Organizational Culture Change: NASA after Columbia and Lessons for Healthcare

1. 1 Organizational Culture Change:NASA after Columbia and Lessons for Healthcare  Thomas R. Krause, Ph.D. Chairman and Co-Founder BST Behavioral Science Technology, Inc. NOTES: Throughout this presentation, edits are required to customize it for your site. For example, edit slide 1 for names and titles as indicated in red. See: Slide 12: green checkmarks Slide 21: their OFS scores Slide 22: their LS scores Note: both 21 & 22 are used again at 61 & 62. Modify slide 65 based on the information from exercise that ends at slide 64. Modify slide 66 as you did slide 1. You must prepare for this workshop by coaching the senior-most leader on their specific role. Specifically, they should be scripted to give a real stretch challenge to the group, tell it’s priority and what he/she will be looking at to evaluate achievement. The object is to create a felt need for help from the consultant in the coachees. All sections before Developing a focus should be completed by lunch. The rest of the day is devoted to developing a coaching focus. Note: everything beyond slide 66 is extra and will be deleted before this is distributed, once it’s finalized.NOTES: Throughout this presentation, edits are required to customize it for your site. For example, edit slide 1 for names and titles as indicated in red. See: Slide 12: green checkmarks Slide 21: their OFS scores Slide 22: their LS scores Note: both 21 & 22 are used again at 61 & 62. Modify slide 65 based on the information from exercise that ends at slide 64. Modify slide 66 as you did slide 1. You must prepare for this workshop by coaching the senior-most leader on their specific role. Specifically, they should be scripted to give a real stretch challenge to the group, tell it’s priority and what he/she will be looking at to evaluate achievement. The object is to create a felt need for help from the consultant in the coachees. All sections before Developing a focus should be completed by lunch. The rest of the day is devoted to developing a coaching focus. Note: everything beyond slide 66 is extra and will be deleted before this is distributed, once it’s finalized.

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3. 3 Project Goals Assessment and Plan: 30 days Measurable progress: 6 months Transform culture: 36 months

4. 4 Initial Scope: Assess & Plan Administer BST Safety Climate and Culture Survey Interviews at 3 locations (HQ, Johnson, Glenn) Review past surveys and other data Recommend plan

5. 5 16 person BST team 2 sub-contractors Top level NASA Steering Team at HQ Site level implementation teams

6. 6 Assessment Findings

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8. 8 Problem statement The Columbia Accident Investigation Board’s view of organizational causes of the accident: 1. Barriers prevent effective communication of critical safety information and stifled professional differences of opinion 2. Failure to recognize that decision-making was inappropriately influenced by past success 3. Acceptance of decision-making processes that operated outside of the organization’s rules

9. 9 Before starting, let me say a few things to establish context. First, organizational culture change is not easy. Many organizations recognize the need to change their culture, but few are really successful at doing it, sometimes in spite of substantial efforts. By definition, organizational culture tends to be stable, and when it does change, it tends to be a gradual process. Knowing these things, leadership within NASA, in response to the Columbia Accident Investigation Report and their own sense of necessity, have taken on the task of transforming their organizational culture. It may be useful to distinguish ‘organizational culture’ from ‘safety climate’. The former, organizational culture, has to do with the values that drive the organization, its beliefs and practices, ‘how we do things around here’. Often these factors take the shape of unstated assumptions, things we just take for granted without thinking about it. ‘Climate’, refers to a particular area of functioning, the things that the organization recognizes, responds to and rewards, at a particular time. Climate tends to be particular, short term and foreground; culture more general, long term, and background. It’s important to understand this distinction because climate changes in response to immediate events and efforts, and culture does not. A single event, like the Columbia tragedy, can change the safety climate in the organization. But unless the right things are done by leadership, the culture of the organization may not change, and since climate changes are short term, after a period of time things go back to the way they were. It’s very likely that the safety climate in NASA changed immediately following Columbia; the challenge is how to assure that the culture also changes. Before starting, let me say a few things to establish context. First, organizational culture change is not easy. Many organizations recognize the need to change their culture, but few are really successful at doing it, sometimes in spite of substantial efforts. By definition, organizational culture tends to be stable, and when it does change, it tends to be a gradual process. Knowing these things, leadership within NASA, in response to the Columbia Accident Investigation Report and their own sense of necessity, have taken on the task of transforming their organizational culture. It may be useful to distinguish ‘organizational culture’ from ‘safety climate’. The former, organizational culture, has to do with the values that drive the organization, its beliefs and practices, ‘how we do things around here’. Often these factors take the shape of unstated assumptions, things we just take for granted without thinking about it. ‘Climate’, refers to a particular area of functioning, the things that the organization recognizes, responds to and rewards, at a particular time. Climate tends to be particular, short term and foreground; culture more general, long term, and background. It’s important to understand this distinction because climate changes in response to immediate events and efforts, and culture does not. A single event, like the Columbia tragedy, can change the safety climate in the organization. But unless the right things are done by leadership, the culture of the organization may not change, and since climate changes are short term, after a period of time things go back to the way they were. It’s very likely that the safety climate in NASA changed immediately following Columbia; the challenge is how to assure that the culture also changes.

