Change Enablement
20 min read

The Evolution of Organizational Culture in Healthcare: Why Change Matters

Published on
December 28, 2023

The Evolution of Organizational Culture in Healthcare: Why Change Matters


In the dynamic world of healthcare, where innovation is not just a goal but a necessity, organizations are continuously exploring new ways to boost their effectiveness and elevate patient care.

One such groundbreaking concept reshaping the landscape is the Teal culture.

Emerging as a transformative force, Teal culture promises to revolutionize the healthcare industry with its unique approach to organizational design and management.

At the forefront of this transformation is Buurtzorg, a Dutch nursing organization that has defied conventional models to create something extraordinary.

Founded by Jos de Blok, a nurse himself, Buurtzorg has become a shining example of how Teal principles can not only be applied but can thrive in a healthcare setting.

With its emphasis on self-management, holistic patient care, and team empowerment, Buurtzorg offers invaluable insights into the practical application of Teal culture in healthcare.

This article delves deep into the strategic change management principles that can guide healthcare organizations in their shift from traditional (Amber) to innovative (Teal) cultures.

Drawing inspiration from Buurtzorg's pioneering model, we explore actionable strategies, confront the challenges of this cultural shift, and chart a course for healthcare leaders ready to embark on this transformative journey.

We are not just talking about technological advancements or policy reforms here; this is about a profound reshaping of the organizational DNA – a bold leap from the structured stability of Amber to the dynamic, fluid world of Teal

Decoding Teal Culture: A New Paradigm in Healthcare


In the dynamic landscape of healthcare, where change is both a constant and a necessity, the call for a transformative approach has never been more urgent.

Enter Teal culture, a concept popularized by Frederic Laloux in his book, "Reinventing Organizations."

This culture represents a paradigm shift in the way organizations are managed and led. It is defined by three core principles:

  • self-management,
  • wholeness,
  • and a purpose-driven approach

These three pillars enable employees to engage deeply in their work and contribute meaningfully.

To receive your complimentary copy of our free PDF Guide "How to change & transform your organization to succeed in a turbulent times (keeping your people on board)" for healthcare / pharmaceutical & medical devices organizations, simply click on this link.

Contrasting sharply with traditional models, particularly the Amber paradigm (or traditional top-down culture) that has long dominated the healthcare industry, the Teal culture offers an alternative vision.

Amber organizations are marked by their rigid hierarchical structures, emphasis on stability, and a top-down approach to decision-making.

In contrast, Teal organizations thrive on adaptability, employee empowerment, and holistic thinking.

This shift isn't just a change in organizational structure or policy; it's a fundamental rethinking of operational, leadership, and stakeholder interaction models within healthcare entities.

The Teal culture's impact in healthcare is profound and multifaceted.

It challenges the conventional hierarchical structure of healthcare organizations, promoting a more decentralized decision-making process.

Rather than relying solely on top-down authority, a Teal culture empowers individuals at all levels to take ownership of their work.

This empowerment leads not only to greater job satisfaction and employee engagement but also enables quicker and more effective responses to complex healthcare challenges.

At the forefront of applying the Teal culture principles in healthcare is Buurtzorg, a Dutch home-care organization.

Buurtzorg has revolutionized patient care by implementing a model featuring self-managed teams, minimal hierarchical structures, and a strong focus on patient-centric care.

This approach not only enhances patient outcomes but also boosts employee satisfaction, serving as a beacon for reimagining healthcare delivery.

One of the key aspects of the Teal culture is its emphasis on wholeness.

In this context, healthcare professionals are seen not just as job titles but as whole individuals with unique strengths, passions, and emotions.

This holistic approach extends beyond the employees to encompass patient care, considering patients' physical, emotional, and social needs, leading to more informed and effective treatment plans.

Additionally, a Teal culture promotes a culture of collaboration, encouraging teams to work across disciplines towards shared goals.

This collaborative environment fosters the sharing of knowledge, resources, and expertise, leading to more innovative solutions and effective healthcare services.

