by David Bright
Several years ago I had the chance to visit an extraordinary hospital, ProHealth (a pseudonym) in the Northeastern United States. It was an astonishing experience and a great example of the principles of extraordinary organizing at work.
The buildings and grounds were stunning. Quiet, classical music played from hidden speakers in the parking area, which was broken up by beautifully kept gardens. The main entrance had sweeping cathedral ceilings. Natural light penetrated every corner. A grand piano played a soothing tune in the lobby while a waterfall trickled down from the second floor into a small garden area. One could not help but feel that this was a different kind of place, a place of healing and compassion.
As our guide ushered us around the facility we were impressed to see that this feeling permeated the whole building. Each ward was organized into pods of rooms, with nursing stations hidden in out-of the-way locations. All the hallways were carpeted and there were small, family friendly mini-kitchens scattered throughout the building where visitors could cook or share a meal with patients. Our guide explained that volunteers regularly baked homemade bread, just to fill the halls with the scent of home-baked cooking. Then he paused for a moment when the opening bars of Braham’s Lullaby played over the speakers to note “You hear that? It means another baby was just born!”
This was truly an innovative place, a place with an air of genuineness and authenticity. Smiling, supportive nurses and housekeepers felt it important to do helpful, small things. Stories of innovation and creative thinking were abundant. Employees seemed genuinely empowered. An atmosphere of mutual respect was apparent in the interactions between people. Even where they disagreed, it was inspiring to see how they came together.
With this first impression as a background, I was fascinated to learn the difficult story about the emergence of this exemplary organization.
A History of Severe Conflict
In the decade before our visit, a number of larger healthcare organizations had made inroads into the hospital’s doctor and patient base. ProHealth had responded with a comprehensive, employee-driven strategy. They used a participatory process to ask employees for perspective and advice. They designed a new, very patient-friendly hospital, created cost-cutting measures, and improved customer service. These efforts were championed by the COO, Scott Patterson (another pseudonym), who enjoyed a reputation among the 750+ employees as one of the most charismatic, compassionate leaders they had ever known. Throughout the organization, he was noted as a key leader and champion of change—an individual who seemed to have a natural capacity for galvanizing employee support.
Then, a series of unexpected, negative events created shock-waves throughout the organization. Most notably, Patterson suddenly resigned without explanation. Employees responded with outrage, speculating that two top administrators were corrupt and had felt threatened by Patterson’s success. Unconfirmed rumors were rampant that these administrators had suggested a direction for the hospital that Patterson would not support, and that he had resigned on principle.
Employees launched an all-out campaign to win Patterson back. After three months and an intense public relations fiasco, the hospital’s board eventually asked the two administrators to resign and offered Patterson the post of President and CEO. The day Patterson returned, he was greeted by over 300 hundred cheering employees.
Unfortunately, the hospital’s financial position had deteriorated because of the crisis and because of recessionary pressures in the local economy. For six months, Patterson and his team deliberated over the challenges by engaging employees and asking for ideas and perspective. Yet, they eventually came to the difficult decision that an equivalent of 10%, or 75 positions, had to be eliminated.
A POS Perspective
Now, let’s pause here and consider what it must have been like at that moment. Things were bad. Very bad. Employees were worried. The residual effects of deep conflict were still in the air. The impact of the decision was likely to cause severe pain for many of the organization’s members. If you were Patterson what would you do?
A POS perspective offers an interesting perspective for addressing such concerns.
Consideration #1: At what point on the POS continuum is the organization right now, and what kind of change do we really want to create?
One of my good friends, Kim Cameron, and I have observed that Positive Organizational Scholars sometimes use an interesting framework for understanding and exploring the unique dynamics of extraordinary organizations [1]. Roughly speaking, we can think of this framework in three states: the dysfunctional state, the ordinary-equilibrium state, and the extraordinary state.
The dysfunctional state is a condition of negative deviance and spiraling entropy. Organizations in this extreme state are at serious risk. They may be unprofitable, ineffective, and inefficient. A toxic atmosphere may prevail and unethical behaviors may be commonplace. Metaphorically, this is like the patient in the hospital.
At the other extreme, the extraordinary state is a condition of positive deviance. In the extraordinary state organizations thrive and contribute value to society; they are not merely effective, but excellent. Quality is off the charts. Interpersonally, people honor one another and organization members feel valued. Flourishing occurs at every level. Metaphorically, this state is akin to Olympic-level fitness.
In reality it is rare for any organization to function all the time at either extreme, which explains the “in-between” or “ordinary state.” This is because both people and organizations tend crave stability, steadiness, and predictability. It is typical for change to be accepted so long as it reinforces perceptions of norms, while change is resisted if these perceptions are challenged. As both people and organizations, we are conditioned to be rather ordinary because the extreme state—in either direction—is difficult to sustain.
This framework presents an interesting observation. On the one hand, there is an inherent momentum in the human condition to heal and return to the ordinary state: most people and organizations resist being in the hospital or “on-the-ropes.” When there is a perception that crisis is imminent, people often rally to embrace and support measures that lead to their collective survival. Yet, on the positive side of the continuum, there is also resistance to change. Think about the Olympic athlete who has to maintain a rigorous regimen to stay in top shape. The moment this athlete slacks off, even a little, he or she will slide toward the ordinary state. Similarly, the moment any high-functioning organization slacks off, it will also slide back toward the ordinary state.
