Why Culture Change is Difficult Discussion Paper

Culture Change

Organizational culture refers to the ways in which the leaders and employees embody the organization’s core values, mission, and vision. Culture determines how health professionals perform their duties, collaborate with each other, and relate with patients. Changes in organizational values may inform change in culture. For example, the LGBTQ movement has influenced organizations to promote practices for inclusivity and this is part of organizational cultural change. For instance, nurses can be trained on the language to use when interacting with members of the LGBTQ to promote trust building within the patient-provider relationship.  Why Culture Change is Difficult Discussion Paper

Why Culture Change is Difficult

In health care, culture change is tied closely to evidence-based practice: health professionals and organizations adopt practice standards and attitudes that have been proven to improve patient care and outcomes. For example, the use of LGBTQ-friendly language to promote trust-building may increase compliance with the treatment plan (Bass & Nagy, 2021). Some factors create barriers to cultural change adoption in healthcare.

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Personal Bias

During the cultural change process, the vision bearers communicate the agenda to the rest of the team. For example, departmental leaders may explain the nature of the problem and how this new cultural change initiative may solve it. However, health professionals may resist change due to personal bias. They may have a different view from the organizational leaders and feel disinterested in the initiative (FitzGerald & Hurst, 2017). For example, when introducing LGBTQ-friendly culture, some health professionals may feel that they do not need to go out of their way to accommodate LGBTQ interests. Some health professionals already hold negative attitudes about the LGBTQ movement because it goes against their values. Why Culture Change is Difficult Discussion Paper

New Habit Formation Takes Time

After receiving the cultural change memo, the employees may embrace its implementation but struggle with consistency because the formation of new habits takes time. According to research, the average time it takes to form a new habit and becomes automatic is three months (van der Weiden et al., 2020). The authors explain that the formation of new habits depends on a person’s level of self-control. The aspect of self-control is important because the long-term goal of cultural inclusivity may clash with short-term goals such as serving patients in the shortest time possible. A nurse may not want to go the extra mile to accommodate LGBTQ interests. For example, they may forgo providing LGBTQ patient education during the session to make more time to serve the rest of the patients in the queue, make time for reporting, and leave immediately after the shift ends. Eventually, LGBTQ patients may record poorer health outcomes compared to their counterparts due to healthcare inequalities. In this context, disciplined health professionals will find ways to achieve long and short-term goals without compromise.

Ways to Make Culture Change Easier

Leading by Example

After explaining the need for change and the initiative’s ability to meet this need, nurse leaders should lead the cultural change by example. For example, they should start using LGBTQ-friendly language during boardroom meetings. For example, they can include other gender descriptive terms when addressing people as opposed to using “ladies and gentlemen” only. The employees will eventually copy the leaders’ example. Why Culture Change is Difficult Discussion Paper

Training Employees

During employee training, nurse educators should lead nurses in identifying their implicit and explicit biases against the LGBT community and their origin. The employees should learn to practice self-awareness to prevent their attitudes from influencing their actions.

Practice Patience

Nurse leaders should understand that new habits take time and should not pressurize the employee into immediately embodying the new culture. Instead, they should expect the employees to develop new habits gradually and promote consistency.

Appropriate Nurse-Patient Ratios

Healthcare leaders should employ enough health providers to achieve the appropriate skill mix and patient-provider ratios (Montgomery et al., 2019). This approach will encourage the employees to implement the change initiative because they are not overworked.  Why Culture Change is Difficult Discussion Paper

References

Bass B, Nagy H. Cultural Competence in the Care of LGBTQ Patients. [Updated 2021 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563176/

FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: a systematic review. BMC medical ethics, 18(1), 19. https://doi.org/10.1186/s12910-017-0179-8

van der Weiden, A., Benjamins, J., Gillebaart, M., Ybema, J. F., & de Ridder, D. (2020). How to Form Good Habits? A Longitudinal Field Study on the Role of Self-Control in Habit Formation. Frontiers in psychology, 11, 560. https://doi.org/10.3389/fpsyg.2020.00560

Montgomery, A., Panagopoulou, E., Esmail, A., Richards, T., & Maslach, C. (2019). Burnout in healthcare: the case for organisational change. Bmj, 366. https://www.bmj.com/content/366/bmj.l4774/rapid-responses Why Culture Change is Difficult Discussion Paper