In a previous article, we discussed the all too common problem of healthcare professionals remaining silent about impaired or incompetent colleagues, thereby endangering the care of patients. We hinted that organizational culture played a large part in this behaviour.
Another related, malignant, and no less common symptom of dysfunctional organizational cultures is indecision.
You are probably familiar with this situation: one person (usually the most senior member) dominates the conversation in a lengthy meeting, performing something of a monologue in the process, but no decisions are made. This is just an example. Indecision, when present, tends to pervade the entire organization, affecting both small and big decisions alike.
For most companies, when indecision sets in, profits might fall, market share might be lost, staff morale might suffer.
However, for healthcare organizations, when indecision becomes ingrained in the culture, not only may all the ill effects above be seen, but the quality of care and patient safety can be compromised.
In his classic Harvard Business Review article “Conquering a Culture of Indecision” [PDF—268 KB], Ram Charan shares his insights into this corporate disease.
Charan suggests that instances of indecision in organizations are due to people failing to connect and engage with one another. In indecisive corporate cultures, people are hindered by “group dynamics of hierarchy”, and those who need to execute the plan lack commitment and fail to act decisively.
According to Charan, leaders create a culture of indecisiveness; they can also break it.
His remedy is through “decisive dialogue”—interactions between employees that promote intellectual honesty and trust—which is both exemplified and encouraged by leaders. Charan’s belief in the power of dialogue to change corporate culture is encapsulated in this sentence:
Indeed, the tone and content of dialogue shapes people’s behaviors and beliefs—that is, the corporate culture—faster and more permanently than any reward system, structural change, or vision statement I’ve seen.
Further, honest dialogue needs to be entrenched in the organization’s social operating mechanisms, i.e. meetings, reviews, and other situations through which people in the organization transact business—clear lines of accountability for reaching and executing decisions have to be established.
Finally, follow-through and feedback are required in creating a decisive culture. Through honest feedback, high performers are rewarded, struggling employees coached, and progress-blocking behaviours discouraged.
Decisive dialogue (and action) is not easy to instil throughout the organization but leaders who achieve this can transform an anaemic organization into a dynamic one.