Academic journal article Organization Development Journal

Safety at the Center: A Model That Accelerates Learning

Academic journal article Organization Development Journal

Safety at the Center: A Model That Accelerates Learning

Article excerpt


In designing a leadership development program to help leaders change the culture of a major medical center, we accelerated learning by introducing practices that created a safe place to learn. We practiced "choice-based change" by paying careful attention to the hidden drivers of change, choice and control. On 360-degree pre- and post-tests we found significant positive change on 89 of 94 items and culture scores improved significantly. Bottom line profitability increased significantly as well.

Safety at the Center: A Model that Accelerates Learning

Healthcare is a complex, fast-changing industry. The University of Maryland Medical Center has 6,600 employees and a total of 669 licensed beds, 265 of them intensive care beds. Over 1,000 attending physicians work there. Together they serve over 300,000 patients a year, including those referred for the most serious, complicated problems. Critical partnerships are required between care providers with vastly different kinds of training. Physicians, vital partners in the care process, are not employed by the hospital. Technologies change at a rapid rate. As a result, care providers are continually required to learn new protocols and develop new routines. Administrators juggle priorities to find funds for capital costs. Margins are small and competition is fierce.

In the late 1990's the medical center had a difficult time financially. Using the Denison culture survey (Denison & Neale, 1999), the medical center leadership determined that the organizational culture was having a negative impact on financial performance. The CEO, senior vice presidents, and vice presidents learned that they needed to change the culture to increase their profitability and achieve their goals. The low scores on the Denison survey and a subsequent 360-degree leadership survey indicated that directors needed new skills to effectively lead through change. Our plan was to design a change leadership program to help directors lead during turbulent times.

Developing whole leaders

Learning is critical for leaders, especially those in complex, fast-moving industries, such as healthcare. But the kind of learning necessary to develop strong leaders is the kind that requires introspection, a notion that is counterintuitive in fast-paced organizations. As the OD consultants who developed the change leadership program, we observed that participants had more insights and were willing to explore topics in more depth when activities are structured in a way that reduced the likelihood of participants' experiencing unwanted exposure. As a result of this observation, we developed practices and processes that helped participants increase their sense of control in the group setting. We found that the more we respected their privacy, the more openly participants explored on a personal and group level. We paid such careful attention to developing a climate of safety that we began to call it a science of safety.

This paper describes the use of processes that increase a sense of safety among participants in a learning setting. It provides an overview of each step in the process of preparing leaders to learn, from getting ready, inviting participation, inquiring, managing participation, and providing a theoretical base for increasing internal awareness. This approach led to positive business outcomes in many areas of the business.

What we discovered about the importance of safety surprised us. We learned that the level of openness and creative exploration increased when we adhered to practices that protected individuals' right to choose their level of engagement and exposure. We used the data that emerged from the group as the training program progressed to understand what was needed next, and used emergent design strategies, designing as the data was revealed to us, to meet directors' needs.

Our goal was to help leaders develop the skills and relationships they needed to make the culture stronger and healthier. …

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