Overall, the adoption of a Teal culture in healthcare signifies a shift towards a more dynamic, inclusive, and human-centric approach.

It aligns with the complex and diverse nature of the healthcare industry, offering a framework that resonates with the evolving needs of both patients and healthcare providers.

By embracing self-management, recognizing the wholeness of each individual, and fostering collaboration, healthcare organizations can adapt more effectively to changing conditions, resulting in a more fulfilling and efficient work environment for everyone involved.

Buurtzorg: A Revolutionary Model in Healthcare


Buurtzorg, a Dutch homecare organization founded in 2007, stands as a testament to the transformative power of Teal principles in healthcare.

Established by Jos de Blok, a nurse himself, Buurtzorg was born out of a dissatisfaction with the traditional, bureaucratic healthcare system.

De Blok's vision was to create an environment where nurses could utilize their expertise and intuition to the fullest, ensuring the best possible care for patients.

At its core, Buurtzorg's model revolves around small, self-organized teams of nurses, each responsible for a specific geographic area.

Typically, a team comprises 10-12 nurses working with around 60 patients.

These teams exemplify the Teal principle of self-management; they operate autonomously, making all critical decisions regarding patient care, from determining the necessary care to scheduling and coordination.

This level of autonomy is a radical departure from traditional healthcare models, where decisions are often made higher up the hierarchy, disconnecting caregivers from the decision-making process.

Holistic care is another pillar of the Buurtzorg model, aligning perfectly with the Teal culture's emphasis on wholeness.

Nurses at Buurtzorg are trained and encouraged to view each patient as a whole person, considering their physical, emotional, and social needs.

This approach enables them to make more informed and compassionate decisions about care, moving beyond treating symptoms to nurturing the overall well-being of patients.

Patient-centric care is also central to Buurtzorg's philosophy.

Nurses are given the flexibility to spend as much time as needed with each patient, fostering deeper connections and understanding.

This patient-centric approach often leads to better outcomes, such as higher patient satisfaction and improved health status.

It echoes the Teal culture's focus on purpose, where the primary goal is to serve patients' best interests.

The impact of Buurtzorg's model has been significant and multi-dimensional.

Studies have shown that, despite the higher time investment per patient, the overall costs of care are lower compared to traditional models.

This cost-effectiveness is attributed to Buurtzorg's approach leading to fewer hospital admissions, reduced healthcare complications, and shorter hospital stays.

However, the journey of Buurtzorg has not been without challenges.

One significant challenge has been scaling this model while maintaining the quality of care and the autonomy of teams.

As the organization grew, ensuring consistent application of Teal principles across all teams and regions became increasingly complex. Another challenge was integrating this model within the broader healthcare system, which often operates under more traditional, hierarchical structures.

Buurtzorg had to navigate and sometimes challenge these existing systems to create a space for its innovative approach.

In summary, Buurtzorg offers more than just a promising model; it provides a real-world example of how healthcare can be reimagined and restructured to be more compassionate, effective, and aligned with the needs of both patients and healthcare professionals.

It stands as a beacon for the healthcare industry, demonstrating the practical applicability and benefits of embracing Teal principles, while also highlighting the challenges and considerations in implementing such a transformative approach.

To receive your complimentary copy of our free PDF Guide "How to change & transform your organization to succeed in a turbulent times (keeping your people on board)" for healthcare / pharmaceutical & medical devices organizations, simply click on this link.

Teal Culture Around the Globe: Diverse Applications in Healthcare


The implementation of Teal principles in healthcare extends far beyond the borders of the Netherlands and the pioneering model of Buurtzorg.

Around the world, various healthcare organizations are embracing these principles, each adapting them to their unique cultural and operational contexts.

1. NHS (National Health Service) - United Kingdom


The NHS has been a pioneering force in experimenting with Teal principles, which emphasize self-management, wholeness, and evolutionary purpose.

The Frimley Health NHS Foundation Trust has taken this approach to heart by adopting aspects of self-managing teams and decentralized decision-making, empowering frontline staff to provide more responsive and patient-centered care.