To get back to Patterson’s dilemma, when presented with the opportunity to think through a moment of crisis, he may have asked himself a simple but critical question: Is the change we are proposing intended to repair or fix a dysfunctional aspect of the organization (e.g , to return us to the ordinary state), or is the change intended to extend or elevate the strengths in an organization?
If we want to build truly extraordinary organizations, then we have to commit to the principles that are required to get there, not just in the good moments, but in the extreme moments too. In fact, the commitment to POS is most tested during the tough times. This is when the authenticity and resolve of people to follow a POS path is most demonstrated.
Question 2: How can we build the positive potential of our organization through this difficult moment?
It is at the moment of crisis that the true character of an organization is tested. When confronted with a crisis, many companies and leaders tend to hunker down. Yet, these are times when people are deeply passionate and often willing to get involved if given the chance. POS research tells us of a least three critical conditions that need nourishment if an organization is to be or become extraordinary:
- An atmosphere of connectedness. It is crucial for people to feel connected to one another and to the organization. For example, Jane Dutton and her colleagues [2] have observed that when people are engaged with one another in “high quality relationships,” they are more forgiving, they are more inclined to share their ideas and creativity, and they can also help one another make sense of and deal with difficult circumstances.
- A sense of purpose and hope. It is important that people have an idea of “what could be” to inspire their thinking and action. This can be described as a “heliotropic pull,” which comes from the biological term used to describe how a plant tracks the sun across the horizon. In difficult moment, people need a source of energy to pull them forward. They need a personally meaningful, self-determined vision that there may be better times in the future [3].
- Conversations filled with inquiry and a concern for others’ perspectives. When people feel threatened or at risk, these negative emotions kick in their defensive mechanisms. Physiologically, people can’t help but think about survival when they are concerned about self-preservation. The best way to counter this very natural tendency is to questions that invite people to think about the situation from other points-of-view. There are a number of ways to do this. For example, Appreciative Inquiry is a POS-related methodology that encourages visioning and perspective-building through positive questions [4].
Patterson’s Approach
Interestingly, Patterson and his team were highly successful in nurturing the conditions I’ve just described. First, they continued to engage employees as much as possible. A series of meetings were held with employees over a period of two months in a variety of formats. The intention wasn’t just to inform their people about the decisions that were taking place. They wanted to listen. They asked searching questions to deeply explore feelings and perceptions in the organization. They asked for innovative ideas about how best to carry out the downsizing decision. Every member of the organization was actively encouraged to submit their ideas through small and large-group conversations. These discussions were not always easy, but they made a significant difference in helping to reinforce or build connections among employees across the whole system.
Second, Patterson and his team insisted on developing a lofty vision for the future of the hospital. They didn’t just think about survival, they worked hard to create a strategy that would establish the organization as a key player in a sustainable niche in the market. They constantly talked about preserving a culture of caring and compassionate care. They worked to exemplify these ideals in their behaviors and conversations.
These initiatives were mirrored at every level of leadership. Department managers held several open discussions with their members to keep them informed and invite input. A number of useful ideas were generated. In one nursing department, for example, the employees collectively asked to reduce hours across the board in their department, rather than release anyone. Other departments came up with similarly self-driven ideas.
Because the process was employee-driven, the implementation of the restructuring plan was remarkably smooth. Remaining employees were extremely dedicated to the success of the organization and within 10 months the hospital had completely recovered its financial position. Nearly every employee that lost a job was eventually invited back. All this was possible because Patterson and his leadership team had nurtured a sustained POS- oriented dynamic that helped people stay connected, feel a sense of purpose and hope, and focused on the broad picture.
The result was that this moment of crisis became a major source of energy for the future. ProHealth employees were passionately committed to the organization because they felt like the organization was committed to them. They felt this commitment at their core because it had been tested and proven during the tough times.
This story teaches us that moments of crisis, though difficult, are also moments of truth. These are the times when the true character of organization becomes transparent.
For this reason, the principles that build a positive organization are perhaps more important during turbulent times. In highly functional organizations, positive, appreciating dynamics make it possible to harness the potential energy found in negative forces. Where difficult decisions have been made, people are able to talk openly and honestly about the pain they are suffering, while working pro-actively to envision a distinct, positive future. If a positive dynamic is strong in such circumstances, an appreciative understanding of the negative can provide substantial fuel for later transformational change.
[1] Bright, David S. and Cameron, Kim L. (in press). Positive organizational change: What the field of POS offers to OD practitioners. In J. Stavros, W. J. Rothwell, & R. Sullivan (Eds), Practicing organization development: A guide for consultants. San Francisco: Pfeiffer.
[2] Dutton, J. E., & Heaphy, E. D. (2003). The power of high-quality connections. In K. S. Cameron, J. E. Dutton, & R. E. Quinn (Eds.), Positive Organizational Scholarship: Foundations of a new discipline (pp. 263-278). San Francisco: Berrett Koehler.
[3] Bright, David S. and Cameron, Kim L. (in press). Positive organizational change: What the field of POS offers to OD practitioners. In J. Stavros, W. J. Rothwell, & R. Sullivan (Eds), Practicing organization development: A guide for consultants. San Francisco: Pfeiffer; and Cameron, K. S. (2008). Positive leadership: Strategies for extraordinary performance. San Francisco: Berret-Koehler.
[4] Bright, David S. (2009) Appreciative Inquiry and Positive Organizational Scholarship: A philosophy of practice for turbulent times. OD Practitioner, 41(3): 2-7.