Transcript: How to Change Organisational Culture (EP89)

 

Brendan: Welcome to The Culture of Leadership. We have conversations that help you develop and become a more confident leader. 

This is my conversation with Matt Kelly. 

Matt's a leader who knows how to change organisational culture. In 2019, he was internationally recognized for it being the first Australian to be invited to speak at the world's leading Patient Experience Summit held by Cleveland Clinic in Ohio. He was also named New South Wales' Business Leader of the Year. As head of Regional Operations, North, Matt's a member of the executive team at Healthy Care, which is a leading private hospital operator in Australia. 

Culture is the behaviour you accept in your business. Ultimately, the senior leader drives the behaviour. Matt shares what he does, and how he works with his team, to create an organisational culture that brings them delight, not despair. He also unpacks what he calls the ‘Triangle of T’ and how it’s linked to changing organisational culture.

This is the ‘The Culture of Leadership’ podcast. I’m Brendan Rogers. Sit back and enjoy my conversation with Matt.

Matt: Trust is a big thing for me. As I went into more senior roles, I always tried to make sure that I created an environment of trust, where people could feel safe enough to be vulnerable and say what they weren't happy with. I think that's part of this whole values conversation as well. What's important to people really is drawn out through that process. 

Trust is a funny thing as well. Trust is a word that covers so many different things. It can mean so many different things to people. You drive down the road and you trust that the person coming towards you on the other side of the road is not going to drive in front of you. That's trust. But you also trust that people are going to use the information about you in an appropriate and safe way as well, so you need to create that environment.

Brendan: What trust do you believe is needed in that business environment that you've got great experience in when you're looking at culture change?

Matt: I talked about the triangle of T. On the base of the triangle, you've got transparency. I guess you could call it integrity or that just being true to what you say. Transparency and trust at the base of the triangle can lead to fantastic teamwork.

If you have an environment of trust and you look at the performance of those people, it is very reflective of the culture. If you have a culture of trust and high performance, then that's a great place to work. But if you've got a workplace of distrust and low performance, that's not a very great place to work.

Brendan: What does trust and distrust look like?

Matt: In the workplace, I guess you're really looking back at that vulnerability and honesty with each other about what behaviors and what's acceptable in the workplace. I guess this leads into what's the culture of your workplace. If you've got a distrusting environment, that's not a great reflection on the culture of the workplace. I don't think anyone would try to set up a distrustful culture in their workplace because it's low performing, low production, not productive at all.

Brendan: What's Matt Kelly's definition of culture?

Matt: I guess it's a unique combination of behaviors that are expected and accepted in the workplace. When I ask people about what's the culture like in your business, it's funny a lot of people will go, oh, it's lovely, it's great, or it's bad. I said, well, that's actually not a description of your culture. That's a description of how you feel in that culture. That's an emotion.

I think it was one of your previous podcasts. I think it was with Norman. He talked about culture as being the personality of the place. If I said to you, can you describe Matt Kelly's personality, you wouldn't say it's good or it's bad. You would talk more about what it's like to be with me.

I challenge people to think a little bit deeper about what the culture is like. Do you have a culture that's teamwork-driven, goal focused, customer service focused, consumer-centric? How do you describe it? Is it adversarial, distrusting, and fractured? Because that's a great way to think about where you want to be as well and how to get there.

Brendan: You mentioned trust earlier and the T triangle.

Matt: Yeah, the triangle of T.

Brendan: The triangle of T. I'll get you to unpack that a little bit more. But the triangle of T, trust, transparency keyword you used there at the bottom of the triangle, how does that relate to developing the culture that you're going to be delighted in and proud of?

Matt: Transparency and trust enhances teamwork. If people are honest with each other, then people can respond better. We've used values as a cornerstone to develop a culture and talk about behaviors that are acceptable or expected of people.

One of my favorite tag lines that I use everywhere in any place of work I go into is "The standard you walk past is the standard you're willing to accept." It's a quote from David Hurley, our governor general now. He said it to a graduating year when he was in the armed forces. I do use that as an example, especially in the orientation of new staff.

If you walk past something, and you see something that is not acceptable or you don't agree with it, don't walk past it. Stop, challenge it. Ask why it's like that. It's a platform that enables people to highlight things that are actually not okay with them in a safe way as well. The standard you will pass might just be a piece of paper on the floor. If you haven't closed the bin properly, the tap's running, that sort of stuff. But it also may be the way another staff member speaks to each other.

Brendan: When we met at Gosford Private Hospital when you were a CEO—I think you had three hospitals under your remit at that time—do you remember anything significant about that time we met? Anything you may have done in relation to the standard you walk past?

Matt: The date just that you were there? No. I was just me.

Brendan: So it wasn't memorable for you?

Matt: My recollection of you being there that day was that I came to show you what we were doing with values around the hospital, how we were demonstrating it, how we were permeating that into the workplace. Visibility is very important, but just showing around the hospital as well. I don't believe you'd been to the hospital before, so I toured you around.

Brendan: Thankfully, no.

Matt: That's right.

Brendan: From a good health perspective, I haven't been to the hospital.

Matt: Yeah, and that's actually something that we talk a lot about when we talk about empathy, but we won't get into that just yet. But no, I don't remember exactly why. You happen to have recalled something.

Brendan: What happened to your coffee?

Matt: What happened to my coffee? If you start messing with my coffee, that's a problem. I can't remember what happened to my coffee.

Brendan: I'll stop teasing you. But in relation to the standard, you walk past to see the standard you set, the expectations you set, then, so we got a coffee take away because we were walking through. It was overfilled or there was a leak in it or something like that. You went back and you got a wipe. But through the course of our journey around the hospital, actually it was very early on, and it just dripped. It was dripping, and it dripped onto the floor.

Matt: Right. Did I clean it out?

Brendan: Yes.

Matt: Oh, good.

Brendan: A really simple action. But believe me, not hospital-specific, but I've certainly been in enough rooms in my time where something like that could happen or staff left after a meeting, and the leader has an expectation that someone else will clean that up.

Matt: Yeah. I've worked for those leaders before.

