A Health Care Facility

Faced with shrinking funding and increasing expenditures, this 950-bed acute care teaching hospital implemented the principles of Continuous Quality Improvement throughout the organization. CQI requires complete commitment and support from the CEO and the senior management team and an understanding of the culture of the organization and the roadblocks to change that can arise.

In a four-year turnaround, this hospital developed a culture enabling them to handle the financial crisis in a Constructive manner (dealing with issues before they became problems) as opposed to their Passive (hoping the problems would go away) and Aggressive (using quick fixes when forced to act) styles at the beginning of the study.

The OCI was used to measure the current culture of the hospital at the beginning of and throughout the study. The profile indicates that the organization had a tendency to be Defensive (both Passive and Aggressive) in their situation. Armed with this knowledge, the CEO realized that implementing a CQI program in this culture would generate more fear than innovation. Therefore, the CEO was extremely careful in how he and his team presented and started the CQI program. They worked to remove the fear factor by communicating openly and promoting the early successes of the program.

After four years… Success!

With serious organizational development and many changes, the culture became more Constructive. The CEO was fully involved and a strong leader for the changes. The Passive and Aggressive tendencies were greatly reduced, allowing the CQI program to bring about procedural improvements and subsequent reductions in cost. The careful implementation of CQI afforded other benefits for the hospital as well. In year four of the program, the local business magazine rated the hospital as one of the "Top 10 Employers". In fact, the magazine stated, "It seems every employee has his/her own story to tell explaining why the hospital is 'such a great place to work'."

While there were significant positive results and benefits from the CQI program, the CEO recognized that their journey was not over. He estimated that the CQI program was at least a ten-year journey. With this timeline in mind, the CEO wanted systematic feedback on how well the CQI program was working so that adjustments could be made to ensure its continued success. An enhanced survey was used to measure culture, tangible outcomes and results as well as the systems, processes and structures that could be changed to improve those outcomes.

One example of the several outcomes measured in the enhanced survey was section of questions asking the organizational members about their perceptions of the CQI program.

Examples of these questions include:
To what extent do you agree with the following…

1. The idea of quality improvement may sound good, but does not apply to everyone's job.
2. People in this hospital put more energy into catching mistakes than into figuring out how to do things right the first time.
3. I do not think CQI will have lasting impact on this hospital.

The answers to these questions were used to measure the overall attitude organization members had about the CQI program. The results show a drastically different view of the organization's culture. It is important to note that both profiles came from the same organization. The group who had a negative attitude towards CQI experienced the fear of change that was warned in the initial survey (year 1). Those who had a positive attitude toward CQI viewed the culture as being extremely constructive.

Follow up questions revealed that those with a negative attitude had never received any direct training or knew anyone who had participated in a process improvement team. This type of information helped the CEO and the organization focus their continued efforts in improving the communication and the experience of CQI throughout the hospital.

A Financial Institution

An organizational alignment project, entitled The Champion Within, was undertaken in the Systems and Technology division of a very large bank. Everyone in this 2500 person technology division took part in this initiative. It started with the senior management team and eventually rolled out to all team members.

In the Awareness phase, the OCI profiles revealed an organization still in shock from recent downsizing and cost containment and unable to support the very aggressive goals for market growth that the Business units were pursuing. This was followed by the Champion Within program. Each level in the organization took part in the process as an intact team. During each session, the OCI results were presented prior to each participant receiving either their Leadership Impact report or self-scored Life Styles Inventory. This was deliberate so people felt compelled to change their individual attitudes and behaviors in order to create a more constructive culture - one needed to support their strategic plan.

Next, the Group Styles Inventory was completed for intact teams to gauge their effectiveness. Followed with the action planning necessary to align their team performance with the organization's vision.

After three years…success!

• Team sessions now focused on goals & objectives established in the original workshops.
• OCI results were dramatically different.
• Creative ideas began to flow.
• The hiring profile for managers changed from a focus on task to a balance of task and people management.
• There was a 10% increase in cost savings per annum
• There was an increase of 33% in on-time project deadlines.
• Client satisfaction soared.
• The internal IT shop became vendor of choice for the business units.

An Insurance Company

The IT management team of was looking for a way to align the culture of their division with a whole new strategic thrust requiring a wholesale change to their current technology. This was causing a rift in the organization between "veteran staffers" and the new hirers whose updated skill sets were seen as threatening.

"The Leader Within" was implemented as part of the Organizational Alignment Process and viewed as their solution to bridging the growing gulf. Intact teams, starting with the senior managers, were trained in Creating a Champion, Team of Champions and Champion Leadership. High potential team members were then assigned the role of Continuous Improvement Leaders and, after a train the trainer, they became responsible for the follow-up sessions devoted to team goals and objectives.

After only two years…Success!

The culture change was so significant, that the team leaders were asked to present their findings to senior management.

The Circumplex, LSI, GSI, OCI, OEI and LI are copyrighted by Human Synergistics and Human Synergistics Center for Applied Research and appear here with permission of the publisher.

^ Top