The trusted source for
healthcare information and
Changing human attitudes usually changes workplace climate
Occupational health professionals may not necessarily consider themselves messengers of corporate culture but, according to the experts, the ability to help change cultural attitudes may be an important arrow to have in your quiver as you target health and safety improvement.
Pamela F. Levin, PhD, RN, associate professor at Rush University Medical Center, Chicago, provides a recent real-world example of the interrelationship between culture and the occ-health profession. "We had a departmental faculty meeting yesterday and shared the new proposed mission statement for the medical center," she relates. "There was nothing in [the new statement] regarding employees; in the previous one, there used to be an allusion to the health and well-being of employees. Not only was this a violation of Mission Statement 101, but for someone in occ-health, where your responsibility is to ensure health and safety, if your organization does not embrace that in their value statement or mission statement, what kind of tone are you setting?"
To reinforce her point, Levin notes that OSHA’s guidelines on how to create a program put management and employee commitment at the top of the list. "If you do not have that attitude toward how important a healthy and safe work force is, you will not have a climate that will support initiatives aimed at that," she asserts. "The organization will do just enough to comply with regulatory issues without really embracing those values."
Culture or climate?
Levin notes that when discussing this issue some people use the term "climate" rather than "culture." "They can be interchangeable," she says, "Although climate can be a very loaded term. When many of us think about diversity, for example, we’re talking about organizational climate."
"If you go into the literature, you can find all kinds of fairly abstract theoretical discussions about the distinction; but for the practicing manager, they are not worth a hoot," adds Paul A. Reichelt, PhD, organizational psychologist and research associate professor at the School for Public Health at the University of Illinois at Chicago. "It is reasonable to use them basically in the same general way, although culture is more encompassing. Basically, what people are talking about is, what is it like to work in this organization?" he says.
When people talk about culture on a broad scale, says Reichelt, they are describing shared values and shared norms within the organization. "If you talk about somebody working in a corporation who is responsible for occ-health, things that might be part of the culture are that everyone believes that work is a good and valuable thing, and that everyone in the organization believes it is better to get people to do things when they know why they are being asked, as opposed to just ordering them to do it."
Reichelt offers the example of encouraging employees to follow a healthy diet plan. "If all you did was just provide the correct nutritional information, you could run into problems," he notes. "Even if employees understood what you were teaching them, they might put that together with what they already knew themselves, and they may combine incorrect information with correct information and make a mess. You first have to knock down commonly held myths — such as, It does not matter what you do,’ or Some people just can’t lose weight.’ You have to point out that even though lots of people believe this, it is wrong."
Certain areas of occupational health require culture change more than others, says Levin. "Certainly safety deals a lot with human attitudes, as does wellness," she notes. "Program-ming that includes a human element, like diversity, may depend more on culture change for success."
Not an option
An occupational health professional really has no choice but to study organizational culture and seek to change it if change is required, Reichelt insists. "You have to understand what the culture is if you are an occ-med professional," he says. "If you simply understand what is going on in terms of proper nutrition and diet, smoking, and so forth, plus the occ-health issues for that particular industry, that’s all well and good, but if you think you can just present this information and everyone will go out and act on it, you are wrong. If the culture of the organization, for example, is that anyone who exercises is a chump, you can present as much information as you want and nothing will happen because peer support is against it."
Reichelt says he saw the power of organizational culture in action when he worked with several fire services. "They have very specific cultures," he notes. "They work 24-hour shifts, then they are often off 48 hours, then on 24. They live in a small building 24 hours a day and have a very strong culture. Here in Chicago, I talked to one fireman who was into physical fitness. He also really liked fighting fires. So, he got himself transferred to a house where the guys were into physical fitness and in an area that tended to have more fires. You have to realize that there’s a fit between the individual and the culture that mutually influence each other."
Given that the right culture may be critical to occ-health success, how does one determine if change is needed — and, more importantly, how can change be engendered? "There are, in fact, paper-and-pencil tools people use [to determine culture status]," Reichelt notes. "Some of them have labels that include words like organizational culture or climate. These can be used to judge what culture is on certain dimensions."
The occupational health professional should think of culture change as applied discipline, he continues. "You’re trying to do specific things to help people get healthy. If you want to get them to understand that smoking is bad for their health but the culture is against it, you would probably want an instrument that would get at their core beliefs. What are the kinds of changes we want to make — such as in health promotion — to help employees stop smoking? Whatever you are trying to accomplish, you need to find out the kinds of issues that would be barriers to making changes, and what would facilitate those changes."
This is probably not something a typical occupational health professional could do on his or her own, he continues. "You’d probably want to look to somebody who has experience in measurement and survey issues for help," Reichelt advises.
Can, or should, occ-health professionals become change agents themselves? "Any person in their role will have something in their educational background about changing behavior, but to be a major change agent is a daunting task," Reichelt says. "If you try to pull it off all by yourself, you would need the help of a consultant who really understands change."
There are a number of issues that come up time and time again, such as the fact that change makes people uncomfortable, he notes. "No matter how good the change is, it will meet resistance. Before bringing about the actual change, you need to lower resistance, to cut barriers. For this, you should look to experienced organizational consultant for help. There are some who specialize in organizational culture change," Reichelt explains.
Such changes must cut across the entire organization, says Levin. "An appropriate culture climate means an organization that embraces health and safety in a broad, holistic way," she asserts. "That includes decent personnel policies, a climate in which gender issues are not a problem, and so on. But the right climate helps to ensure commitment from management and the employees. It reduces the barriers, so it’s a facilitating force. If [the right climate] is not there, it’s a continual battle to try to look at ways to improve health and safety."
[For more information, contact:
• Pamela F. Levin, PhD, RN, Associate Professor, Rush University Medical Center, Community and Mental Health Nursing, 600 S. Paulina St., Chicago, IL 60612. Telephone: (312) 942-8842. Fax: (312) 942-2549. E-mail: Pamela_F_Levin@rush.edu.
• Paul A. Reichelt, PhD, Health and Policy Administration, School for Public Health, UIC, 1603 W. Taylor St., Chicago, IL 60612. Telephone: (847) 674-6948.]