Brendan: Haven't we all? It just flashbacked at me. It was such for me and the things I look at in leaders. A great example of what you're saying is it was such a pivotal moment about the leader you were. Others it was maybe insignificant.

Matt: I didn't remember it.

Brendan: It was just what you did. You just did it without thinking. It wasn't like, hey, can you get someone to clean this up for me or whatever? You just made the effort. You went and got some stuff and cleaned it up. You took ownership of that, boom. You weren't, hey, I'll get someone else on the CEO thing. You just did it.

Matt: I guess it's a combination of my upbringing, my parents, but also my training as a nurse. I often challenge our managers to consider, don't ask someone to do something that you wouldn't do yourself. In my early days as a management and CEO even at Gosford Private, I remember when we first started cardiothoracic surgery at the hospital, I had a lot of experience in cardiothoracic surgery.

I'd come from a lot of training in cardiothoracic surgery and intensive care units down in Sydney. It was the first case that we'd done at the hospital, so I followed that case right through the theater and went straight to intensive care, which is where I cut my teeth as a nurse. I worked in a trauma intensive care unit in the UK and then worked around in cardiothoracic ICUs.

When the patient came into the ICU, I helped the staff get the patient into the bed and settled in, and took him down from the theater staff, and did an ECG on the patient. The cardiothoracic surgeon took a photo of me. I said, what are you doing? He said, I'm keeping this photo. This is the first time in my career I've ever seen a CEO do an ECG on a patient.

I think that's a fantastic thing for the surgeon to then go and talk about our hospital, that we're all there to look after the patient, but it's also great for your staff to be able to see that you actually know what you're talking about. You've been there, you do it, you can do it, you know how to do it. But because of my role at the moment, I don't do it very often because they're here to do it. We've all got different roles and responsibilities. Their role is just as important as mine, it's just different. Yes, I would clean up after myself.

Brendan: Your mom and dad would be very proud, I'm sure.

Matt: Yes. I'm sure they are.

Brendan: If we think about your role as CEO previously and CEO of a few hospitals, in culture and starting to set the scene about how to create a culture that we, again, like I referred to, we delight and we're really proud of, if you come into an organization and there are always things to improve but it's not where you want the culture to be, how do you assess that? What are you doing to start to make those observations and understand where it is today? Based on your own experience, where you may want it to be in the future?

Matt: I'm getting a bit more experienced at that now because now I cover eight hospitals. I'm walking into different environments each time. Initially walking in, it's about observation, walking around and being part of the culture, being part of meetings, being part of the core business, whether that's patient care delivery or serving customers, whatever it is. Just observing what that's like and how people work in that environment.

Chatting to the staff as well about how they feel, about their workplace, is really important. It also gives a reflection of the culture of what's acceptable and what's not acceptable, how good and bad behavior is dealt with, and how performance management is looked at. 

It also helps you form an opinion of what's important to the staff. Okay, what's important to the business? How does that marry up with what we're all here to do? How do we focus everybody on the goal of the place? 

We try to use the platform of mission, vision, and values to frame that direction or the goals for the staff. For patients, we use that same platform to say to our patients, this is what you should expect from us. If you're not experiencing this, we'd really like to know about it so we can improve it for you. And then you've also got to use it in performance management and maintaining that.

Another little tagline. You'll notice, I love taglines. Persistent consistency. You got to persistently drive the message that the values are important, but you got to be consistent with that message as well. Don't change the message. Be sure that you get the message right and continue to always bring it forward in all of your interactions.

The setting of a culture is something that you don't do in a boardroom, in a meeting room, or on Tuesday afternoon. It's actually a slow burn. It's something that takes a long time. Change is hard. But when you start challenging behaviors of people, that's harder. There'll be a lot of situations that you never expected. You should always expect the unexpected. Things will pop up that you never thought were going to be a problem in challenging people to follow the business values and to reinforce those.

When you're looking at reward and recognition, sometimes people have never been rewarded for what they do. I've often had people taken aback just by simple words to recognize them for what they've done, even though it may be their job. But if they've done it in the right way, and you've highlighted it as the way they've done that reinforces our company's vision and our values here, it might be the first time anyone's done that to them. That can be quite confronting for some of them, but it also can be very rewarding.

Brendan: What's your view on the power of financial reward?

Matt: Reward and recognition is a challenging thing. It's actually a minefield. I'm talking about looking after a group of staff. I think it's 700 staff at Gosford Private. Now, across my eight hospitals, you're talking about 3000 staff. Every one of those people feel rewarded in a different way. Tailoring a reward and recognition program that enables staff to actually choose from a way to be rewarded is really important.

We have a platform in our company called Love Your Work, and it's a staff recognition platform. Each site executes it differently. We have Love Your Work barbecues, which is a generalization for all of the staff, but we also have Love Your Work awards. These awards are nominated through patient compliments and staff referrals as well. They refer each other for Love Your Work award.

We'll recognize them and give them a certificate, but then we'll talk to that person and go, what's rewarding for you? Is it a coffee voucher for the next two weeks? Or do you want to park in the CEO's car park for a week? Or do you want some extra time to do something in particular?

Financial reward will work for some people. Just give me the $200 gift voucher. I want a gift voucher with JB Hi-Fi. If they get it and they go, thank you, then they're rewarded. But other people I've found, it can offend them, because they all of a sudden go, oh, I was just doing my job. I was like, yeah, but you did it so well, and you're doing it the way we wanted you to. And they go, oh, I don't need that.

When we walked around the hospital, I think we went and showed you the Love Your Work tree. In our staff room, we have laminated a tree on one of the pillars in the middle of the staff room. Beside the tree, we have all these flowers. On each of the flowers is one of our five values. And on the flower, staff can nominate each other.

I would love to nominate Beryl for a respect value because she really showed respect to the patient that's in room 243 today, and they stick it on the tree. When the rest of the staff are coming in for lunch, or they're coming through for the rest of the day, or even they're scanning out, going home, they see a new flower on there. Then they go and ask Beryl, what happened with that patient? Oh, that's amazing, good job. And then this momentum moves through the staff of reward and recognition just by highlighting the behaviors and what's acceptable and what we expect of each other in focusing on that.

