What do we mean when we discuss culture, which is sort of an all-encompassing word that seems difficult to pin down, or can be a rather nebulous way to refer to something bigger than any one individual or team.

Many definitions are available to describe culture. Formally, culture can be defined as “the [predominant] beliefs, values, attitudes, behaviors, and practices that are characteristic of a group of people” (Warrick, 2015).  Culture can usually be described as the symbols, power structures, organisational structures, control systems, rituals & routines, and stories of a group.

Why does culture matter, well for starts let’s look at some differences between high and low performing cultures.

High Performance Cultures	Low Performance Cultures
Leaders are skilled, admired, and build organizations that excel at results and at taking excellent care of their people and their customers	Leaders provide minimal leadership, are not trusted and admired, and do little to engage and involve their people
Clear and compelling vision, mission, goals, and strategy	Vision, mission, goals, and strategy are unclear, not compelling, not used, or do not exist
Core values drive the culture and are used in decision making	Core values are unclear, not compelling, not used, or do not exist
Committed to excellence, ethics, and doing things right	Lack of commitment to excellence, questionable ethics, and a reputation for doing what is expedient rather than what is right
Clear roles, responsibilities, and success criteria, and strong commitment to engaging, empowering, and developing people	Unclear roles and responsibilities and little interest in fully utilizing and developing the capabilities and potential of people
Positive, can-do work environment	Negative, tense, stressful, and/or resistant work environment
Open, candid, straightforward, and transparent communication	Guarded communication, reluctance to be open and straightforward, and consequences for saying things leaders do not want to hear
Teamwork, collaboration, and involvement are the norm	Top-down decision making with minimal teamwork, collaboration, and involvement
Emphasis on constant improvement and state-of-the-art knowledge and practices	Slow to make needed improvements and behind times in knowledge and practices
Willingness to change, adapt, learn from successes and mistakes, take reasonable risk, and try new things	Poorly planned change, resistance to change, minimal learning from successes and mistakes, and either risk averse or risk foolish

Culture can either be built in a purposeful way or left to chance. As we strive for excellence we need to be methodical about building and sustaining cultures we want to drive excellence. A few guidelines then:

1. Make strategy and culture important leadership priorities
2. Develop a clear understanding of the present culture
3. Identify, communicate, educate, and engage employees in the cultural ideals
4. Role model desired behaviors
5. Recruit and develop for culture
6. Align for consistency between strategy and culture
7. Recognize and reward desired behaviors and practices
8. Use symbols, ceremonies, socialization, and stories to reinforce culture
9. Appoint a culture team
10. Monitor and manage the culture

What most of struggle with is how to actually do that. Of the many papers and articles I’ve read on the subject, my favorite might be from the International Society of Pharmaceutical engineers (ISPE).

The ISPE in 2015 introduced a cultural excellence framework which was expanded on in their 2017 Cultural Excellence Report. I’ve returned to this report again and again and continue to mine it for ideas for continual improvement and change in my organization.

The six dimensions to build and maintain cultural excellence are:

1. Leadership and vision: Leaders establish and engender the vision for the organization. Their thoughts, words, and actions about quality are critical in establishing and maintaining a culture of operational excellence. Leadership and vision, therefore, play a key role in establishing the culture, either within a local manufacturing site or across the company.
2. Mindset and attitudes: These play a key role in driving cultural performance, although they can be difficult to define, observe, and measure. Leaders can assess, monitor, and develop the desired cultural excellence mindset and attitudes within their organizations, using the practical and powerful approaches outlined in this report.
3. Gemba walks: Management engagement on the floor is a powerful way to demonstrate quality commitment to all members of the organization. Gemba walks allow site leaders to communicate clear messages using open and honest dialogue, and provide a real indication of progress toward desired behaviors at all levels. Gemba walks also empower front-line employees by recognizing their contributions to site results and involving them in problem-solving and continuous improvement.
4. Leading quality indicators and triggers: There are inherent links between culture,
   behavior, and leading quality indicators (LQIs) that drive desired patient-focused
   behaviors. Monitoring and surveillance of key triggers and the design of LQIs are highly recommended practices to help shape cultural excellence.
5. Oversight and review: Management oversight and review practices that engage both management and employees support a healthy quality culture because they demonstrate transparency, facilitate dialogue, bring attention to issues so they can be addressed, and highlight best practices so they can be replicated.
6. Structural enablers: These support the desired behaviors, help speed the pace of change, and improve performance over time. They include:
   –– Develop a learning organization
   –– Establish learning teams
   –– Influence and recognize organizational change
   –– Solve problems proactively
   –– Identify true root cause

Sources

• R.D. Day. Leading and Managing People in the Dynamic Organization. Psychology Press, London, UK (2014)
• ISPE. Cultural Excellence Report. ISPE, Bethesda (2017)
• R.N. Lussier, C.F. Achua. Leadership: Theory, application, and skill development (6th ed.), Cengage Learning, Boston (2016)
• D.D. Warrick, J. Mueller (Eds.), Lessons in changing cultures: Learning from real world cases, RossiSmith Academic Publishing, Oxford, UK (2015)