1 THE POSITIVE ORGANIZATION
One day, I was talking with a young surgeon whose academic specialties included evaluating hospital performance. He thinks very deeply about what factors increase or decrease a hospital’s effectiveness, and we were discussing how successful hospitals function. In the middle of our conversation, he paused and then surprised me with a question: “Why do people in finance so often end up as heads of organizations?”
This question caught me off guard, and I improvised some answers. I told him economics is a potent discipline, and people who master it have precise analytic tools. As they move up in their organizations, they learn to rigorously evaluate the allocation of resources in the system. By the time they reach the highest levels of the finance function, they have great skills for controlling an enterprise.
A commonly held belief in business circles is that people in economics and similar analytic disciplines know how to solve important technical problems and how to efficiently utilize resources. Therefore, they can keep things under control.
My friend nodded, but not with enthusiasm. He expressed some reservations about people who base their leadership on control, problem solving, and efficiency. I was not sure what was on his mind. So I asked him to elaborate, and he told me two stories. Each one was about leadership and culture in a hospital setting.
Two Hospitals, Two Cultures
The first story begins when my friend went with a team of colleagues to visit Hospital 1 and were warmly greeted at the front
door by a man in a top hat. Inside, they saw the usual information desk and waiting area but also spaces available to the community for such things as weddings and cooking classes. As they toured the hospital, they got the impression this hospital was like a five-star hotel.
On their tour, they happened to bump into Hospital 1’s CEO, who welcomed them and asked if he could help them in any way. He chatted with them for a half hour and shared his vision and philosophy.
During the rest of the tour, they asked the employees about the CEO. People at the lowest levels talked as if they had a personal relationship with the man. They also spoke with pride about the vision and values of the hospital. Clearly, people were unified and felt good about what they were doing. Their every word and action seemed to convey that they were fully committed to the hospital’s success. There was a positive culture that seemed to focus, unify, and animate them.
My friend and his associates left deeply impressed. While they were all doctors who have spent their lives in hospitals, it was clear that they had just observed a hospital that exceeded their expectations. They had just encountered a truly “positive organization.”
Shortly thereafter, my friend was dropped off at the front door of his own hospital: we’ll call it Hospital 2. Given his recent visit to Hospital 1, he began to think about contrasts between that organization and his own. He then experienced one of the differences.
As he walked in, he was met by a gruff woman who wanted to know if he was a student. He explained that he was a surgeon and was scheduled to operate. She would not grant him entry, citing hospital policy. He would have to go back out and walk around to the employee entrance. The surgeon tried to handle the situation artfully, but the woman threatened to call security. He went back out.
A few days later, he related what had happened in a meeting with a senior officer of Hospital 2. This person responded to the story by asking for the name of the woman. The executive wanted to fire her.
My friend told me that this particular senior officer put a lot of emphasis on being in control and fixing problems. His first inclination, for example, was to terminate the troublesome woman. He assumed that she was “the problem.”
To the administrator’s mind, firing the woman was the right thing to do. He wanted to establish and maintain order and control. He wanted to make the hospital run better. A person who seeks a predictable, smooth-running organization often focuses on disruptions and disruptive influences:
the natural inclination is to fix those disruptive problems. In this case, the knee-jerk solution was to fire the woman.
When we focus on a problem, we are not seeing the whole system. We are paying attention to something within the system. Likewise, when we focus on a single person, we are not focusing on the culture of which that person is a part. The aforementioned senior executive did not stop to wonder what systemic conditions within the culture might have caused the woman to behave as she did. It did not occur to him that if he fired the woman, the problem might not go away. The next person in the same role, responding to the same culture, might eventually behave in the same manner as this woman had.
When people focus on the part rather than the whole, it does not occur to them to ask a most important question: How might the entire culture be reshaped so the people flourish in their work and exceed expectations as they perform?
This book is about creating more positive organizations. The preceding question reflects the simplest definition of a positive organization.
IN A POSITIVE ORGANIZATION, THE PEOPLE ARE FLOURISHING AS THEY WORK. IN TERMS OF OUTCOMES, THEY ARE EXCEEDING EXPECTATIONS.
To flourish is to grow and thrive. To exceed expectations is to successfully do more than people expect you to do; it is to move toward excellence. Hospital 1 had a culture of excellence. The young surgeon and his colleagues entered Hospital 1 with similar assumptions about what a hospital is like. During their visit, those assumptions were challenged. The surgeons saw people were flourishing and exceeding expectations. They saw a hospital that was performing at a high level because it had a positive culture. The surgeons had seen something that created dissonance in the way they viewed the world. Now they would have to decide whether to disregard it as an anomaly or examine that information more closely.
Mental Maps and Culture
Like the surgeons, all of us have a set of assumptions or beliefs that help us navigate the world we live in. These beliefs are acquired over time from the people we live with and work with. We learn from these people
and from our own experiences what works and what doesn’t. These assumptions and beliefs then become like maps in our minds that guide our responses to what we observe and experience around us.