We call it patient-centered care. We used to call it patient-centered care, we now call it person-centered care, because we include staff in that person-centered, doctors or patients. We had one of our executives at our conference once say, the person that is standing in front of you should feel that they are the most important thing in your day right there.

Brendan: In your environment, that's what person-centered care means.

Matt: Yeah. When you've got that person in front of you, they should feel that they're the most important thing in your day at the moment.

Brendan: Can you name the values?

Matt: Yes. We have five values in our company. These five values are actually across our whole company. We have 17 hospitals across the group right down to Tasmania and as far north as Tyree at the moment. Our five values are very hospital-focused, but we talk about best practice, best experience, respect, it's personal, and my favorite is positive energy.

Brendan: Tell us a bit about what does it's personal mean and looks like in your environment.

Matt: It comes back to that person-centered care. You talked about when you came into the hospital. Unfortunately, I've never been to that hospital. We often reflect back to the staff that you come here every day. It's your workplace, it's very simple. You don't have any worries about coming here. But nearly every single patient that walks in this place, if they had the choice, wouldn't be here.

There's always a drive to remember or have an empathy for the anxiety, the anticipation, the hope, that nearly every patient who comes through the door has for what we're going to do for them. Everybody's life experience is different. We need to be able to tailor at the bedside for that person. It's a personal experience. That's what it's personal is about.

Brendan: What was your last one? I don't remember it. The one that's your favorite.

Matt: Positive energy.

Brendan: Tell me about it.

Matt: Positive energy is a great reflection of I feel the culture in your workplace. It's been said before, but if you can measure or think about how much laughter is in your workplace between colleagues, that's a great reflection. I'm a bit of a positive person. I love to have a joke. I like to see the positive side of things.

A happy smiling person is great customer service, but it's also a reflection of someone's happy to be part of that culture. Someone's happy to be part of that workplace. Someone's happy in the execution of their role. Positive energy is important to use as a value for us, especially when we come back to the behaviors part.

If someone's not really demonstrating positive energy, the staff now have a platform to go, is that positive energy? Not only does it call out that maybe someone's not feeling positive today, but it actually reflects a mirror. Just hold up a mirror in a non-confrontational way to another staff member to go, hey, you're starting to sound a bit sharp today. It's also a bit of a welfare check as well.

We talk about the welfare check when people seem to be going off path. Is everything okay today? That's something that, again, when I said you got to expect the unexpected, was very challenging for some people. Their life experience had never really enabled them to have a conversation with someone to check on them.

When we started the project, we knew that we already had a very good culture in Gosford Private, but we would like to improve on things. There's always the ability to change things up. When we started with the leadership team, we really focused on the five values, what they mean to us as a group, and how this looks in our environment. But it became obvious that we needed to really equip them to enable difficult conversations, to equip them to educate the staff that they look after in how to do that as well.

We had to backtrack a little bit as well and educate them on conflict resolution and behavior management, those sorts of things. But when we talked about the five values, we talked about the dos and the don'ts. When I talk about leadership teams, it's not just managers. You can be put in a leadership role, departmental manager, those sorts of things, but leaders are also people who affect the culture.

Leaders are people who others follow. Sometimes that's positive, sometimes it's not. But we as a leadership team got together and talked about each of the values, and we talked about the dos and the don'ts. What behaviors do reflect this value? What behaviors don't? How would we go about fixing that? And then we challenge them to take it back to their teams.

We only choose one value a month, because as I said, it's a slow burn. We got to take it a little bit at a time. Choose one value right this month, we're doing respect. In each department, we want you to sit with your team. We want you to talk about, if respect is a value in our department, what behaviors do we do that support that value? What are the behaviors also detract from that value?

It was interesting. As I walked around the hospital, the dos were all very similar. The don'ts were different. When you looked at the don'ts with that team, you actually started to realize that the don'ts were the things that were frustrating each other in that team.

Each little team has a culture. The things that were being called out as don'ts, some of the staff were looking at them and go, I do that, and then they go, okay, so other people aren't finding that as supportive of our base. It changes people's behavior. We do this right from day one at orientation.

We put up the five values. We get new staff to walk around and write down things and behaviors that they think would support our value that would detract from it, so right from the beginning. In fact, we even put it in our interview questions.

We ran a scholarship for enrolled nurses. We asked for applications. We asked them and said, these are our five values. If you were an enrolled nurse in our hospital, how would you demonstrate these five values in your daily work? We use that as an application process and a vetting process.

It was fantastic. People get a real sense of what's important to the organization before they even step in the door. We'd permeate that as well out on our websites. We've got a YouTube channel with videos, that stuff as well. In any of our communication, we use those things as well.

Brendan: I'm getting a bit of a flavor that values are pretty important around culture. In your organization, you're a part of healthy care. There were values in place. There may have been some refinement over time, but those values, let's say, are pushed down through the organization. People are expected to mirror and talk and do some of those things you're talking about.

If I'm a business owner and my business may be traveling along okay, and all of a sudden I've got staff, and then I've got more staff than maybe what I can handle competently because they've not had to do that before, what advice do you give to me to say values are important around culture, and getting something that delights you? Here's how you need to start that ball rolling. How do you create a set of values that are unique to that organization?

Matt: If there are values in place already, just a sense check is that what we still are is that we're still reflective of where we want to be. If you don't have them in place, then you've got to start right at the beginning with the mission, vision, and values. What's the goal of the business? Do you have a framework set and established to enable you to build on that?

Do you have clear policies and procedures or employment contracts around what's expected for code of conduct, performance management, HR types of things? Do you have those tools ready to fall back on if you need to? And then, is everyone aware? 

This is something that was done in a meeting room, in a boardroom and put on a poster in the corner and then forgotten about. The sense of checking yourself as well is, have I been demonstrating this? How am I reinforcing this? How am I being persistently consistent with the message about what's important here and what our values are?