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15. 15 ABC Analysis

16. 16 ABC Analysis

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18. 18 Power Factors

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20. 20 Feedback for change: Providing information about performance in relation to a goal Feedback is not praise, not emotional, not gratuitous — it is simply feedback. The key to performance improvement is a feedback-rich environment.

21. 21 Feedback for change: Providing information about performance in relation to a goal Feedback is not praise, not emotional, not gratuitous — it is simply feedback. The key to performance improvement is a feedback-rich environment.

22. 22 Specifically, evaluate the presenting complaint from the point of view of each the Model’s rings. We know how to evaluate culture—OFS. Specifically, evaluate the presenting complaint from the point of view of each the Model’s rings. We know how to evaluate culture—OFS.

23. 23 The leader impacts the culture through his/her Practices. And we know how to evaluate these practices: 360 Leadership SurveyThe leader impacts the culture through his/her Practices. And we know how to evaluate these practices: 360 Leadership Survey

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29. 29 The survey has been modified to also look at how closely the leader approximates the ideal of Transformational Leadership.The survey has been modified to also look at how closely the leader approximates the ideal of Transformational Leadership.

30. 30 Vision Acts in a way that communicates high personal standards in safety Helps others question and rethink their assumptions about safety Communicates the organizational vision through wordand action Demonstrates willingness to consider and accept new ideas Helps people consider the impact of their actions on the safety of others, and on the organization’s safety culture Challenges and inspires people around the safety vision and values Describes a compelling picture of what the future could be

31. 31 Credibility Admits mistakes to self and others “Goes to bat” for direct reports; represents and supportsthe interests of the group with higher management Gives honest information about safety performance, even if it is not well received Asks for ideas on how to improve his/her own performance Acts consistently in setting and applying safety standards Is willing to make safety-related decisions that are unpopular or involve some personal risks Demonstrates personal concern for employee well-being Follows through on commitments made Treats others with dignity and respect

32. 32 Communication Encourages people to give honest and complete information about safety, even if the information is unfavorable Keeps people informed about the “big picture” in safety Communicates frequently and effectively up, down, and across the organization Actively communicates and discusses safety information with direct reports Shares with people the background and reasons for safety policies and procedures Listens actively and with respect to safety concerns that are raised Constructively says what he/she is thinking Asks what others are thinking Makes sure that others feel comfortable and safe in raising issues and concerns

33. 33 Collaboration Promotes cooperation and collaboration in safety Asks for and encourages input from people on issues that will effect them Helps others resolve safety-related problems for themselves Encourages others to implement their decisions and solutions for improving safety Seeks out and listens to diverse points of view Expresses confidence in the ability of others Supports the decisions that others make on their own Gains commitment of others before implementing changes

34. 34 Action Orientation Is proactive rather than reactive in addressing safety issues Gives a timely, considered response to safety concerns Demonstrates a sense of personal urgency and energy to achieve safety results Performance driven — delivers results with speed and excellence Focuses safety efforts on the most important priorities Shows persistence in solving safety problems Does whatever it takes to make safety improvement initiatives successful Seizes safety improvement opportunities whenthey arise Is creative and innovative in improving safety

35. 35 Feedback and Recognition Publicly recognizes the contributions of others Readily recognizes people for safety work well done Praises safety efforts more often than criticizes them Gives positive feedback and recognition for good performance Finds ways to celebrate accomplishments in safety

36. 36 Accountability Gives people a fair appraisal of their efforts and results in safety Clearly communicates people’s roles in safety Fosters a sense that people are responsible for the level of safety in their organizational unit Sets clear responsibilities in safety for direct reports Holds people accountable for meeting their commitments Regularly reviews with direct reports indicators of their safety performance

37. 37 Leadership Survey Results

38. 38 This leadership style has been shown to favorably impact safety outcomes and to develop the leadership abilities of reports as well as to incline the leader to best practices. It is of course easier for some personality types than others.This leadership style has been shown to favorably impact safety outcomes and to develop the leadership abilities of reports as well as to incline the leader to best practices. It is of course easier for some personality types than others.

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40. 40 Transformational Leadership Dimensions Workshop Average Score

41. 41 This is where it all starts. The big 5 are stable over a lifetime. Thus, it pays to know yourself–then you can build on strengths and compensate weaknesses. This is where it all starts. The big 5 are stable over a lifetime. Thus, it pays to know yourself–then you can build on strengths and compensate weaknesses.

