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The main reason why many cultural change and transformation programmes in large organizations fail is because you can’t change ‘the culture’. Not because ‘you can’t’, as the silly article in HBR says, but because there isn’t one. There are many subcultures interacting and overlapping, and only an illusion of an overriding one, that only exists in theory. This is hard to accept when many people, particularly at the top of those large enterprises, talk about ‘our culture’.

Take the example of the British National Health Service (NHS). Many people say ‘they need to change the culture’, but it is not clear to me ‘what culture’. The whole thing? OK, so is it because staff don’t care? Oh no, people may say, staff are very caring. So, it is that it is over-managed in a bureaucratic way? Well, a bit, people may say, but it needs some structure. Ok, let’s try again, money? It’s money, surely, not enough. Yes, maybe. OK, that is not a lot of ‘culture’ but a political decision. Mmm, perhaps it’s ‘complexity’. Most likely. Etc.

That was a caricature dialogue. If we had time and went down and down, you’ll find the following:

  1. There are incredibly good people doing their best and dedicating their life to the service. You want ‘those cultures’.
  2. There are plenty of examples, all local or regional, where things are changing exponentially for the better (service, patient-centrism). Can I have these please?
  3. When all discussions about processes and systems and structures and money have been exhausted, you’ll find that many changes needed are in fact behavioural changes. Not efficiency (process) but behaviours.
  4. Those behaviours may not have  been crafted properly, other than at a very high, non-operational level (‘we want a culture of trust’; me too, but, (1) what is it? and (2) how can I get one?)
  5. There is no behavioural change plan in place, or not one that is really effective and follows the rules of large-scale behavioural change.

My hypothesis is that a massive, miraculous, top-down ‘change programme’ in those large organizations will be unworkable, most likely mis-directed (e.g. ‘a communications plan’) and potentially dangerous. Why the latter? Because every time an ill conceived ‘change programme’ fails, the next well conceived one has a big mountain to climb. Thanks for the favour.

The key to large scale, behavioural based, patient-centric ‘change’ is to localize those efforts to reasonable clusters and focus on a well conceived and orchestrated Push and Pull, simultaneous ‘local’ plan. The Push has to do with communicating the direction of travel. The Pull is bottom up, and peer-to-peer (nurses to nurses, doctors to doctors, patients to patients, for starters). But it must be orchestrated properly following strict ‘social movement rules’; not left to awareness workshops, and the worship of passionate people and self-appointed change agents.

A mountain on fire, starts with a little fire here, a little fire there, and suddenly joining and scaling up. The mountain is on fire. You don’t get the mountain on fire by having somebody with a match for every single tree. Or running workshops about the quality of the trees. Or the readiness to change by the arsonists. Or the personality traits of the tree managers. Or… the mountain of fire plan needs a good orchestration.

Forget ‘the culture’. It is a distraction. Work on as many localized sub-cultures of a reasonable size as possible. This has to allow for Viral Change™ mechanisms to work. It is 75% bottom up and 25% top down. And this is no matter how much money, which politicians, how much love and passion are individually placed every day, let alone how many intellectual workshops you can run.

The answers for those large organizations is in grassroots, social movements for a cause. You can’t have anybody in charge of this who does not know how social movements work. That excludes men and women of one book, and an MBA as sole credentials. No single domain has an answer. It’s an orchestra.



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