Stretch Goals and Culture Change

In the healthcare sector many organizations work very hard to change the mindset of their workers around failure. If you fail or make a mistake there can be very real, very serious consequences to your patients. However, if healthcare workers try to hide their errors that can make everything much worse.  To combat this many organizations have adopted systems thinking about failures and mistakes, it is never one persons fault but a failure of the system, and no punishment for failures/mistakes if they are reported early. This is so people don’t feel fearful of what will happen to their job if something goes wrong. However this culture of accepting failure doesn’t improve hospital performance it just helps mitigate disasters. In other nonprofits failures will happen when you are setting aggressive goals, but I wonder if there is also a numbing effect, especially among workers who are hard to motivate, the 9-5 worker who just wants to do what they need to to get by. It’s hard to think about these types of workers in non profits because, to us those who choose to dedicate their lives to non profits should be full of fire and passion to close the mission gap, but that isn’t everyone. Remember Christina told us about her co-workers who had trouble getting on board with NIH’s mission of saving lives and curing cancer.  How do you create a culture where people aren’t afraid to fail, but still want to strive for greatness. Not fall into the hospital trap of mistakes/failures are no ones fault and no one should feel bad about making them.  That because this is a system problem no one worker can change it so we should all just go with the flow.

I’ve been thinking about a company that has taken Professor Rob’s course and is creating a mix of attainable and stretch goals to get quick wins and improve confidence while improving outcomes and inspiring greatness. But that companies workers see the stretch goals and the attainable goals, and simply understand stretch goals to be the goals we never hit and attainable goals as the ones we do, so they only try at the ones they know are attainable. If you are a new CEO and you are trying to make big changes in an organization that has been stagnant and the workers aren’t motivated, how do you do that with goals. Or if you are a leader in a very big company one like IBM with over 400k workers, can these goals be impressed upon each and every worker like your mission and vision, should companies be creating goals training? What about companies like GE (was) that are resistant to setting business goals based on “dreams you don’t know how to accomplish?” Companies where not just the board and the bankers want conservative plans but the workers do too? The workers of ENRON will tell you what a blessing predictability can be. 

This is where professor Rob began talking about rewards, and how those can accurately measure performance and keep people motivated to reach their goals. Here is again where I will bring in a healthcare analogy. Rewards haven’t been shown not to work among physician populations unless they are largely negative, which is problematic when an organization is trying to build a positive culture around failure. My questions to the group are how do you get all of these amazing benefits tied to stretch goals, when you have an unmotivated or fearful workforce? How do you change the culture of an organization to embrace failure without accepting complacency?  How do you replicate all of these things in a really big company?

– Allison B.

 1. Armour BS, Pitts M, Maclean R, et al. The Effect of Explicit Financial Incentives on Physician Behavior. Arch Intern Med.2001;161(10):1261-1266