If you have those and it's just that we've got new people and we haven't had the opportunity to highlight them then, then it's about communicating that. We use an orientation. First day at work, sit down, these are our policies, our procedures. This is your mandatory education, but this is also what's expected of you here.

We use that platform to then remind the rest of our staff that we're already there. We're still telling all the new staff that these are our values. As I said, if you permeate the values into everything you do in your daily communication to staff, we have a platform that's just like Facebook, all of the stuff around. It's called Workplace.

We send out columns with regards to policy changes and when the next education sessions are on, what meetings are on, or those sorts of things. We also use it with the Love Your Work, so we do lots of hash tagging, #positiveenergy, #bestpractice.

Brendan: Using the values.

Matt: Using the values to link back. Someone has demonstrated best practice, look at what they've done. Or we're educating about aseptic technique today, come on down and do your mandatory education. #bestpractice. It's important to permeate it into everything you do. It's also important that people understand what you mean by best practice, respect, or positive energy.

Brendan: What do best practice do versus a best practice don't?

Matt: Best practice dos are following policy and procedure, cleaning up the spilled coffee on the floor when I keep dropping the coffee all around the hospital. That's one of my things.

Brendan: It's those unsteady hands.

Matt: Yeah, too much coffee. It's just shaking all the time.

Brendan: Vicious cycle, isn't it?

Matt: Yeah. I get a long black with a dash of skimmed milk. I don't know what it is with plastic cups or whatever it is, but they tend to always drip. That's why I've got to keep cups. I put my KeepCup in there. I swear, I have keepcups now because they don't drip.

Anyway, side note. Don'ts are shortcuts. You're not putting the right waste in the correct being. You're not using the correct technique for bandaging. Whatever those sorts of things, it's about policy and procedure and the gold standard of care that we provide. That's what it means in our environment.

Yes, it's important to make sure that people understand what you expect when you say best practice. We do a little technique if you want to try a little technique that we do with new staff. I got a piece of paper here for you. Or you can draw it anyway. Just draw anyway.

Brendan: I'll draw it here because Mark has said that I can't move the laptop, because it might get in the shot or something. What do I need to do?

Matt: You imagine you're in an orientation. I'll give them a pen and a paper and I'll say, without asking me any questions, without looking at what the person beside you is doing, without really thinking about it, draw a picture of a tank.

Brendan: Of a tank?

Matt: Yeah. Now you won't be assessed on your artistic skill. Really, this is about you just documenting down. When I ask you to draw a tank, you draw it.

Brendan: Note for those listening to this episode, I'm drawing on the reMarkable, a beautiful tank. At the moment, I'm just putting the big gun bazooka maybe at the front of it.

Matt: All right, that's enough detail. We get the idea of what you're drawing.

Brendan: Are you bored with my tank already?

Matt: Not at all.

Brendan: Do I show you my tank?

Matt: No, because I can see it from here, but you've described exactly what you've drawn.

Brendan: I better show the audience my tank. They'll be very interested in seeing my tank. Can you see my tank?

Matt: It almost looks like a submarine thing.

Brendan: It's an aqueduct tank.

Matt: But then what I do is I put up on the board, three pictures and say, who drew this? The first picture is a water tank. And invariably, we always have a cup of people put their hand up. The second picture I put up is a fish tank, and there are always a few people that have drawn that.

The last one I put up is exactly what you've drawn there. It's a tank, a military tank. But we use that example to say, when I say tank, when I say respect, when I say best practice, you immediately have a thought in your mind. All right, scrub that out. This is the second part of the exercise.

Brendan: Note to everyone listening, I just dropped my pen on the ground.

Matt: I wonder if I'm going to do this too.

Brendan: You do. I don't need this again.

Matt: You don't need that again.

Brendan: Okay, so I can just erase that on the reMarkable. Okay, what do I do now?

Matt: This time, I'm going to get you to draw another picture, but I don't want you to draw a single thing until you are 100% sure what I want you to draw. Brendan, please draw a pen.

Brendan: Please draw a pen.

Matt: You can ask me any question you like to just make sure that what you have in your mind is what I want you to draw. Don't draw anything until you are 100% sure what it is.

Brendan: I have an image of a pen in my mind.

Matt: Tell me about the pen.

Brendan: The pen is a black pen.

Matt: I guess it could be black.

Brendan: It's got just one of those little plastic things hanging off the side of it. You just put it in your pocket and you look really, really important.

Matt: Oh, it's not that.

Brendan: It's not that?

Matt: No.

Brendan: What pens do they have in hospitals?

Matt: This is not a hospital-based question. What pens are there?

Brendan: What are the pens? There's a sheep pen.

Matt: Ah, yeah.

Brendan: A pig pen?

Matt: Great. Pig pen, that's exactly what it is.

Brendan: Now you've got me. You've got my creative juices flowing, Matt. 

Matt: That's right. But so then, what invariably happens is around the group, everyone goes, ah, how many sides to the pen? Is there a pig in it? Is there mud? What type of fence is it? Then I go, is everyone 100% sure what that picture looks like now? They'll go, yes. So then they all draw it, and nearly every picture in the room is the same. I put it up on the board, it's exactly the same.

We use that example, especially in health, in a hospital, especially with new staff, new nurses, and new people around the hospital environment. If you're not 100% sure what to do when you've been asked to do it, please ask. If you're not 100% sure what's expected of you when we ask, please ask. Make sure what you are about to do, what you're about to draw, is exactly what you've been asked to do, because that's best practice.

That will give our patients the best experience. Now the staff will respect you for it. You'll feel rewarded. There'll be a much more positive environment if everything's been done correctly.

That's a little example we use with our staff just to get them in the mindset that just because I said respect or just because someone's saying to you that that's not respectful, doesn't mean that it is for you or vice versa. You need to make sure you understand that you're talking the same language.

Brendan: I need to quantify that. How important in your mind is the behavioral qualities and alignment of people coming into your organization versus the technical competence side? Where I need to quantify that is, don't think of it from the hospital perspective, only think of it from a general business.

I'm imagining that if the technical competence of your staff in a hospital is not where it needs to be, you'd like to think they're not going to be getting the job. How important is it generically from a behavioral point for you versus technical competence?