42. 42 But our graphic is flat, 2D. What we have said is that leadership is multi-dimensional. But everything we have been saying up till now is that leaders are multidimensional so we really need a multidimensional graphic.But our graphic is flat, 2D. What we have said is that leadership is multi-dimensional. But everything we have been saying up till now is that leaders are multidimensional so we really need a multidimensional graphic.

43. 43 Using the safety leadership excellence model for culture changeIntervention Plan

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45. 45 Say coaching specifically Review each item with Scott/PatSay coaching specifically Review each item with Scott/Pat

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47. 47 Early results

48. 48 These efforts are starting to have impact, although it is still early. We are seeing leaders beginning to do things differently – seeking out other opinions, inviting feedback, listening more carefully, generally encouraging upward communication, and giving their support of the change effort. Equally important, the people working on these initiatives are positive, even enthusiastic, and optimistic about the changes that are taking place. In September we will examine and document where specific progress has been made, and incorporate learnings into the broad intervention plan. These efforts are starting to have impact, although it is still early. We are seeing leaders beginning to do things differently – seeking out other opinions, inviting feedback, listening more carefully, generally encouraging upward communication, and giving their support of the change effort. Equally important, the people working on these initiatives are positive, even enthusiastic, and optimistic about the changes that are taking place. In September we will examine and document where specific progress has been made, and incorporate learnings into the broad intervention plan.

49. 49 Indications of progress (continued) One Implementation team had a well-known skeptic as a member. After observer training he got up and told the group that he hadn’t been in favor of this, but now that he understood it he thought it was going to make a big difference. Individuals requesting to have 360 leadership survey done to provide them with feedback Training evaluations consistently indicating that participants arrived as skeptics and left as believers (“prisoner” to “advocate”) Division Chiefs giving each other feedback in a staff meeting, referring to the coached behaviors Observer invited to observe MMT meeting

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58. 58 In summary… Changing culture is essentially about leadership, and we have seen that NASA’s leadership is committed to making these changes. The safety climate at NASA remains very strong. Progress has begun on the harder, longer-term job of changing the culture. This is necessary in order to assure that the current strong climate continues to be sustained and that the value for safety remains a strong influence in the future. If present activities and trends continue, it is likely that NASA will be successful in transforming its culture. In summary, changing culture is essentially about leadership, and we have seen that NASA’s leadership is committed to making these changes. The safety climate at NASA remains very strong. Progress has begun on the harder, longer-term job of changing the culture. This is necessary in order to assure that the current strong climate continues to be sustained and that the value for safety remains a strong influence in the future. If present activities and trends continue, it is likely that NASA will be successful in transforming its culture.In summary, changing culture is essentially about leadership, and we have seen that NASA’s leadership is committed to making these changes. The safety climate at NASA remains very strong. Progress has begun on the harder, longer-term job of changing the culture. This is necessary in order to assure that the current strong climate continues to be sustained and that the value for safety remains a strong influence in the future. If present activities and trends continue, it is likely that NASA will be successful in transforming its culture.

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60. 60 Organizational Culture Change:NASA after Columbia and Lessons for Healthcare  Thomas R. Krause, Ph.D. Chairman and Co-Founder BST Behavioral Science Technology, Inc. NOTES: Throughout this presentation, edits are required to customize it for your site. For example, edit slide 1 for names and titles as indicated in red. See: Slide 12: green checkmarks Slide 21: their OFS scores Slide 22: their LS scores Note: both 21 & 22 are used again at 61 & 62. Modify slide 65 based on the information from exercise that ends at slide 64. Modify slide 66 as you did slide 1. You must prepare for this workshop by coaching the senior-most leader on their specific role. Specifically, they should be scripted to give a real stretch challenge to the group, tell it’s priority and what he/she will be looking at to evaluate achievement. The object is to create a felt need for help from the consultant in the coachees. All sections before Developing a focus should be completed by lunch. The rest of the day is devoted to developing a coaching focus. Note: everything beyond slide 66 is extra and will be deleted before this is distributed, once it’s finalized.NOTES: Throughout this presentation, edits are required to customize it for your site. For example, edit slide 1 for names and titles as indicated in red. See: Slide 12: green checkmarks Slide 21: their OFS scores Slide 22: their LS scores Note: both 21 & 22 are used again at 61 & 62. Modify slide 65 based on the information from exercise that ends at slide 64. Modify slide 66 as you did slide 1. You must prepare for this workshop by coaching the senior-most leader on their specific role. Specifically, they should be scripted to give a real stretch challenge to the group, tell it’s priority and what he/she will be looking at to evaluate achievement. The object is to create a felt need for help from the consultant in the coachees. All sections before Developing a focus should be completed by lunch. The rest of the day is devoted to developing a coaching focus. Note: everything beyond slide 66 is extra and will be deleted before this is distributed, once it’s finalized.