Organizational culture can be described in a number of valid ways. Vestal, Fralicx, and Spreier (1997) define four dominant cultures that are demonstrated in health care; this book will refer to them as driving forces behind culture, or the chief motivators for the organization. The organization must understand the driving forces behind its dominant culture so that it can understand how to appropriately promote empathy within the culture. Organizations, like people, respond to different motivators. Each of these driving forces can be molded in an empathic framework, as long as they are understood. Further, although particular factors that have been agreed on by strategists and upper management often drive the culture within an organization, the environment of the organization can also be driven from within at the team level.
THE CULTURAL DRIVING FORCE THAT MAKES THE BEST USE OF TECHNOLOGY. A culture that is focused on making sure that technology is used to its fullest advantage describes the traditional culture, rich with hierarchies and management structures. Government agencies and subsidiaries frequently subscribe to this culture. This, of course, is the most traditional driving force in most business; the need to be on the cutting edge has motivated business for decades.
When technology is the driving force in an organization, work may be very specialized in order to reap the maximum benefit from technical expertise. Consequently, within the technological culture, there is perhaps more potential for silos and individual differences than in any other type of culture. The leader within this organization may have a particular challenge in forming and managing teams. A specific challenge involves integrating shared leadership into the organization, which contrasts with the traditional "decision at the top" methods. In addition, because this cultural driver results in an emphasis on rules over creativity, there is not as much opportunity for the leader to encourage team thought and consensus about a desired change. Efforts to affect the culture in this type of organization will result either in a slightly modified version of the traditional hierarchy or a complete change to a less structured, less hierarchical culture. In order to effect this, senior management must be willing to align with those driving the change, and adequate support must be garnered from the ranks to put the changes into motion. The leader in this case must be alert to the insecurities and sensitivities of people comfortable with a structured, rigid system and help them manage their emotions as they react to the change. Taking steps to let colleagues know that their sensitivities and insecurities are acknowledged can immediately promote a framework of empathy upon which to build.
THE CULTURAL DRIVING FORCE THAT EMPHASIZES QUALITY, CUSTOMER SATISFACTION, AND SERVICE. As a more patient-centered approach to service delivery becomes desirable due to both marketing and best practice factors, many organizations that were once motivated by keeping up with and obeying all the rules are turning to the quality and satisfaction driver to define their mission. The disease management company that I am affiliated with is an example of a company driven by these motivators. At the end of the day, the important factor is whether patients received quality care and were satisfied, so staff and management alike must focus on the outcomes of their work. A growing number of health service organizations, including hospitals and HMOs, are motivated by the drive to provide quality service and customer satisfaction. This results in a closer look at the patient experience: exactly how do patients perceive the care they receive, and what would they like to see improved? The empathic organizational desire to understand patients' feelings can be applied to staff as well.
The leader in this type of organization, then, has the delicate responsibility of balancing the needs of the customer with the needs of the staff. As we have seen, there is the potential for conflict between patient satisfaction and staff satisfaction. To successfully strike this balance, the leader can use empathy to understand the primary motivation of each team member and to sustain the vision espoused by the organization.
To maintain high standards for quality of care and service, the leader also must promote change and continual improvement of process. Placing team members in charge of the change process, cross-functional training, and continuing education activities (Vestal, Fralicx, and Spreier, 1997) shows that the team is growing in knowledge and that the leader empathizes with each team member's need to advance and learn as an individual as well as to perform functions as part of the team.
THE CULTURAL DRIVING FORCE THAT EMPHASIZES BEING THE FASTEST AND THE BEST. Organizations with this culture seek to do things faster and better than anyone else in the market; speed is of utmost importance, and the culture literally becomes time-based. Organizations adopt this mentality because of perpetual change in the environment and the need to keep ahead of change. Best suited to this type of culture are individuals who have a high sense of urgency and who are adaptable, intensively creative, and decisive. Organizations motivated by these factors usually have flatter, leaner hierarchies than other types of organizations, and they often use cross-functional work groups (Vestal, Fralicx, and Spreier, 1997). When staying ahead of rapid change is the driving force in an organization, the leader must be empathic with the emotional impact that rapid changes have on each team member. In this instance, the empathic framework is of utmost importance. A paradigm of empathy will not slow the pace of change, but it will bolster those who are shaken by it. Empathy in this case is focused on keeping employees happy and less disgruntled by continual, rapid change. When an individual is not well suited to his cultural driver (for example, perhaps the individual has a low sense of urgency) the leader will need to use empathy to understand what motivates urgency in that individual and work with her to make urgency a defining aspect of her behavior at work.
THE CULTURE DRIVEN BY FLEXIBILITY AND ADAPTIVE THINKING. This culture emphasizes the value of networks, or virtual organizations, in an attempt to respond to the need for flexibility in response to constant change in the market. Perhaps no cultural driver typifies the workplace of the future better than the network culture described by Vestal, Fralicx, and Spreier (1997), in part because of integration of services and the need to go outside the organization for resources. Leaders in this type of organization must be flexible, effective at finding and using resources even outside the organization, and able to think "outside the box." The use of network structures, or virtual structures, where individuals in teams may be in different buildings or across the country, is growing in many industries, including health care. Maintaining a network of diverse and multifaceted divisions—for example, the home health division, the rehabilitation division, the acute care division, the clinic division, the insurer— requires the empathic skills of facilitation and negotiation, skills that require identification of emotions and the ability to use them to facilitate thought. In short, this culture is most likely to involve relationship building with the added challenge of depending on team members who are across the country and coming from a different perspective of the same organization. The empathic framework reinforces the need to identify and acknowledge the diversity that characterizes virtual teams.
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