Matt: Behavioral reflects on both staff and patient experience or consumer experience. Let's talk from a business. We're very good at elevating people who have technical expertise, but might not have great managerial expertise. That same goes in reverse. You can have people with fantastic people skills, but still need to be technically enhanced through education.

I think it's the mindset of the person that's important in having them in their role. If you've got an environment of improvement and a culture of query, where people are always checking on how they're doing things and trying to make sure they're doing it right and improving on that, then you'll always win with your staff. They'll feel rewarded, and you're developing parts of them to make them feel more rewarded but also better employees.

Behavior has a fantastic way of just dragging people down when bad behavior starts. It can just snowball and [...]. Unless you've got a framework in place to be able to stop the snowball growing, it will be extremely difficult to stop the momentum of that.

Brendan: What's a framework that's worked for you?

Matt: Obviously, utilization of the values is important. But in that performance management side of things, we obviously have some pretty robust performance management tools. We do talk about the ability to raise a concern in a non-confrontational way early to highlight the behavior as, hey, that's not great, and then you can coach them into it. But really, as you get to the third time around, that's when you move to those more rigorous HR performance management tools, where you put people on performance improvement programs or plans, or performance management plans, however you term those things.

It's a lot about clarity. If you come back to the triangle, transparency about what's expected, which is all about work and the behavior in that workplace, which is supported by your policies and procedures, your code of conduct, the employee is quite clear then as to what they need to do. They trust that you're there to improve them as an employee and keep them there as an employee. It will just enhance teamwork.

Brendan: What are the other parts of the triangle now that you mentioned it again?

Matt: Transparency and trust leads to teamwork. If you don't have teamwork, then there's a trust fracture. If you don't trust each other, there's a fracture in the teamwork. If you're not trusting someone, you're not transparent with them. They're connected to other swats of the triangle that's interrelated.

I do try to put transparency and trust on the base of it, because without those two things you'll never lead to teamwork. It's something that trust is a difficult one. It's one of those base dysfunctions of a team. I'm sure a lot of your listeners may have heard of The Five Dysfunctions of a Team.

Brendan: Let's hope so. It comes up reasonably often.

Matt: Yeah, but it is. Trust just creates the environment to be vulnerable, to show your weaknesses, and to be able to build that teamwork. I'll do another little engagement. It's almost a game.

Brendan: I'm game, Matt. What do you have for me?

Matt: I'll just tell you the framework of it. It's a team thing. I call it the value of 10.

Brendan: The value of 10?

Matt: Yeah. I came up with this because I heard a guy on TV one day say, 5+5=10, but so does 6+4. It made me think about the fact that if we think about 10 as the goal, what we're trying to do, the target of the day, the task, what we're trying to achieve, sure, 5+5=10. Some people might not feel like they have the skill set of a five.

What I do is I actually give everybody a number between 1 and 10. I say, I want teams of two. You're not allowed to have the same number in your team, and you've got to get to 10. Go. Invariably, you end up with people fighting over the 5s and there are people fighting over 6 to try and get to a 10.

Essentially, you end up with five groups of people. One and nine, two and eight, three and seven, six and four, and five and five, and then I get them all to sit down again. Then I say, okay, this next task is a little bit harder, so you actually need three people to build this team to do that task. Go.

That's a little bit harder, because you can only get three teams. I'm not going to do the math. You figure it out. Then I get them all to sit down again. Then the last one is I go, okay, this is a very complex task. No nine is ever going to be able to do this. We're going to need at least four people to do it. Go.

Everyone from five up is sitting there and go, I can't be on that team, because I've already taken up half of the team, so you end up with a team of one, two, three, and four. I used that task as a team building thing to say, we're all here and we will have different roles. For each task, we have a different value, maybe.

Sometimes the task is so small that one person can do the majority of it, and then someone else just comes through, the nine and the one. Other things are very complex in this hospital. Right from the second someone comes through the front door into your business, wherever it is, one, two, three, and four, each have a touchpoint with that customer. Everyone contributes to getting a 10 out of 10. That's just another little team building exercise I do.

Brendan: I love it. What's the craziest thing you've seen that team building exercise?

Matt: The panic. There's this initial panic of some people as well. I've got to get my team, I've got to get my team. And then there'll be one person standing there with their nine going, I can't see anyone that can help me. It's always good. It always ends up with a few laughs as well. It's engaging.

It's non-confrontational. It just reinforces the fact that you may be excellent at your job. But without the twos, the threes, the ones, and the fours, we'll never get a fantastic patient experience, consumer experience. We won't be able to reinforce best practice and have respect for each other.

Brendan: What's a leader's key role or roles in this culture-building process?

Matt: I spend a lot of time making sure they're on the same page. As I said before, it can be a positive or a negative role as a leader. We can have someone who is very negative, very anti-establishment, or against what we're trying to do, and they can get followers.

We spend a lot of time engaging with the leaders, ensuring that they are on the bus—let's talk about getting on the bus and not on the bus—and that they are clear and transparent with the message that we're trying to deliver. When I'm talking to other executives about their teams, please think about your middle managers and your leaders as carrier pigeons. They are the carrier pigeons of your culture.

If you have one leader who doesn't agree with the way you're going, doesn't buy into the direction, or is not actually on the bus, they are a leader that will get followers. They will end up with people following that direction and not where you're going. It's pivotal and key to make sure that those leaders are on board with that.

Again, persistent consistency. Back checking, making sure they're still on the bus, welfare checking. Are they still okay with it? Do they need some support in doing that? How does that support look? Just some more time, education, a chat, a coffee, or is it something more like time off?

Brendan: You've been the CEO in a large organization. Whether big, small, or whatever the ultimate leader, what are the things that you think each day, they need to be very deliberate about that impact the culture?

Matt: Maybe it's easier if we talk about how I go about my day.

Brendan: Please.

Matt: I said about checking yourself. If I may have had a bad day about something else or some other negative thing that's going on in my role is affecting me, I always try to get back above the line and talk above and below the lines, behaviors, dos and don'ts. Get yourself into the right mindset. However you do that, whether it's just getting another coffee, taking a breather, or listening to some music, those sorts of things.

