How to Change Organizational Culture in Health Care


May 10, 2023
D.C. Foster

Every weekday, our chief medical officer holds a morning meeting for hospital staff. The meeting covers a variety of subjects—it’s also a chance to catch up with each other as colleagues and share information. During this time, each treatment unit and discipline are asked for a status report.

As staff shared their updates, I found myself becoming aware of how many people said the word, “Nothing.”

Saying “nothing” meant that there was no news or updates to report. Once one person in the room said it, every subsequent person without an update echoed the word. “Nothing, nothing, nothing.”

Technically, nothing to report is positive—but as the word bounced around the room, it had a hollowing effect.

Influencing Positive Culture Change in Health Care

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

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

As my coworkers echoed the same words, I remembered the advice from the conference. I also recalled what I had learned from my CPI Nonviolent Crisis Intervention® training:

Behavior impacts behavior. Teaching staff to choose overtly positive language will resonate at a fundamental and lasting level with our patients.

I decided to make it my personal campaign to make my own response more affirming, positive, and inclusive.

The next time we came together for our morning meeting, I tested my new approach. Instead of saying, “nothing” I announced, “We’re good.”

At first, it didn’t catch on. The majority of other 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 observations with three different colleagues in separate disciplines, who also sat in separate areas around the room. The next time we met to share status updates, they repeated after me, “We’re good.”

Then it happened.

Just as my colleagues had echoed the term “nothing” in previous meetings, they started to echo our new motivational responses of “we’re good.” This simple change in verbiage helped shift the overall tone of our morning meetings, which became more positive and uplifting as the trend continued.

When I reconnected with my coworkers to thank them for helping to 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 enhanced the positivity of their thoughts—and that this energy was contagious among their peers, and most importantly, their patients.

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 is interesting to consider how much our words can transform not only the perception of those around us, but also how they can inspire action or empathy depending on how motivational and positive they might be. Our cognitive chemistry makes us highly responsive to not only positive thinking, but also positive speaking.

CPI Training Benefits for Staff and Patient Care

While it seemed like a harmless choice, the word “nothing” meant everything. As we made a team effort to use more positive, upbeat phrases, the results were palpable. This simple change helped patients and staff as we pursued our goal of changing the organizational culture in health care within our hospital.

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

Our staff experiment in adopting meaningful vocabulary consisted of replacing one neutral word with two positive ones. What single word could you tweak in your own vocabulary to empower lasting organizational culture change?

Discover the impact CPI training can have on your health care culture:

Find Training

About the Author:

D.C. Foster Headshot

D.C. Foster is a Behavioral Health Intervention Specialist at Arizona State Hospital in Phoenix, Arizona and is a Master Level CPI Certified Instructor. For over 30 years, Foster has worked with individuals classified as Serious Mental Illness (SMI), Forensic, and Sexually Violent Persons (SVP). In 2012 he became a CPI Certified Instructor and has used his training to create a more person-centered, trauma-informed, recovery oriented therapeutic environment for patients. Foster has become a leading member of the CPI Certified Instructor community and he regularly exchanges his training strategies and professional development techniques with fellow Instructors.

Originally published in 2019.

Schedule a Consultation

Learn how CPI’s training programs can benefit your organization.

Let's Connect