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CHAPTER 11
FUTURE PULL Understanding the Culture in Culture Change by LaVrene Norton
health, the healthiest long-term care organizations widely circulate decision-making power to frontline staff, self-led teams, and, most importantly, the resi- dents.
Of course, good circulation through the body de- pends on the heart’s ability to take in blood. If the ar- teries are clogged and letting only a small stream of blood into the heart, a health crisis may be imminent. If we consider the vision as the heart of the organiza- tion and the formal leadership as the coronary arteries, we understand that the quality of the information and decisions that flow through them to staff, residents, and families depends on the quality of information the leaders take in.
Is the executive a “hero-CEO” who listens only to a few advisors and rarely ventures from the office while issuing directives down the spiraling, faceless hierar- chy? Or is she in the “fundamental state of leadership,” circulating on the floor, listening to workers and cus- tomers to learn the real story, leading by example as she stops to clean up a spill, accomplishing desired outcomes by organizing and empowering teams, and inspiring others to find meaning and purpose in their jobs and lives, thereby stimulating
fresh ideas and better service and care while lowering staff turnover rates? She is probably someplace in be- tween.
THE MYTHS AND REALITIES THAT COEXIST IN THE ORGANIZATION
It is normal for people in organizations to say one thing and believe another. (Quinn, 2004)
We all pretend to one degree or another. We tell our host the meal was great even though we thought it bland. We compliment the presenter on the feedback survey even though we fell asleep during his lecture. We say how great it is working here even though staff turnover rates are shockingly high. In nursing homes, staff and residents alike may say how wonderful it is to live here even though in reality the residents endure a much lower quality of life than they had at home. The larger the gap between the myths and realities that coexist in any organization, the more troubled its cul- ture.
The tendency, often unconscious, to please those in charge or put a “happy face” on our true circumstances makes it all the more difficult to cut through the myths and see the realities of organizational culture. Staff, residents, family members—everyone is guilty of this. This is why customer surveys and focus groups have limited usefulness in revealing the truth. It is com- monly acknowledged among many of my colleagues that, according to surveys, people are about 85% satis- fied no matter their situation—proof that people adapt and conform themselves to their new situation. For example, a woman may have had high expectations in life before entering a nursing home, but after 3 months it becomes clear to visiting friends and family mem- bers that her quality of life has gone downhill. Still, she says, “Oh yes, it’s going well. The food is not bad. I have no complaints.”
The various management styles presented in the first section of this chapter can perpetuate these myths. For example, if the CEO uses an authoritarian model, taking in only the information a few advisors want him to hear, he may begin to believe his own hubris and perpetuate the myths that are destroying the organiza- tion.
Years ago, while I was consulting with an Action Pact client, a social worker led me on a walking tour of her organization. As she was telling me how great it was to live there and how well the staff treated and respected the residents, a woman approached us. She stopped so closely in front of my guide that their bod- ies nearly touched. She seemed about to burst in her desire to say something to the social worker, but she waited respectfully for a break in our conversation without interrupting. To my dismay, the social worker failed to acknowledge the woman’s presence and con- tinued to ignore her while going on about the resident- friendly culture. The social worker’s obliviousness to the gap between what she was telling me about her organization’s culture and its reality was all too clear.
So how do we cut through the myths to find the truth? In Action Pact’s organizational culture assess- ments mentioned earlier, we start with storytelling, often sitting in learning circles with staff, residents, and family members to hear their observations on liv- ing and working there. Usually, their stories focus on the positive aspects, but in the process of hearing each
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