Health care leaders need to employ patience and persistence if they're going to create a beneficial, shared culture in a growing system.

Consistency
Health care systems with a strong culture ensure that their environment is represented in all of its offices or operations. To achieve this, the organization must apply and measure the same processes, policies and rules throughout the field. If there is a significant variance, then the culture will not be seen as important or a contributing factor to the organization's success. Everyone within a system contributes to its culture, whether through support, neglect or subversion.

Fostering a Connection
Cultural transformation is not something that can be forced on people in a short period of time. Culture influences human behavior and is also a reflection of group behavior. Rules and policies can be implemented or enforced, however culture is how employees think and respond to the surrounding actions and behaviors of managers, customers and others; they are connecting with their environment.

With hospitals having to make compensation decisions influenced by patient satisfaction scores, strict guidelines, working with accreditation agencies and so much more on a daily basis, if the overriding culture isn't strong, the result is a lack of consistency in policy adherence, hospital performance , and patient care. All of these can have a subtle, negative influence.

A shared culture is a very powerful contributor to organizational performance. A culture with an emphasis and reward structure on factors such as customer service, quality, equitable promotions, meritocracy and results will have high employee morale, good attendance, frequent new idea generation and low employee turnover.

There is no simple formula for developing an 'ideal' culture--it needs to be established over time. I have listed the following standards that can contribute to a shared culture:

- A common set of demonstrated values that are important to the organization; its people and its customers.

- A shared understanding, across all levels of the organization, of how the values and culture contribute to the value proposition of the system.

- Consistent use of policies, practices and processes, particularly talent management practices, which reinforce the shared values. Performance measures based on the values are incorporated with performance management criteria, which are in turn integrated with rewards, recognition and promotion criteria.

- Open and frequent communication across the organization as to how the values and culture contribute to organization, team and individuals success (such as outstanding achievement award, results directly related to demonstrated values and so forth)

- Managers at all levels who "practice what is preached."

It takes tremendous synergy on behalf of the managers, employees and customers to create a positive shared culture. Values have to be established and practiced, all communication has to be clear and consistent, and time has to be allowed for everyone to acclimate and contribute. If these steps are taken the desired shared culture will ultimately emerge within the organization.