Optimising Healthcare Culture

There is a famous saying in business circles that is attributed to American management consultant Peter Drucker: “Culture eats strategy for breakfast” (1). This glib pronouncement does not mean that businesses, including healthcare institutions, do not need operational strategy. Rather, it denotes that if there are significant issues or poor performance within an organisation, cultural improvement should be preferred over alteration of strategy. It also implies that the best strategy will not count for much in an environment with poor culture. Indeed, a good organisational culture often negates the need for many strategy initiatives, as creative solutions to problems often arise and are implemented organically.

We have discussed the difficulty of defining, assessing, and understanding culture. But strategy is different – it is more easily understood, more visible, and better defined. Most definitions of strategy are something like, ‘A long-term plan for achieving a goal or a result.’ Within these words is the key to the difference. A plan is the result of a cognitive process has been thought out, and the goal or results are defined end points. Culture is sensed instinctively, and any changes, good or bad, can become embedded over the longer term with ongoing effects.

When considering the idea of strategy, we understand that it can be communicated, written down, and thought of as a linear path to success. Strategy is superficial, visible, and controllable. It is a process that has clear timing of implementation, and easily measurable success or failure. Strategy involves mechanistic change. Culture change is more organic. A change in culture will involve processes that are deeper, less visible, and more mysterious. To create successful culture change is harder but more permanent than strategy implementation, as it is part of the evolution of the organisation. Strategy change involves what an organisation does; culture change involves what an organisation becomes.

[1]       Drucker, P. F. (2020). The essential Drucker. Routledge.

This is an excerpt from the book From Hurting to Healing – Delivering Love to Medicine and Healthcare (2023). Hambone Publishing. https://amzn.asia/d/ffBkIUp