Cultural Transformation – Understanding Your Stakeholders is Key to Success!

Cultural transformation is a term used often in organizations going through a big change. It’s become the norm in health care, to the point that “cultural transformation” occurs multiple times in every health care organization.

The consulting firm SmartMinds defines cultural transformation as “the dynamic process of irreversibly changing the outlook (culture) of an organization; and correspondingly its policies, processes, and behaviors that result in a more effective mode of operation.”

While most health care organizations do well updating policies and processes to support cultural transformation, they often struggle with encouraging corresponding staff behaviors to support it. That shouldn’t be surprising, considering how we’re physically hard-wired to resist change, even when it’s beneficial. The emotional control center of our brains, the amygdala, interprets “change” as a physical threat, and releases fear, fight or flight hormones to protect us from change.

Within that core physical context, you will want to be mindful of the human dynamics that could positively or negatively affect your cultural transformation efforts. Organizations seeking successful changes to support strategic goals and cultural transformation need behaviors that align with their efforts. This means:

1. Understand your internal and external stakeholders and their motivations
2. Develop an action plan to achieve your cultural transformation goals
3. Celebrate your positive efforts toward cultural transformation

Understand Stakeholder Motivations

Cultural transformation impacts both internal stakeholders as well as external stakeholders. Your internal stakeholders range from your leadership team to front-line staff who can make or break your goals. Unlike in other industries, health care’s internal stakeholders directly impact patient lives. As such, seek to understand the motivations of your internal stakeholders. A stakeholder analysis can support a successful cultural transformation by providing understanding into:

• All key stakeholders – The step of identifying key stakeholders is often overlooked or incomplete. Spend sufficient time identifying all those impacted by your cultural transformation. For example, if your cultural transformation is about implementing a new patient satisfaction program, obvious stakeholders include clinicians and quality teams; less obvious stakeholders may include the member services team that might get calls about the program. A complete stakeholder list will support a successful transformation. The list should be a living document, as new stakeholders may arise as the project progresses.
• Stakeholder needs – Each identified stakeholder group has specific needs which should be defined. This can be done through conversations with a stakeholder representative or the full group, depending on its size. The goal is to understand stakeholders’ needs and where they may fall on the change acceptance curve (see sample below), from non-support to support.In terms of acceptance of a cultural change, most stakeholders progress from awareness to understanding to buy-in and ownership. For example, a nursing stakeholder group might be aware of a cultural transformation and still not understand how it impacts the group, and are thus not yet at buy-in or ownership. Knowing this will help you determine what this group needs to progress.
• Stakeholder influence – Each stakeholder group, as well as certain key individuals within each group, has direct or indirect influence over operational processes related to schedule, scope, resources and/or quality. Identifying each stakeholder group’s influence can support you in meeting their needs and mitigating any potential risks or issues. For example, the nursing stakeholder group has direct influence regarding care quality. A patient advocate leader within that group may have additional influence over the schedule. That needs to be factored into your efforts.
• Engagement preferences – This includes understanding stakeholder communication and participation preferences. This is critical, as stakeholder communication and participation directly affect movement along the change curve. Rather than making assumptions about each stakeholder’s preferences, ask. Is the preferred means of communication in-person or by e-mail, text or social media? Is it through weekly meetings, monthly dashboards or quarterly updates?

Develop an Action Plan

Once you understand your stakeholders’ motivations, you can develop stakeholder-specific action plans to support your goals. The actions plans should include:

• Stakeholder profile – Summarize each stakeholder groups’ needs, influence and engagement preferences identified during your assessment phase.
• Communication plan – Stakeholder-specific communication plans should be developed based on stakeholder preferences and include status on the change acceptance curve. For example, if you have a stakeholder group just now hearing about the cultural transformation and in the awareness phase, your focus should be on providing information on what the change is, why it’s important, and a general overview of the scope and timeline. On the other hand, if one of your stakeholder groups has been involved for awhile and is in the acceptance phase, your communication plan should be focused on identifying how their responsibilities may change, how they can communicate this change to their teams and what they should expect next.
• Engagement plan – Stakeholder-specific engagement plans should also be developed in alignment with your communication plan. This should identify the best methods to engage each group. For example, you may have quarterly meetings with some and daily huddles with others.
• Issue management plan – Identify how you will manage issues that will come up throughout your cultural transformation. The issue management plan should include how issues will be tracked and escalated and an identification of resolution teams. If issues were identified during your assessment phase, document and start working on resolution plans.

Celebrate Positive Efforts

Cultural transformation is becoming the norm in health care and understanding your stakeholders’ motivations and developing an action plan to support them will lead you to success. Having fun along the way will also support your chances of achievement. Celebrate small and big victories, recognize outstanding stakeholders and tell your teams how you appreciate their efforts. And yes, even in health care, something like a pizza party is still a great way to build camaraderie, celebrate your cultural transformation and enjoy your collaborative efforts!