On my phone, I've got a load of screenshots of funny memes, or also just reinforcing leadership roles, culture, positivity, that thing, however you go about it. Getting yourself back above the line is also about breathing before responding, stop. If you're breathing in, you can't respond, so breathe in.

Sometimes you might need to delay what you're going to do. But once you're back above the line, it's walking into the workplace. Again, I'm a positive guy, so positive energy. One task I really tried to do, and this is not an easy thing when you've got a hospital of 700 staff and 1000 other transient vendors, people, reps, those sorts of things coming in and out of the hospital each day or the business each day, but I try to remember people's names.

Saying good morning, Brendan, is a simple task, like wiping up coffee off the floor. But it actually is something that I never realized, it actually has an effect. I had a staff member in one of the angiography suites in a hospital. She had just worked in that angiography suite, nowhere else. I'd never worked with her anywhere else.

I had met her on my first trip to this facility. When I came back the next time, I remembered her name and said, oh, hi, Anna, how are you? She just stared at me and said, how do you know my name? I only told you my name once. She said, you're the first executive I've ever met that remembered my name, hi. It changes their face immediately.

Brendan: There's a recognition program, the reward recognition we spoke about.

Matt: Yes. In fact, actually in the UK—this is a little side note—there's a lady over there who ran a program, Hello My Name Is. That's the reverse. It's the introduction piece. It's about I'm not your nurse for the day, I'm not your doctor for the day, or I'm not your customer service person today. I'm Matt. Hi, I'm Matt. Let's decide that opening.

Brendan: Names make it personal, don't they?

Matt: Names make it personal. Positive energy sort of, again, just hello, how are you, but also being present wandering around the workplace. Walking through the area, cleaning up your coffee after yourself, talking to each other, talking to the staff, is a really important barometer for how things are.

How's the productivity today? What's the flow look like? What's the unit look like? What's the business look like? How are people feeling today? But it's also about being a step ahead of any little thing that might be starting to raise its head. Those interactions in the corridor or in the corner of the workplace is when you might find out a little tidbit that you might need to get onto before it escalates.

Brendan: What's your how-I-remember-names hack?

Matt: I try to picture someone else's face that I know well with that name. That's basically it. But I do seem to have just a little bit of an aptitude for remembering people's names. I never realized I did it, really.

My wife pointed out to me once years ago that even when answering the phone, calling a customer service center, or meeting someone the first time, I actually say their name. They introduce themselves and I go, oh, hello, Brendan, how are you? She said, you say their name all the time. I said, yeah, but it reinforces their name to me, so then I remember.

Also, the person I'm talking to sets them up to think, okay, they know my name. That's also important when it comes to the negative side of performance management. You're able to go over to that person and go, Brendan, I've heard today that you may not be 100% not displaying positive energy. Is everything okay? How can we help? What's going on?

Getting an extra 10 minutes today to get back above the line. Those conversations are difficult to start with. But when you practice it, it gets easier. As I said, you need to create an environment where people feel able to be vulnerable enough to say that to others.

I knew I was winning at Gosford Private one day when I came. We set up things that are not negotiable in our hospital. We didn't start with the behaviors. We started with simple things like wear your name badge.

I knew one day that we were getting through to people when I was walking through the ward, just meeting with the staff and I saw a cleaner, and I said, good morning, Muriel, how are you? And she went, fine, but where's your name badge? I went, oh, you're right. I don't have my name badge on. Thank you. And I went off and got my name badge on. But I thought, that's fantastic.

The cleaner is more than happy to tell the CEO. That's not negotiable. Here, get your name badge on. I also knew we were winning as well with the staff who'd been there for a long time when we were getting staff complaints about performance management, where they were reflecting our values in that complaint saying, if we value positive energy, if we value respect here, Beryl is not showing respect in the way that she is treating us.

Brendan: Brilliant results, isn't it?

Matt: It's very rewarding. We were very lucky. The team at the Gosford Private where we started this was a fantastic team to start with. They really grabbed this project with both hands, and we had some fantastic results.

Another important thing when you're establishing a great culture is to celebrate the wins. Celebrating the wins is not only rewarding for you as a business, but it's also rewarding for the staff members. You and I connected with Chamber and other reward programs around on the Central Coast. We started entering those Chamber of Commerce awards, and the hospital did amazing things.

It wasn't that me as the CEO was winning these things. It's all about the team. We used the team or we engaged with the team to be part of that. They were very proud of some of the awards that they've won. It started to permeate out into the healthcare world as well. We were starting to see it being picked up by other hospitals in our group, the way we were going about this.

I had people contacting me from far and wide to ask us about how we do it. We even got invited to go and speak at a patient care summit in Cleveland in the US. We're the first Australian presenters ever at that conference. They wanted us to come and talk about how we went about culture.

Brendan: That's huge.

Matt: Yeah. We went across and gave a presentation in America. It's the first time any of the Australians have been at. It's the world leading patient care summit and patient-centered care. It was fantastic.

Brendan:  I know that from what you've shared with me a while back—obviously, I just researched around today's episode—for me, that actually is a really powerful thing. You have international and you speak in the we, even though you were leading the organization and you're asked to come along. Again, an admirable trait in a leader talking about the we in the contribution of everybody.

Chamber recognition. Personally, I hold little value because there are different ways of those things happening. But you personally and the organizations you've led, you've had recognition from international organizations and peer bodies. That must be quite pleasing for you.

Matt: Very rewarding. I mean, we're talking about culture and things today. That culture has enabled us to be recognized in other things as well. Providing an environment where people who are passionate about particular things, actually sees growth and recognition in that area.

We have some amazing sustainability experts in our hospital. We've started some amazing sustainability projects. And we started promoting what we were doing with those sorts of things on Facebook and LinkedIn, those areas.

Again, we were contacted from the UK, asking how we were doing this. It's important to be able to celebrate the winds and give staff the platform to be able to go outside the box a bit. That's when people become innovative. If they're clear on what the goals are, they are always trying to be innovative to reach that goal.

