Workplace culture

Use assessment and reporting to build a process for making cultural change

by Jason Ladicos

Everyone has probably witnessed disrespectful or disruptive behavior in the workplace at some point in their careers. Institutionally, however, we usually turn our heads and ignore the problem. In a survey quoted by A. Lorris Betz in his Leadership Plenary talk at this year’s AAMC Conference, 70% of participants indicated that they observe disruptive behavior each month, and 11% said they observe it every day.

Bad behavior is a symptom of a larger cultural disease. With a culture of disrespect where disruptive behavior is tolerated, a viscous cycle exists where the resulting hostile work environments lead to more bad behavior, dissatisfied patients, and an increase in malpractice suits. Worse, students and residents will take their cues from their faculty role models, and emulate those bad behaviors.

Changing workplace culture is a big undertaking, and it requires both leadership and a lot of hard work. Once you’ve decided to make a change, a great place to start is with a measurable goal – how will you know when the initiatives you put in place have succeeded? Once you have defined your goal, get started measuring how well (or not) you’re currently doing. You can do this by adding relevant questions to existing score cards, or assessment forms. For example, here are some questions you could ask in order to measure whether the change you want is happening:

• In the past 30 days, have you been a victim of harassment on the job?
• My department or agency works hard to create a workplace that prevents harassment. (scale of 1-5)
• I am satisfied with the way in which my department or agency responds to matters related to harassment and discrimination. (scale of 1-5)
• I am satisfied with the way in which my work unit responds to matters related to harassment and discrimination. (scale of 1-5)

Initially, the scores you collect might be quite a bit lower than you thought, but that’s okay – once you start measuring the problem, and seeing the results, you’ll have a baseline to judge the effectiveness of your efforts. Here are a few tips to make this process go smoother:

1. Make the data you are collecting public – the data should be anonymized, but you need to be transparent about how things are going. Quality improvement is a team effort, and your faculty, students, and staff will be much more likely to get on board if you’re not seeking to place blame, but trying to get everyone working together to improve results.
2. Share the results - doing this on a regular basis can be a great motivator for everyone as they see the measurements move up or down as you try new things to implement change. If you are consistent with reporting results, your team will also see how committed you are to making this a lasting change, and will be more likely to participate in the process.
3. Build in a little bit of competition – break down scores by categories such as department, or site, and share them. The people at the campus hospital aren’t going to feel good about the folks at the city hospital posting better results week after week. Use this opportunity to drive the cultural changes you want.

Creating lasting cultural change to eliminate disruptive behavior takes time, but getting started is as easy as coming up with a measurable goal and using tools like one45’s assessment and evaluation forms to start collecting feedback about how you’re doing. As you start collecting data and sharing the results with your colleagues, you will be able to measure the effectiveness of your change initiatives and get buy-in from everyone on the team. No one wants to work in a hostile environment, so make the most of the assessment tools available to you and start making a change today.