture within a health care institution? The role of leadership cannot be over-emphasized. After all, an organization’s culture – its lifeblood – is squeezed from the deeds of its leaders, drop by precious drop, and then trickles down, infusing all other attitudes and actions. It can be oxygenated, pure, energizing. It can be diluted and weak. It can be toxic.

Not all health institution leaders fully understand this – the power they wield in fashioning their organization’s culture, nor fully appreciate that it is their deeds, not their words, which ‘trickle down’ and influence, for better or for worse. Not some of their deeds; every deed.

But it is not just the deeds of leaders that shape organizational culture. The daily actions of every health care provider also play a major role. Here, it is often the smallest and most quiet deeds, silently observed, that make the biggest difference – the helping hand, the encouraging word, the patient ear, the extra effort, the simple touch. Indeed, such acts of caring and compassion have a magnifying effect that can be transformative, reinforcing as they do to physicians, staff and patients that the latter do indeed come first.

The power of organizational culture is immense. A positive organizational culture is indeed the “secret sauce of greatness.” That each of our acts contributes to it should be remembered by all who labor in the health care field.

-Robert Allan Bear is a retired nephrologist, health care consultant and author of the medical novel Sorrow’s Reward.


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