Changing Our Service Culture

Walking in the Footsteps of Giants

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Sociologists, advocates for various causes, religious, national and international leaders, all have pondered the question of how to change attitudes and behavior of groups of people to bring about a desired outcome.

Several have identified key components of culture change: Leadership is not reserved to those with titles; anyone can go first. Sustained culture change is not achieved through laws and regulations alone, and not through occasional feel good “kumbaya” experiences.

Bringing About Change

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A 5-step approach: • Challenge the present - search for opportunities, experiment and take

risks. Leaders go first. They set the example by what they do, not just what they say.

• Inspire a shared vision - forge agreement around common principles and common ideals.

• Enable others to act - foster collaboration, strengthen others and build trust. “We” is the magic word; not “I”.

• Model the way to the desired goals - that is, live what you say. • Encourage the heart of everyone involved. A genuine

“Thank you” is also magical in its effect on the heart.

The Leadership Challengeby James M. Kouzes and Barry Z. Posner

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Advice from Experts on Culture ChangeThe Institute for Healthcare Improvement also identifies five steps in culture change, with many similarities to the steps in The Leadership Challenge:

• Set the direction (mission, vision, and strategy) • Establish the foundation - leaders align their actions with the

shared values• Build will - creating trust and a positive relationship between

the leader and the constituents builds the will to join in the work

• Generate ideas/possibilities from every corner of the workforce

• Execute change - built on a foundation of credibility.

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Let’s Use Plain TalkThe critical elements of culture change are few:

Words - Articulate clearly and repeatedly the change you want to seeWitness - Model the behavior you want and treat violations with concernWiden the search - Ask for suggestions from every type of stakeholderWeave new practices into the daily life of the facility through adequate training and resourcesWalk into the unfamiliar all together armed with determination and resolve.

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OMH has focused the aim of our change efforts to embrace a strong and lasting commitment to nonviolent and non-coercive care that understands and responds compassionately to the effects of trauma in the lives of the persons we treat and serve.

We aim to be, and be perceived as, healers and not as enforcers.

Our Commitment

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OMH Culture ChangeIn concrete terms, this means:• Creating environments where individuals feel safe, listened to,

prized (we do not feel prized in dirty and broken environments) and where interactions communicate understanding and respect. In short, we are about creating environments where positive relationships can flourish.

• Reducing the use of restraint and seclusion and other coercive interventions, like point systems open to staff manipulation.

• Providing skills training and transition opportunities that prepare individuals for “ordinary lives” in the community.

• Training staff in collaboration and the use of positive behavioral interventions and supports.

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Our culture change continues to be a work in progress because…

• Culture change is a long-term commitment that involves everyone embracing and modeling behavior that reflects a common mission and vision.

• It is hard work that calls for personal courage to assess our particular “cultural pathologies” and stand against them. (C. Lerche, “Building Peace Through Reconciliation”)

• It requires that we reject “pessimistic inevitability” thinking. (Kriesberg, 1998)

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History shows that persistent and dedicated belief in the power of the

human brain to adapt and to create can lead to unimaginable results.

Adapted from Elyn Saks, Professor of Law and Researcher at USC

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A Broader Perspective

Consider the almost unimaginable that has been accomplished by people committed to change.

• The Truth and Reconciliation Commission paved the way for the reconstruction of society in South Africa.

• The ending of centuries of demonizing and hostility between tribes and sects in Africa and elsewhere, like the Tutsi and Hutu in Rwanda, Burundi and the Congo.

• The Civil Rights and Freedom Movements in the US and around the world.

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There is no change without personal conversion. This conversion is a choice - a daily, hourly, minute-by-minute choice. Choosing to act in conformance with the shared vision “is taught by apprenticeship and drill.”

Adapted from Stanley Hauerwas, American Ethicist Duke Law School and Duke Divinity School

Change occurs one heart at a time.