Culture as an Organizational Strategy

Developing a leadership strategy is a critical responsibility for health system leaders. The strategy needs to be sensitive to the organization’s mission, vision, and values; be nimble enough to adapt to acute changes; and specify the organization’s path forward for a designated period so that specific goals are realized for the benefit of those being served.

Strategy depends to a large extent on culture. Culture requires investments in both financial and human terms to develop, execute, and maintain. In this issue of the PLJ, we highlight what organizations are doing to advance their strategic goals by developing culture and, most importantly, how those organizations translate culture into climate, which represents the specific and actionable, accountable, and expected behaviors to advance a synergized culture.

The culture of an organization helps all personnel understand the “why” of its existence. In this issue, a field report from the Cleveland Clinic reviews its onboarding program, “To Act as a Unit,” designed to acculturate new medical staff to organizational values. Understanding that culture is a dynamic and evolving process for development, we have included an article that describes the use of an innovative “Pause and Learn” action-learning process developed by the National Aeronautics and Space Administration and adapted to the healthcare environment to capture timely, critical lessons learned in response to COVID-19 and apply them forward.

In an effort to advance a culture of safety, we have included a paper that expands upon traditional safety models and systemic barriers to include a consideration for the human factors that affect outcome. This framework may help leaders more realistically weigh risks and benefits of initiatives and avoid negative consequences that can come from their decisions. One example of this is included in the field report investigating the effects of overnight shift work on emergency medicine physicians.

Finally, all of us bring personal and professional concerns to work each day and this may have important implications for our performance and the overall culture. The remaining articles touch on this point. One article examines physician compensation plans and metrics that align physicians with organizational strategy and goals, executive performance targets, and improved patient outcomes. The final paper shares the experiences of a department of surgery during the COVID-19 pandemic and its success in maintaining engagement and morale among physicians.

Culture is one of the most important strategic considerations facing organizations because it has implications for the core functions and success of the organization and its people. This issue’s contributions align across this theme, offering real-life examples to inform your daily work as a physician leader.

As the official journal of the American Association for Physician Leadership, the Physician Leadership Journal provides a platform for you to share your research with members throughout the world. Now is the time to use this platform to help inspire change in healthcare and to improve the way we deliver care to the patients, families, and communities we serve.

Send me your thoughts at editor@physicianleaders.org. We would enjoy hearing stories about relevance of mentorship and the methods you use to assure that you and your team are well cared for in our demanding careers.