Key Drivers of an Organisation’s Culture

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The ability to lead change is a critical quality of an effective leader. Many would argue that our assessment of a person’s ability to inspire and implement change helps us decide if a person is a good manager or a great leader.

Most health care organisations are struggling with potential disruptors, including digital transformation, increasing patient volume and acuity, staffing shortages and changing patient and family expectations. Any healthcare organisation that is unable or unwilling to change is most likely facing a very grim future. Organisations need leaders to be skilled at leading change efforts, but the reality is that most have no formal training or experience on what it takes to make a change effort work well.

When it comes to change management, our ability to understand culture and lead cultural transformation is linked to creating confidence in the individuals we are asking to try something new, adopt new behaviours, change the way they solve problems, or modify the way they communicate. In this module, the three most powerful drivers of culture will be explored and linked to effective leadership through change.



Most organisations have values and a mission posted on their website. They are presented to the organisation in a polished and idealised way. However, those become obsolete if the leaders and key influencers do not role model those values. People in the organisation will copy the behaviours of their leaders in order to be like them and create a sense of belonging, with the belief that the display of those behaviours will help them fit in and be successful. We learn this by looking around, mainly toward our leaders. What behaviours helped elevate them to the top? All become symbols, which we will discuss later. By themselves, behaviours are one of the most powerful tools leaders have to design and change the culture. If leaders and the key influencers can change their own behaviours by living more aligned with the values declared, people would understand, accept, and adopt it faster.

If you notice, as a leader, that people are not displaying the behaviour you would like to see in the organisation, you need to first look at yourself and ask: “What am I (and my colleagues) doing that might cause others to believe it is the right behaviour?” The interesting thing is, we are all leaders or an example to someone else in the organisation. So, in the end, we can all do something about it. The question is: How can you respond to the challenge?

Understanding how behaviours influence the culture is a great way to create change. How can you role model the behaviour you would like to see in the organisation?



These are related to all the processes you have in place in your organisation. Some might be based on historical decisions and others might be more recent or born out of necessity. How is success in the organisation measured, and how is it reported? What HR processes are in place, how is compensation defined, and what is the bonus scheme based on? How is a budget allocated? These are all examples of systems at play. Systems are deeply ingrained in an organisation and can be difficult to change. The question to change culture toward the behaviours you need should never be about the systems you currently have, but rather about the systems you will need two to three years from now. You need to stand in the future. Once you are there, look back to define the plan to get there.


Activity #1

Where do you see an opportunity for a systemic change in your organisation to create the culture you need? If you had a magic wand?


How to complete this activity and save your work: Type your responses to the questions in the box below. When you are done answering the question navigate to the ‘Export’ page to download and save your response. If you prefer to work in a Word document offline you can skip right to the Export section and download a Word document of this exercise there.

Reflection Exercise



These are the most visible and recognizable. When you walk into an office building, you can get a first sense of the culture by observing people at work, how things are organised, who is where, what you see on the walls, parking lot allocations, office spaces and how people talk to each other.

Other meaningful symbols include the way a budget is allocated, how time is invested, who is promoted and who is not, and how accomplishments are celebrated. Are they individuals or teams? What values and what results are taken into account? Does any of this sound familiar?

One of the more relevant symbols is the story or stories being shared. Like any other community, we often share stories about how things were created and who succeeded (even creating myths). We share stories that are funny and stories about failure. We share learnings, and many times we talk about cases and people. We create symbols, ideas, myths, and a future based on history. One of the most powerful assets for cultural change might be which stories are being shared in the organisation. When linked with behavioural change and new systems, everything comes together, making sense to people in a faster, more effective way.


Activity #2

Reflection Exercise


Culture is a never-ending process of defining and redefining who you are as an organisation — and finding new ways to bring this alive in new contexts, with new people, addressing different challenges. You are always designing the culture, and you create a significant amount of change in a short period of time. You might call it a project if you want to “shock” the systems to address big challenges and to get specific budget and focus. However, culture — as a concept and as a whole — will continue to evolve. It will need to be taken care of beyond your timeframe, and there will not be a day where you say, “We did it!”

Having this mindset will change the way you think about culture change.


Activity #3

Reflection Exercise



Check Your Understanding


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Leadership for Nurses in Clinical Settings Copyright © 2022 by Dr. Kirsten Woodend, Dr. Catherine Thibeault, Dr. Manon Lemonde, Dr. Janet McCabe is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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