Our mental maps guide us in all areas of life: they create our picture of what family life is like. They tell us what to expect in areas like education, religion, and recreation. Because our assumptions are a product of our experiences, we take our beliefs as truth and seldom doubt them. We hold them tightly, and we tend to deny messages that challenge them.1
The mental maps we hold influence our approach to, and our beliefs about culture in our organization. In my experience, there are a few common ways that managers tend to think about culture. Group one, “The Discounters,” ignore the fact that culture exists, and they often completely overlook or discount its impact. Group two, “The Skeptics,” recognize that culture exists, but they have tried to make change, failed, and then incorrectly concluded that the culture is unalterable. Since experience doesn’t lie, “The Skeptics” “know” that aspiring to excellence is both unrealistic and impractical.
Finally there are the few “Believers.” These managers have also experienced organizational constraints, but they know culture change is possible because at some point they have tried and succeeded. In succeeding they learned something important. Instead of seeing the culture as a fixed constraint, they see it as the key to success. They recognize that their job is to lead culture change so as to create a more positive organization.2
Managers in all three of these groups carry a conventional mental map. We call this map conventional because it is guided by normal or common beliefs. For example, one conventional belief is that stability, hierarchy, and control are the keys to running an efficient and profitable business. There is truth in this conventional belief, so that map can be useful. However, when the conventional map is used alone, it can actually become a constraint. It can prevent people from pursuing the creation of an organization in which people flourish and exceed expectations.
The rare supervisors, managers and executives that fall in to the group of “Believers” have an advantage. They accept the conventional map and all of its very real beliefs and constraints, but they have also acquired a positive mental map. The positive mental map allows them to see possibilities that “Discounters” and “Skeptics” cannot see. They see the constraints
and possibilities simultaneously, which allows them to do things the others cannot do. In chapter 2
we refer to this advantage as being a bilingual leader.3
Defying Conventional Culture
In the young surgeon’s story from the beginning of this chapter, Hospital 2 appears to be led by people who only hold the more conventional or common mental map. I had the opportunity to work on a project designed to elevate over 60 nursing units in Hospital 2. We worked with the directors of the nursing units, dividing them into small groups and spending a week with each group to help them see how they could better empower themselves and their people.
The work proved to be a great challenge. It seemed that each time we surfaced some positive practice that might improve a unit, one of the directors would explain why it was impossible to employ it. They spoke of administrators who were punishing, doctors who were insensitive, policies that were inflexible, peers who did not cooperate, and employees who just wanted to do their job and go home. Experience taught these directors of nursing that the organization’s culture was constraining. They did not expect the people in their units or people in other parts of the hospital to flourish and exceed expectations.
As we sought to modify their beliefs and elevate their aspirations, we began to examine the nursing units more closely. We looked, in particular, for a positive exception, a unit that defied the conventional culture of the hospital. The exception existed and was easy to find. When we asked administrators if there was such a unit of excellence, they all answered in the affirmative and named the same one, which I will call Unit 5.
Unit 5 served children who were seriously ill. This was demanding work, and yet they were usually first or second on every hard performance measure. Measures of morale were also high. In many of the other units, turnover was high; in this unit, however, the turnover rate was close to zero, and there was a long list of nurses waiting to transfer in. Why?
Other units in the hospital also served populations like Unit 5, but none performed like Unit 5. They seemed to take a unique approach to everything they did. Earlier in the hospital’s history, for example,
every unit had been given money to hire a hostess to greet new patients. Nearly all the units hired a nurse. Unit 5, however, hired a drama major and then sent her to clown school. When very sick children and anxious parents arrived on the unit for the first time, a very skilled clown greeted them. Within minutes, they felt they had become part of a special community in which they would be treated as full human beings.
When we interviewed the nurses in Unit 5, they told stories of people going the extra mile to take care of patients and each other. They spoke of collaboration and achievement. It seemed to be a place of high commitment and compassion.
The people we interviewed spoke of the unit director in the same way the people in Hospital 1 had spoken of their CEO. It was common for them to express extreme gratitude for the director of their unit. In our interviews, some nurses actually shed tears as they spoke of their leader. Their descriptions suggested that she was deeply committed to creating a positive unit in a conventional hospital.
The Reality of Constraint
Most organizations tend to be like the more conventional Hospital 2, where many of the nursing units were disempowering places. A few empowering exceptions are found, like Unit 5, but it is not the norm.
Recall that we found Unit 5 because we went searching for a unit of excellence, a positive exception in the organization. We wanted to challenge the tightly held assumptions of the nursing directors by exposing them to a positive reality within their system. We hoped to jolt their beliefs and open their minds to the possibility of thinking in a new and more empowered way.
What we learned is this: the directors, like many people in positions of authority, do not aspire to have flourishing people in their units. They instead seek to meet the minimum assumed requirement in order to survive. Survival, not flourishing, is the aspiration of conventional managers. They do not look for or expect to find excellence. When they do find excellence, they tend to ignore it rather than examine and learn from it. Everyone knew about the excellence of Unit 5, but it never occurred to anyone that it was possible to use that success as a lever for creating
a more positive culture in other such units. The conventional focus on constraint
precluded a focus on possibility.
Across the world, supervisors, managers, and executives learn to speak in politically correct ways about improve...