1. Pulse check on group culture
Physician Practice Roundtable
Pulse check on group culture
Understand why culture matters and pinpoint your group’s cultural strengths and weaknesses
Board Update from the Physician Practice Roundtable
May 2019
Today, we’re going to talk about culture—what is it, how does ours stack up, and what could we do to improve?
Sometimes these conversations can get a little vague. Culture is often an ambiguous word, both hard to define and hard to measure.
Our colleagues at the Advisory Board have done some work to make culture a more meaningful, and more measurable, concept that I want talk through today.

2. Distinct yet interconnected concepts
Mission, vision, culture at heart of medical group identity
Mission
“Why we exist”
Current ambition
What do we do today, and for whom?
Communicates purpose and direction to employees, customers, vendors and other stakeholders
Culture
“How we act”
“Consistent, observable patterns of behavior in organizations”
A shared understanding of “the way things are” in an organization
Vision
“What we want to be”
Future ambition
Functions as the "north star" – how do individuals contribute to long term goals?
How is the world different because this group exists?
Source: accessed 5 June, 2013; , accessed 5 June, 2013; accessed 5 June 2013; Advisory Board interviews and analysis.
Starting with a definition of what culture is. It’s actually easier to do this by ruling out what culture is not—and that’s our mission, vision, and values. Mission and vision matter, and they’re related to culture, but they’re not the same thing.
So what is the distinction between each of these concepts?
Mission is our current purpose or role in the health care industry. For example: “We provide high-quality, low-cost care to members of our community.”
On the other hand, vision is forward looking. It describes an aspirational goal we’re working towards. This might look something like: “We strive to be the premier patient-centered medical home in the Northeast.”
But neither of those things are culture. Culture is simply defined as “how we act.” It’s the aggregation of all the different behaviors that an organization engages in, incents, and tolerates. It’s an understanding of “the way things are done.”
When we define culture this way, it stops being so intangible, because we can look at concrete decisions and behaviors in our medical group that reflect how we act. And those are things that we can measure.

3. Making culture more measurable and actionable
Culture is a metric with specific, interrelated drivers
ELEMENT 3
Infrastructure
Investments that support and reinforce the priorities and values incorporated in the vision
ELEMENT 2
Talent management
Decisions that reinforce the vision at every stage of the employee life cycle
ELEMENT 4
Leadership commitment
Priorities and organizational structures aligned with the vision
ELEMENT 1
Cohesive vision
What the medical group intends to achieve
Why is the health care community better off for the existence of this group?
Source: Advisory Board interviews and analysis,
With that definition in mind, we can separate culture out into four elements:
First, cohesive vision: Do we have an aspirational goal that our group is working towards?
Second, talent management: Are we hiring, firing, and promoting people in a way that advances our vision?
Third, infrastructure: Are we making investments in technology and processes that support our vision?
And finally, leadership commitment: Are the actions and priorities of our leaders in line with the group’s vision?
From there the question is, do the operational components on the right side of this slide align with the vision that’s on the left? That’s what makes a strong culture—when the day-to-day operations support a clear vision.
[See the next two slides for more information on what feeds into these four elements if you would like to share that with your board. If you are interested in running the culture intensive at your group, the questions our survey ask are along the lines of the bullets on those two slides.]

4. Exercise: What is our group’s vision?
Define our medical group’s vision in your own words ”
[Add vision statements here]
Source: Advisory Board interviews and analysis,
[Slides 6-7 are designed to help you narrow down on a vision statement for your group. If your group has a vision statement that meets the attributes on slide 7, skip to slide 8 to discuss how your group’s operations support this vision statement.]
The goal of this discussion is to determine whether your group has a cohesive vision or whether there’s variability in how those in your group define it.
Follow these instructions to complete the group exercise:
Start by asking everyone to offer up their understanding of the group’s vision statement. This works well by having everyone write them down separately so participants aren’t influenced by what’s already been said. Alternatively, you can have participants build upon the first participant’s statement.
Add each person’s vision statement to the text box on this slide or write them on a whiteboard or large sheet of paper in the room.
Assess whether or not there’s a cohesive understanding of your organization’s vision.
Open it up for discussion about common themes across the vision statements.
Once you have gotten enough suggestions from the group, move to the next slide, where you will condense these into a vision statement.

5. Exercise: Crafting a vision statement
Four attributes of an actionable vision statement
Simple
Short and memorable; easy to communicate
Vivid
Immediately recognizable
Aspirational
Establishes goals toward which the organization will progress
Differentiating
Defines how organization is different from competitors
Our vision statement:
Source: Advisory Board interviews and analysis,
Now let’s try to turn that brainstorming into a cohesive vision statement.
This slide lays out the four attributes of a strong vision statement. It’s simple, aspirational, vivid, and defines how we’re different from our competitors.
Take the common themes you discussed from the vision statements on the previous slide and work together to refine that into a vision statement that demonstrates these four attributes.

6. Exercise: Evaluating our medical group’s culture
Three operational elements of culture 1
Talent management 2
Infrastructure 3
Leadership commitment
Discussion questions
For each of the elements above:
In what ways does our performance on this element support the vision we just defined?
Where could we improve this element to better align it with our vision statement?
Source: Advisory Board interviews and analysis,
[If you skipped slides 6-7, start by reading your group’s vision statement to the meeting participants.]
Now, let’s talk about whether our operations are working to support our vision statement.
[Open up for discussion using the question prompts listed on this slide, going through one element at a time. The goal of the discussion should be to identify areas of strength and weakness for each operational element. Then, try to come up with 2-3 tangible, implementable ideas for how you can improve your medical group’s operations to better support your vision.]
Thank you for sharing your thoughts on this. I think we all have some ideas on how we can better support our vision statement through our day-to-day operations.

7. Introducing the Medical Group Culture Intensive
FOR MORE INFORMATION ABOUT THE CULTURE INTENSIVE
TO ADMINISTER THE TOOL AT YOUR MEDICAL GROUP
Two-page overview
Learn why culture matters and how the Advisory Board measures it
Explore our culture homepage
Access more information about taking the survey as a group or individual
Sample executive report
Review sample data, insights, and recommended resources
Contact your Dedicated Advisor Or
Source: Advisory Board interviews and analysis.
These exercises are part of a broader initiative, the Medical Group Culture Intensive, that we can participate in as part of our Advisory Board membership.
It’s designed to get a sense of how the rest of our group, beyond those assembled in this room, perceive our visions and operations. We can administer the survey to our group and have their experts present on the results, or we can just use the survey to dig in more to specific operational elements that we could focus on. There’s more information about the tool in the links on this slide.
[Recap any takeaways from the discussion and list any next steps or agreed follow-up.]