If you work with people, work on culture

In my current role as a patient experience leader for a health care system, a large part of my focus is on culture. If you are already familiar with this blog, you have already seen me discuss culture a lot in the context of leadership and in book reviews. I talk so much about culture because it is what makes systems and processes work reliably and without constant auditing.

For years, I have been working to put the pieces together in terms of how to build culture. Using ideas from authors like Simon Sinek, Malcolm Gladwell, Joseph Michelli, and Adam Grant (to name a few), I have created my own definition of leadership and have advocated for articulating a vision and creating systems and processes to bring that vision to life. However putting the pieces together both from research and experience, has at times has felt like a struggle.

Culture CodeThen along comes Daniel Coyle, author of the best-selling book The Culture Code. In this book, Coyle has compiled a clear and well explained definition around the common characteristics of organizations with exceptional cultures that lead to consistently excellent outcomes. Using examples from organizations like Pixar, the San Antonio Spurs, the famous Upright Citizens Brigade improv group, and Navy SEALs, Coyle shows us what these organizations do differently that allows them to deliver results for the enterprise and its people.

The three over-arching characteristics that every group has in common are:

  1. Build Safety
  2. Share Vulnerability
  3. Establish Purpose

Under each of these simple two-word ideas are many different anecdotes, research studies, and case studies that show not only what these concepts mean, but what building them entails for leaders.

He also delves into the nuances of these concepts that may vary depending on the business. For example, in the book he compares organizations that build a culture for high service reliability (Union Square Hospitality Group – think Shake Shack) vs. creativity and innovation (Pixar).

Health care service delivery is an example of a setting where the culture must be built for high service reliability. Much of this work involves creating genuine connections with patients and their families, which helps determine how to meet their needs both including bridging the gaps in their understanding of their condition, the treatment, the workings of a hospital, and the health care system at-large.

Coyle covers the impact of empathizing with the patients in order to the increase their health outcomes and covers how to create an environment for the staff that promotes empathic behavior.

In the book, Coyle discusses a Harvard neurologist named Marci who researched the impact of listening in the medical setting. She studied non-western healers who used methods that were scientifically questionable, yet found that some practitioners had remarkable results.

To explain these outcomes, she says, “What these healers all had in common was that they were brilliant listeners. They would sit down, take a long patient history, and really get to know their patients…They were all incredibly empathic people who were really good at connecting with people and forming trusting bonds. So that’s when I realized that the interesting part wasn’t the healing but the listening and the relationship being formed. That’s what we needed to study” (Coyle p.154).

In health care, we tend to think of communication as “provider to patient”, with the patient simply answering the provider’s questions. As I take a few steps back think about it, wouldn’t someone want to feel known as a person, and not just by a diagnosis? Just listening to the patient gives the provider an opportunity to create that relationship.

Culture in the health care setting, because of the nature of the work at times being life-or-death, is especially important. Guides like The Culture Code help us build those cultures in a safe and sustainable way.

KEY TAKEAWAY: The best companies are deliberate about building their cultures. In health care, specifically, culture can deliver superior patient outcomes if there’s a focus on the caregivers and seeing the patient as a person, rather than a diagnosis.


The Culture Code is available for purchase on Amazon for $28.00 (does not include Prime discount)