Thomas Atchison, who has a doctorate in education, is an American College of Healthcare Executives (ACHE) faculty member, author, president and founder of Atchison Consulting LLC. For more than 30 years, Dr. Atchison has worked with health care organizations on change management initiatives, team building and leadership development. He has consulted for the military, health care suppliers and government agencies on the intangible aspects of health care. He's also taught courses on leadership and change management for ACHE.
Without aligned values, all sustainable change processes will fail.
Alignment of personal and corporate values create the bedrock for all sustainable organizational change. When values are aligned, the day-to-day vagaries of any change process are accepted as the natural outcomes of moving forward. Physicians and staff understand that corporate values are the context for a leader's expectations for improvement.
However, when values are not aligned, physicians and staff have no organizational context. They view all vagaries as evidence that the change process is failing. Many times, such thinking results in the Pygmalion Effect, i.e., a self-fulfilling prophecy.
Values are motivation. Values are the drivers of our behavior. Values are the underpinnings of decisions. Our values are the beliefs that guide us through life. There are no genetically determined values, values are learned. Values are the causes of behaviors and the reasons we engage in some behaviors and not others. Values are what initiate and direct our behavior.
Imagine that a cattle rancher and a vegan are deciding the menu for dinner. The differences in values would be insurmountable, and an agreement about what to cook would be impossible. However, if the person selecting the menu was a vegan and the other a vegetarian, then the probability of consensus is very high. Leaders understand THE critical success factor is aligned values.
The importance of values is obvious throughout history. How many wars are the result of a negative variance in a quarterly earnings report? And, how many wars have started (and continue today) because of a values conflict? One side believes 'X,' the other 'Y,' and the differences justify armed conflict. The American Civil War (which wasn't very civil) had some economic underpinnings, but the main cause was differences in values. The Shiite and Sunni have been at odds for hundreds of years because of a different interpretation of the role of the Prophet Mohammad. The Irish Catholics and Protestants in northern Ireland have been at odds for centuries. While war analogies may seem extreme, conflicts great and small put individuals and groups of people at odds because of conflicting values.
Figure 1 shows the relationship between values and behaviors.
We must remember that in an organizational change process, expected behavioral changes must be anchored in the values of the individual. The degree to which the new behaviors are underpinned by the individual's values equals the degree to which the change will occur easily. Conversely, the degree to which the behaviors are in conflict with the individual's values equals the degree to which the expected new behavior will be resisted.
Today, many clinicians find themselves conflicted between their values for patient-centered care and the intense focus on financial and business issues. For example, a 2012 study of thousands of physicians by Merritt Hawkins found that 'Over 84 percent of physicians agree the medical profession is in decline.'' And, a study from the University of Pennsylvania states that, as a profession, nurses have six times more dissatisfaction than any other industry.
The solution for this conflict between clinical care and political reality is the health care leader's ability to communicate how creating a better future for patient care and community health is anchored in corporate values. Health care leaders are most successful when they create a values-based context for change and explain how business realities will be developed to support positive change.
The leader's message is the critical success factor in determining whether the change process will be successful. Genuine leaders always use corporate values as the context for sustainable change.
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