Contributor: Linda Roszak Burton, ACC, BBC, BS
To learn more about Linda, click here.
“No one who achieves success does so without acknowledging the help of others. The wise and confident acknowledge this help with gratitude.”
~Alfred North Whitehead
The current complexity and uncertainty of disruptive change in healthcare are clearly on the shoulders of institution leaders. They are responsible for supporting employees in managing the overwhelming stress associated with such change while inspiring, engaging, and retaining them throughout the change process. And that’s where organizational culture either supports or obstructs change imperatives.
Scholars and organizational strategists have defined culture in different ways. Standing the test of time is Edgar H. Schein’s (Professor Emeritus at the MIT Sloan School of Management) definition - “a set of shared values and beliefs that employees hold and that determine how they perceive, think about, and react to the organization’s various environments.” Those shared values and beliefs are directly influenced by leaders and are the source of organizational culture.
In our coaching practice, it’s not uncommon to observe multiple cultures existing in one organization. At times, stark differences between departments and units, members of a hospital system, or within a network of specialty clinics. The common denominator at the heart of any culture is leadership. Today’s leaders must role model the appropriate values and behaviors needed to lead through disruptive change successfully. Fear-based leadership (an understandable default for leading through a pandemic) can result in short-term improvements in metrics. However, fear-based, authoritarian leadership will greatly undermine a psychologically safe work culture, and improvements quickly disappear under significant losses of talent, revenue, and poor safety and quality ratings.
Where’s Culture as We Move into A Post-Pandemic Era?
Today, various studies and articles denote as much as 57% of organizations anticipate major changes to their culture due to the COVID-19 pandemic. Two out of three organizations reported keeping employee morale up has been difficult, and one-third said maintaining company culture was a challenge. What’s even more challenging to organizational culture is the intense workloads, high rates of physician and RN burnout, turnover, and the underlying mental health concerns just beginning to surface from the sustained impact of COVID-19.
In March of this year, the U.S. Department of Health and Human Services Office of Inspector issued a Report in Brief, reporting hospitals were experiencing staff shortages, particularly among nurses, raising concerns about patient safety and quality care.
In a recent article in Healthcare Innovation, 4% of physicians surveyed said COVID-19 had changed their employment plans. Of those, 50% are considering leaving for a new healthcare employer, 21% said they may hang up their white coat for early retirement, and 15% are thinking about leaving the practice of medicine entirely.
Reasons Why a Culture of Gratitude is Imperative
A simplistic definition of culture is how employees speak and interact with each other, with leaders driving and influencing the language and interactions. Gratitude is continually gaining attention as imperative in galvanizing its positive impact on culture in the following areas:
- Employee and Organization Health and Well-Being. Numerous health and well-being benefits of gratitude for individuals are well documented. Gratitude is strongly linked to improved mental health by lowering levels of stress and anxiety. Physical health improvements include lower blood pressure, a stronger immune system, improved sleep, and better self-care. Gratitude in organizations leads to a reduction in negative emotions, helps to create shared organization citizenship, and supports organizational resilience. In addition, the neuroscience of gratitude supports the positive impact of gratitude on organizational well-being and generates greater trust among team members.
- Employee Engagement. A culture grounded in gratitude increases employee engagement and encourages more prosocial behaviors and productive relationships. Leaders see fewer undesirable behaviors and have improved psychological capital (the positive developmental state of your employees.) Employees gain hope, have greater self-efficacy, are more resilient, and are optimistic in their ability to achieve goals that contribute to patient satisfaction and quality and safety of care. Our 2019 Gratitude Intervention in the senior care sector resulted in statistically significant improvements (p<0.001) in employee engagement and meaningfulness of work. The intervention allowed employees to increase their awareness of positive emotions, increased hopefulness they could also impact their work culture by incorporating the language and concepts of gratitude, giving them permission to behave differently, and, thereby, strengthening connections.
- Psychological Safety. Defined as the degree to which employees perceive their work environment to be open to expressing different ideas, can ask questions, and voice concerns about disruptive behaviors and potential errors. Gratitude’s positive impact recognizes the benefits of a psychologically safe culture leading to fewer errors, greater inclusion, and a healthy and positive workplace versus a punitive, toxic environment.
- Charitable Giving. With greater engagement, psychological safety, and capital, employees can tap into their best self at work, bringing empathy, compassion, and positive emotions to their chosen profession. A 2018 survey conducted by the National Research Corporation/NRC Health in collaboration with Accordant Philanthropy asked patients what most influenced their feelings of gratitude during a healthcare experience. Thirty percent of participants said gratitude was spurred by the “compassion, empathy, or kindness of caregivers.” Others attribute feelings of gratitude to “outcomes of the procedure/treatment” (23%), “accurate diagnosis” (20%) or “attentiveness to personal/social/emotional needs” (18%). More motivated to give, 34% of participants who say they would make a charitable gift to a healthcare organization indicate “gratitude” would be their primary motivation for a gift.
A Leader’s Role in Creating and Influencing a Culture of Gratitude
As many studies indicate, if culture is a major factor in the post-pandemic era, leadership behaviors grounded in gratitude will help employees feel safe, heard, appreciated, and valued. Creating a culture of gratitude starts with a plan and can include the following elements:
- Start at the Top. Each leader must first embrace his/her personal gratitude practice. By realizing their individual benefits, they are better able to lead and experience organizational benefits fully. Consider creating a culture steering committee comprised of leaders from key services and functions and an external consulting firm expert in the research on gratitude and able to confidently assess current and desired culture, needs, and expectations.
- Invest in Designing Evidence-Based Programs. Make gratitude a leadership development essential, well-aligned with organizational values, contributions, and desired behaviors.
- Review Existing Technologies, Policies, and Programs. Seek to incorporate the best practices in neuroscience, positive psychology, and gratitude. Develop gratitude metrics for organizational and individual performance evaluations.
- Ensure Gratitude Practices are Genuine, Frequent, and Appropriate for Cultural Preferences of All Employees. For example, discern whether public expressions are preferred and welcomed or if private one-on-one expressions are more appropriate. When should gratitude practices be individually based, or when is there a preference for a team-based approach?
- Pilot a Gratitude Intervention. To understand the full impact gratitude can have in your organization. When properly designed, the pilot must include all job functions, incorporate learning and knowledge acquisition, and be endorsed by top leadership. Pilot in one department, unit, or division to create a foundation for building a culture of gratitude seeking to provide safe, high-quality care and a rewarding work experience.
Disruptive Change Provides the Greatest Opportunity for Culture Change
Before the World Health Organization (WHO) declared a pandemic, a 2019 article in Harvard Business Review, “The Wrong Ways to Strengthen Culture,” found 69% of employees don’t believe in the cultural goals set by leaders, 87% don’t understand them, and 90% don’t behave in ways that align with them. In addition, a 2018 Deloitte Global Human Capital Trends report noted that as employee well-being emerges as a strategic priority, so must culture and leadership behaviors change to support this priority.
Now, amid this disruption, is the optimal time for leaders to design a culture of gratitude, institutionalizing it as a core value and developing implementation strategies for sustainability. You and your organization will be poised to overcome the known cultural consequences of the pandemic, create greater hope and resilience in your employees, and strengthen your institution’s impact on community health.
Contact Linda at:
[email protected] or 410.707.3118