Behavior expectations, conduct, and relationships

As our organization goes through dramatic change, many things are open to new ideas and interpretations. I believe we have to learn the lessons of our failures, and must behave differently.

So what does that look like?

Any effective work relationship is built on trust and a sense of common purpose. Healthcare is based on a very high level of trust between vulnerable people in a dependent role and their caregivers. The feeling of trust patients experience is related to the level of trust the members of the healthcare team experience.

• Apologize when things go wrong. No ‘spin’. For example, I am very sorry for the decisions I made about the employment of physicians based on a flawed financial model. I could have asked more questions about the estimates of contractual allowances in those models. I did not do so and the employed physician group is losing more money than it should, or was predicted to lose.
• Use candor about the problems. We need to disclose the systems that are not working. We need to be frank about where our culture is too provider-centric and not patient-centered enough. We have to identify the areas of the organization that need improvement and support the people in those departments, not blame them for failure.
• We must reinforce the good behaviors and have the courage to challenge the bad behaviors when they happen. When a colleague is demeaning to someone and we don’t speak up — we are saying it’s okay. Silence is a decision. In an organization based on relationships, a joke at work that makes fun of gender or nudity sends a message that we are not a caring organization. It risks the relationship we have with our patients while they are vulnerable.
• Our conduct is how our values are demonstrated. What we do shows our values, not what we say we would do or what is printed on the back of our name tags. Our values are demonstrated by how we behave. Our patients don’t notice the wall plaques; they notice how they are treated and how staff treat one another. If the wall plaques reinforce what people experience, it says we live our values.
• Everyone needs reliable information. Clinicians and managers cannot make good decisions without good information. This engenders trust.
• Staff and patients need good communication about what is going on. In this very fast-paced environment, people can easily feel left out. They may also make bad decisions if they don’t know what is going on.
• We are responsible to keep our promises. When we say we will do something, we need to do it. Or we need to tell the person(s) expecting something to happen why it won’t happen.

We are going through a time of change and loss. We have lost some of our sense of who we are as an organization. We have lost a sense of security about the future. Rebuilding ourselves is exciting. At the same time, it means more risk.

As we think about who and what we want to be as an organization, I am interested in your thoughts.

1 comment


behavioral changes and relationships
Amen to the comments above. Don't spin things when things go wrong. Take accountability for it, apologize for it and state how and why it happened and how it will not happen again. Take advice from a multitude of counselors and not just a few "yes" men. Engage many levels of the organization because various people can see different views of the horizon. Just because it says QUEST or MAGNET.....are we REALLY? hmmmmm think about it. think about onesself and this institution. do we really walk the walk or just quote the talk. Trust is built over time, feelings and emotions have to heal. Wounds have to have time......but they can heal. We must heal to move on. But, this may never happen again, full disclosure, accountability, transparency, and no more wasteful use of the hospitals finances used to justify selfish reasons. Change the culture of entitlement to service! Conduct ourselves as we would expect that the community would demand of us. It is their and our hospital after all.