Culture Change from the Inside Out

When I was in graduate school, still under the illusion that I wanted to become a family therapist, I learned a principle of human behavior that I rely on to this day: if you want to change other people’s behavior, you have to first change your own behavior. It’s the whole “for every action, there is an equal and opposite reaction” principle.

Of course, other people don’t always change in the way we want, or even expect. Sometimes, especially with our kids, they find a way to respond to our changes that never occurred to us. But I digress.

What I’m thinking about is the whole culture change movement, taken community by community, building by building. Maybe the culture you’re trying to change is simply the way your day shift interacts with the evening shift.

Maybe you’re trying to get caregivers just to show up on time, and not be such drama kings and queens.

These changes are certainly a part of the work culture. And they don’t change, unless we change our behavior first.

How can you change your culture from the inside out? Start by what you focus on. I was chatting with a colleague about one sure way to change our individual cultures: change the way we orient and train new staff. If we train new people, from day one, to act in a certain way, they may get out “on the floor” and see things happening differently from the way they were trained. They may say, “But that’s not how we’re supposed to do it,” challenging “old-timers” to step up and perform differently.

Debbie Buck (Board of Nursing) tells me that when best practice began to recommend gait belts, few nursing facilities had them in use – or even on the premises. As new nursing assistants were trained to use gait belts during initial training, they began asking their supervisors to please provide them. Now, gait belts are common and available nearly everywhere. It probably was a more effective way to change that particular part of behavior much more effectively than mandating that all staff shall now use gait belts.

What if we teach principles of resident care and of working together in the same manner? As we turn out new staff, trained in new ways, we can change the culture from the inside out – from the bottom up.

It might just be the way culture change really has to happen.