Brendan: I just want to step back to the example about the name badge and the environment. You talked a bit about it's important to set an environment. How do you create a new environment like that, where anybody in the organization can effectively challenge the CEO in a very respectful way and say, hey, where's your name badge?

Matt: It is difficult. We found that using something as mundane as your name badge as a starting block, something small—as I said, it's a slow burn with culture, you have to take a small bit of time—you're starting with something small that actually can enhance the environment anyway. If you think about any business that has customer service related to it, if customers are walking in and the name badge is visible and at the front, it engages the consumer straightaway anyway.

It actually enhances your business. But having a name badge, making sure that everyone's got it, and that you yourself are being persistently consistent and constantly pointing it out yourselves, getting your leadership team to do that, and then enabling staff to do it as well, because you're demonstrating the behavior. It's an environment where they're just doing what the leaders are doing.

Brendan: I know you said a number of times, it is a slow burn. I 100% agree with you. At Gosford Private Hospital and your CRO, how long did it take for you to feel like you were winning the culture challenge or the cultural transformation you're making?

Matt: I think it's a peaks and troughs thing. When we first started and we had a leadership day, and we went through the values, we talked to the whole leadership team, we gave a clear goal, this is our plan, this is the timeline, and we got to go back out to the staff now, that was very positive. We came out very engaged and very enthusiastic about it and then started interacting with the teams.

You can carry on for a little while, but then all of a sudden, as I say, expect the unexpected, then it becomes obvious that we need to train people with conflict resolution. We need to train them in behavior management or we need to actually move to performance management of some people where this is floating up as being their intrinsic way of behaving.

You go through a low period where you feel like, ah, we've actually taken two steps back. But then it's about persisting consistency, getting back on the horse, and making sure that you're still going in, walking around the woods, and saying hi to everyone again this morning, and ensuring that you communicate with those values that are important. Sometimes it's hard to get back above the line yourself, but same for your staff.

Empathy is something that we talk about a lot. It has a very healthcare-oriented feel to it, I feel. Empathy, we talked about it as it's not sympathy. Don't get involved with an emotional attachment. Just have an understanding that someone else might not be feeling about something the same way you are.

Like I talked about, patients walking into a hospital. Every one of them has some form of anxiety, anxiousness, hope, about this day with you, so have empathy for that. The way people react to stressors is very different. Some people smile and go, okay, take a breath, and they're up for the challenge. Others react negatively in their behavior.

Brendan: What have you done or have you had to do anything to build your own resilience around those cultural troughs and the unexpected that does happen?

Matt: I'm this type of person that actually, I can be a bit hard on myself. I get chastised about that a little bit.

Brendan: And then you've given feedback about it?

Matt: Yes. Maybe that's a better way to talk about it. It gets highlighted to me that I reflect on how I went about engagement, how we went about a meeting, or how we went about a particular thing. I always think about how I could have done that better rather than thinking about how did we do that well, and then think about how I could do about it.

Myself, I guess I do some of my own learning things like podcasts and listening, reading, and those sorts of things, but engaging with other people who I respect as mentors who have no real vested interest in what the outcome of that conversation would be, I found that very helpful for me. I obviously have some great contacts around town here, who are very senior in the business world or have been executives for a long time and ask them how they deal with things.

I also use my third place as a sense checker with those guys as well as to what's the pub test for how I'm going and how I went about things. I do challenge myself a lot with how I perform this. There's a lot of expectation on me. I know that because of my role and some people's expectations about how I execute my role. Sometimes it doesn't gel with the way I like to do it.

I always talk to other managers about if they've got a problem with someone and the way they're going about a task, I said, are they still getting a skinned cat at the end of the day? It might not be the way you skin a cat. But if they still got the skinned cat, and they're still following best practice, and they're still reinforcing our values, the way they've gone about it is still okay, then that is best for them. That's the most comfortable thing for them. It's a little bit of education for myself and reading and talking to others.

Brendan: How important do you think that ability to reflect in increasing your own level of self-awareness around certain things and relating that to the impact that you can have as that ultimate leader in an organization or business owner on the environment of trust that you're trying to create to build the culture you're trying to create?

Matt: It's very important. I guess emotional intelligence is something that we spent a lot of time with our leadership team. It was something that was really a new terminology for them to talk about. We've used some local people who are very good at educating our team in those sorts of things and doing a DiSC personality assessment, educating them what that result means as well.

I've done those things myself as well and thought about who I am, which I felt comfortable with what that was. But I think part of those assessments and education is teaching people how to deal with the other personalities.

Interestingly, I did a DiSC assessment again recently just to see what it was like again. I found a Myers Briggs personality type assessment that I'd done 17 years ago. I pulled them both out, and they're almost exactly the same still. My intrinsic personality and my adjusted personality are almost the same as well, which is helpful for me as a leader, because it means I don't have to change myself too much.

I guess like Matthew Elliott said about the change room, the type of person or the way you respond in different situations, you do have to change. I think a lot about my personality in that situation. As I said, I'm a positive guy. I end up being a bit jovial about things, but I also know when to curb that back.

I got told once in the past by someone who was obviously watching me as a leader. He said, do you know that I know when you're about to flick the switch? I said, what switch is that? He said, the CEO switch because you change your posture, you breathe in, and you lower your voice.

It was a conscious thing I remember in the past. I can't go to calm myself internally so that it doesn't come out the wrong way, but people could visibly see that body language before you knew that they were going to get called on something that's below the line.

Brendan: It's so interesting. I smoke a little bit as well because I've had more than a handful of clients say similar things. I guess I'm not initially calling them on something, but when I'm needing to cut them off about where we're going and hey, we need to refocus on something, even when I'm facilitating sessions, I've often had that feedback about. When we spend a bit of time with you, we start to realize that movement that happens before the conversation comes in. We're like a Mills & Boon model, a novel, mate. We know what's going to happen, people watch us enough times.

Matt: Yes, that's true.

