Why lack of accountability and action for poor culture is disastrous for organisations

Updated: 4 days ago

Queensland’s health minister says all of the state’s hospitals should review their processes after an inquiry found “negative workplace culture” could be compromising safety at Caboolture Hospital.


In November, Metro North issued an independent review of Caboolture Hospital after media reports were released regarding adverse outcomes for some surgery patients at the hospital. The independent review focused on governance and now, the findings are out. Despite the identification of a host of alarming issues, including incompetent leadership; lack of enthusiasm for safety; inappropriate behaviours and attitudes; and bullying and harassment, there has been no accountability taken or plan of action created to get to the root of the problems and seriously solve them. Instead, Metro North has decided that giving all hospital staff blanket empathy training is the answer, alongside 18 other relatively superficial and policy driven recommendations.


This band-aid fix lacks the necessary diagnostic measures to find where problems arise and enact long-term cultural change by addressing behavioural issues. Read on to discover why we believe this is an ineffective solution and what would be a more suitable course of action.


Issue 1: It doesn’t get to the root of the problem

Hospitals involve many moving parts, including workers, patients, and protocols; not to mention the connectivity and collaboration between the different departments.


A multifaceted structure lends itself to a multifaceted culture, which means you can’t solve a spread of cultural issues with a one-size-fits-all approach.


Empathy training will only mask the root cause of the problems, instead of bringing them to light in a way that enables them to actually be solved.


Issue 2: No consequences for poor behaviour

A lack of accountability and action means those who have demonstrated poor behaviour will not face any repercussions for doing so. In this instance, this behaviour comes at the cost of patient safety but also impacts the general public, and the organisational reputation and bottom line, due to the loss of trust in an institution that prides itself on caring for others.


Letting workers get away with poor behaviour also increases the likelihood of it continuing past the review, as those who have acted in an indecent way previously have no real impetus to ensure the behaviour isn’t repeated down the line.


Issue 3: It could worsen the current culture

The findings of the Caboolture Hospital review make it very clear that there is an inadequate workplace culture that’s in need of a complete overhaul.


A band-aid solution may temporarily improve the culture, but it doesn’t have the capabilities to make a positive long-lasting impact that transforms the culture for the better. On the contrary, a quick fix could potentially worsen the culture as the problems will remain as they were - unresolved and employees will disengage further.


A sustainable solution

At HENRY REED, we know that every culture is unique and, therefore, every solution must be fit-for-purpose and value adding to the organisation.


Metro North’s focus would be better spent on:

  • identifying the root causes of behaviours leading to the unacceptable levels of risk (including patient safety, lives of patients, wellbeing, and psychological safety of employees), as inappropriate behaviours in the workplace can have a direct link to poor surgical outcomes and performance with life and death consequences

  • using evidence of culture current state to design the ideal culture to correct behaviours, mitigate risks and deliver desired results

  • developing a culture strategy that aligns culture with governance, risk and strategic frameworks to focus resources and activities for the highest impact and return on investment.

  • developing the leadership capability of all influencers, including surgeons and medical professionals, to drive the right behaviours through role modelling, accountability, and effective performance management to ensure people who don’t fit the culture are removed to make way for the right leaders.

A cultural transformation is needed here; this involves conducting a culture audit to provide an independent and unbiased assessment of culture and a business case for change; a culture design to bring together all the different facets of organisational effectiveness to identify the unique elements that will establish an environment for success; and culture leadership to enable the success of all change programs and the achievement of results.


If culture review, culture strategy or leadership capability is something you're considering for your organisation, please book some time for a complimentary discussion.




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