Changing organizational culture in healthcare is not easy, but it's crucial. And it’s possible.

Here’s one small but mighty way to support a big and profound organizational culture change.

At a trauma-informed care conference I attended, a presenter shared a training strategy with me:

“If you want to help your patients, help the staff.”

This inspired me to look for ways that I could make a difference at work, or better yet, be the difference.

(Do your staff face verbal abuse from patients? Check out Verbal Intervention™ training.)

Every weekday, our chief medical officer holds a morning meeting for hospital staff. The meeting covers a variety of subjects — it’s a chance to catch up with each other as colleagues and share information. Each treatment unit and discipline is asked for a status report, and I found myself becoming aware of how many people said the word, “Nothing.”

“Nothing” meant that there was nothing to report. But once the word was uttered, every subsequent person who also didn’t have a status update echoed it. “Nothing.” “Nothing.” “Nothing.”

Technically, nothing to report is positive — but as the word bounced around the room, it had a hollowing effect. No news might be good news, but to me, the word “nothing” was a void that needed to be filled with positive messaging.

Case study: Here’s what I did to complement our organizational culture change

Remembering that my ability to help my patients starts with helping my staff, I undertook a personal campaign to make my response more affirming, positive, and inclusive.

When my department was called upon, instead of saying we had nothing to report, I announced:

“We’re good.”

At first, it didn’t catch on. The majority of attending staff continued to say “Nothing.” I realized that the term was ingrained in their vocabulary, and that I needed allies in this effort to successfully flip the script. Before the next meeting, I shared my observation with three different colleagues in separate disciplines, who also sat in separate areas around the room. When they were called upon for status updates, they repeated after me:

“We’re good.”

changing organizational culture in healthcare
Photo: Aliaksandr Barouski / Shutterstock

And just as my colleagues had echoed the term “nothing” in previous meetings, they did the same thing when my friends and I led the meeting with our motivational responses. “We’re good” helped shift the overall tone of our morning meetings, which became more positive and uplifting, and the trend has continued.

When I reconnected with my teammates to thank them for helping me create this new dialog, they told me that the experience of using words to spark positivity in their peers was simple and gratifying. They each noted that voicing positive words actually enhanced the positivity of their thoughts — and that this energy was contagious among their peers, and most importantly, their patients.

It wasn’t just their perception — research has shown that the mirror neurons in our brains echo what people do and say around us, informing our feelings and thoughts. Negative words, just like negative behaviors, can cause our bodies to produce more cortisol, which can damage our brains and limit our cognitive abilities.

In their book Words Can Change Your Brain, authors Andrew Newberg, M.D. and Mark Robert Waldman noted that by centering your thoughts on an uplifting word, your frontal lobe responds positively, which can stimulate your mind and body into meaningful action. In fact, they found that:

“the longer you focus on positive words, the more you begin to affect other areas of the brain.”

When we take this back to the original spark for my experiment — “If you want to help your patients, help the staff” — it’s interesting to consider how much our words can transform not only the perceptions of those around us, but also how they can inspire action or apathy depending upon how motivational and positive they might be. Our cognitive chemistry makes us highly responsive to not only positive thinking, but also positive speaking.

organizational culture change
Photo: Monkey Business Images / Shutterstock

So while it seemed like a harmless choice, the word “nothing” meant everything. When we made a team effort to use a phrase that sounded more overtly upbeat, the results were palpable. They helped patients AND staff as we kept pursuing our task of changing organizational culture in healthcare within our hospital.

Nonviolent Crisis Intervention® training teaches that behavior impacts behavior, and in teaching staff to choose overtly positive language, that energy will resonate at a fundamental and lasting level with our patients.

Corporate cultures are evolving in healthcare, particularly in behavioral health. Just about every health system and leadership team — not to mention direct care staff — are making big and small changes to make patient care more person-centered. And we ALL have the power to enhance positive change for patients and each other with big and small actions.

Our staff experiment with meaningful vocabulary consisted of changing one neutral word to two positive, inclusive ones. What single word can you tweak in your own lexicon to empower and enhance a lasting organizational culture change?

Editor's note:

For more from D.C. on changing organizational culture in healthcare, don't miss D.C.'s interview on Unrestrained! Get an inside look at his org’s approach to building a coordinated culture of care. He shares:

  • A daily rapport-building technique for developing alliance relationships with patients 
  • Why he asks patients what he can do for them — and how this helps get ahead of problems before they can start
  • Who he trains (spoiler: it's everyone who has patient contact!)
  • Why eliminating the word “No” from staff's vocabulary has a positive effect
  • How they replace “​takedowns” with verbal de-escalation
  • The ins and outs of two ways of changing organizational culture in healthcare: CARE and STEP
  • How the switch from directive to objective turns patient behaviors from tense to “​cake”
  • How dramatically behavioral healthcare has changed in the last 30 years
D.C. Foster

About the Author

With over 30 years of experience at the Arizona State Hospital in Phoenix, D.C. Foster is a Behavioral Health Intervention Specialist and Master Level CPI Instructor. D.C. works with individuals identified as Serious Mental Illness (SMI), Forensic, and Sexually Violent Persons (SVP). Since 2012, he has been using CPI training to create a more person-centered, trauma-informed, recovery-oriented therapeutic environment for patients. D.C. is also a leading member in the CPI Instructor Community, where he exchanges training strategies and professional development techniques with his fellow Instructors.