Brendan: Let's say the positive of that, consistent messaging. You've mentioned consistent messaging. Leadership is very much about consistent messaging. Again, another takeaway for me and hopefully for our audience today is that consistent messaging around those behaviors, those values, those dos, those don't, so you get that real clear contrast of those things, and having the persistence and the consistency around that to have these conversations. 

And making time as the leader that you have done. You say, in your day, what you try to be deliberate about often is getting out and observing, like inspecting. It's not about trying to find people doing the wrong thing, but just being out and about, so you can inspect those behaviors and you can realign things when needed.

Matt: Exactly.

Brendan: Matt, leadership impact. There are two parts to this, first of all. I want to ask you, how do you want people to describe you as a leader?

Matt: I like to hear people describing me as someone who is approachable. Being approachable enables people to come and be vulnerable, to be honest, to trust you, to be positive, someone who is smiling or always happy. 

For me, in my role in hospitals is someone who understands what we do and has a deep understanding and experience around the role that the hospital plays in people's lives. I think that's what I'd like people to say.

Brendan: What's the greatest impact on your leadership journey?

Matt: I guess people-wise, as a leader, my father has always been someone who's been at the forefront of business environments. He worked in the mining industry up in the Hunter Valley. He's always part of the Chamber of Commerce and the council and someone that people always come to refer to. I've always watched him as a kid interacting with people.

I guess in the health industry, I've had some leadership mentors who were executives that demonstrated an environment that I wanted to be part of, and I tried to enhance that in the way I run things. I guess as an effect on my leadership style, there are a lot of people as well that showed me the type of environment I didn't want to create.

I think as environments, the biggest thing that affected the way I lead is probably my years as a nurse. Working in a trauma intensive care unit in the UK, I still see things in my mind from that experience. I think that's what enables me to show weakness, vulnerability, but also have great empathy for people.

Covid has been tough on everybody. I wasn't at the coalface of dealing with Covid positive people getting into our PPE every day, but I was certainly part of making sure that 700 staff or 3500 staff around the state felt safe in their employment. We're given the right tools to look after people and run our hospitals and provide care. You and I bumped into each other several times across the Covid period, and there were times I couldn't even talk to you.

Brendan: Why was it so emotional? What was it that was so hard for you as a leader of such a big organization?

Matt: The sense of responsibility for people when you have no control. There were days when the government would come out with new changes of regulations, and then we'd be coming out every day different, and we would have to change things every day. 

For the staff, for the doctors, and for the patients coming through all of our facilities, ultimately, they come to me looking for the answer, or they want you to know the answer. A lot of the time, we didn't have it.

I care for our staff a lot. That was pretty graphic. A lot of our staff, their partners were losing jobs. It was becoming too stressful to even contemplate coming to work. That environment brought out the best in people, but it also brought out the worst, because as I said, people's ability to react to stress or the way they react to stress is different.

Covid changed my perspective a little bit, but it was also the time that I changed roles as well. My role now as a regional manager looking after CEOs who look after hospitals, is different. I have a greater empathy for them in their roles of what they're trying to do.

Brendan: How do you impact their cultures?

Matt: It's exactly like what I was doing with the team in the hospital, walking around, calling out things that probably don't align with what we're trying to do, the company goals, company vision, the values, and making suggestions about how we can go about fixing those things.

A lot of the time with employees as well and managers, leaders, anyone, it's not about giving them one solution or telling them what to do. It's about giving them a toolkit to choose something that will help. Sometimes people will execute something that isn't really right for their personality and it doesn't work. But if they find something that works well for their personality, they execute it so much better. It's about providing many different ways to go about something. Skin the cat.

Brendan: Mate, two things you've mentioned today and that last bit finally, they're the reasons why I had to have someone like you on the show. I'm very fortunate to have unbelievable guests on our show. Seeing that one election in the hospital about how you can't hold a coffee cup properly and spilling everywhere.

I literally remember the pain in your face and the concern in your face when we run into each other around Covid. I knew that things were tough for everyone. The responsibility I know you carried around and your deep care for people, what pain and anguish that must have caused in a really difficult time.

Mate, it's an honor talking to people like you. Thank you very much. Well done on your international recognition, what you've done with the team at Gosford, and all of the hospitals that you were looking after then and now caring for, again, all of the people in there. They're very lucky to have you as their regional leader. Well done, and thanks for being such a fantastic guest in The Culture of Things podcast, buddy.

Matt: Thanks, Brendan. My pleasure.

Brendan: Mine as well.

Matt: Cheers.

Brendan: What’s the most critical element to change organisational culture? It's trust. It’s a critical foundation to build on. Without it, you’ve got no basis to move forward. Building trust requires transparency. Creating transparency requires vulnerability. Vulnerability is a core component to develop as a leader.

Without vulnerability, leadership development doesn’t happen. That’s why, at The Culture of Leadership, one of the 5 foundational elements in our People system used to create confident leaders, is building Trust. 

These were my 3 key takeaways from my conversation with Matt.

My first key takeaway, Leaders make time to observe culture. To be more deliberate about changing the culture of your business, you have to be clear on what good behaviour and poor behaviour currently looks like. This will help you better understand what changes are needed. Understanding the culture requires you to take time to observe culture.

My second key takeaway, Leaders show persistent consistency. They are persistently consistent in talking about values, sharing what good and poor behaviour looks like in relation to the values. They are persistently consistent about weaving the values into everything they do. Leaders know maintaining or changing culture requires persistent consistency.

My third key takeaway, Leaders know culture change is a slow burn. It requires an unwavering focus with deliberate intentions every day. There’ll be times when you feel like you're winning and times when you feel like you’re losing. Trust in the process. The slow burn to achieve culture change is worth it.

In summary, my three key takeaways were: Leaders make time to observe culture, Leaders show persistent consistency, and Leaders know culture change is a slow burn.

What will you do today to improve your organisational culture? Let me know at thecultureofleadership.com on YouTube or via our socials.

Thanks for joining me.  Remember, the best outcome is on the other side of a genuine conversation.

Thanks for listening to The Culture of Leadership.

You can access the show notes at the cultureofleadership.com.

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