The trust’s supportive culture focuses on learning and development, enabling employees to grow, progress, and excel.

The trust’s core values of Committed to Excellence, Working Together, and Facing the Future are more than just words on posters and banners throughout its hospitals; they are actively promoted among staff and embedded in the organization through leadership briefings, appraisal structures, training programs, recruitment policies, and procedures.

By embodying these values, the Frimley Health NHS Foundation Trust is setting a new standard for healthcare providers everywhere.

More about Frimley Health NHS Foundation Trust

2. Heiligenfeld GmbH - Germany


Heiligenfeld GmbH, a private hospital located in Bad Kissingen, Germany, stands as a remarkable example of Teal culture in action within the healthcare sector.

The hospital has distinguished itself through its innovative management practices that prioritize creating a supportive work culture.

This culture is rooted in trust, empathy, and compassion, significantly reducing conflict and enhancing employee well-being.

Central to Heiligenfeld's approach is the emphasis on regular large group reflective meetings.

These meetings serve more than just a forum for discussion; they are instrumental in building a strong sense of community and bolstering team spirit.

Such practices align closely with Teal's principles of wholeness and self-management, as they encourage open communication and collective decision-making.

Heiligenfeld's management philosophy revolves around key areas such as cooperation, team spirit, health, inspiration, innovation, spirituality, development, learning, and leadership.

These pillars are crucial in achieving the well-being of all workers, echoing the holistic nature of Teal culture. Rather than relying on traditional forecasting methods, the hospital's strategy development is based on 'sensing.'

This approach reflects a corporate culture of "attentiveness," which fosters a supportive team environment, a sense of community, and an awareness of co-creativity.

The hospital’s success in creating such a supportive work culture is attributed to its balanced approach, which combines professional skills, social responsibility, and affectionate human interactions.

This balance ensures that while professional competence is maintained, the human aspects of healthcare are not overlooked. By focusing on these elements, Heiligenfeld GmbH has effectively integrated the Teal principles into its operational model, showcasing how healthcare organizations can thrive by placing equal emphasis on employee engagement and patient care.

Discover Heiligenfeld's holistic healthcare approach.

3. CareMore Health - United States


CareMore Health, operating across several states in the U.S., exemplifies Teal culture through its innovative approach to team-based care.

This model breaks down traditional silos by fostering interdisciplinary collaboration among various specialties – from physicians to social workers – ensuring comprehensive and integrated patient care.

CareMore's teams are designed to be agile and responsive, addressing the full spectrum of patient needs, which is pivotal in managing chronic diseases and complex cases.

This approach is not just about medical treatment; it's about understanding and addressing the social determinants of health, a core aspect of the Teal philosophy.

Discover CareMore Health's innovative approach

4. Vita Health Group - United Kingdom


In the UK, Vita Health Group stands out for its commitment to Teal principles, particularly in integrating mental and physical health services.

Recognizing the interconnected nature of mental and physical well-being, Vita Health Group offers a range of services from psychological therapies to musculoskeletal support, embodying the holistic approach of Teal culture.

Moreover, the organization empowers its staff, encouraging innovation and input across all levels, thereby fostering a sense of ownership and alignment with the organization's purpose.

Explore Vita Health Group's holistic services

5. BuurtzorgT - Netherlands


BuurtzorgT in the Netherlands expands the Buurtzorg model into mental health care.

This organization is pioneering in its use of small, self-managing teams to deliver community-based mental health services.

These teams operate with a high degree of autonomy, making decisions that directly impact patient care.

By focusing on building strong patient-caregiver relationships, BuurtzorgT emphasizes personalized care, which is crucial in mental health services.

Their approach is a testament to the effectiveness of Teal principles in a mental health care context, demonstrating improved outcomes and patient satisfaction.

Learn more about BuurtzorgT's mental health care model

6. St. Olavs Hospital - Norway


St. Olavs Hospital in Trondheim, Norway, is an example of a traditional hospital setting experimenting with Teal-inspired models.

In certain departments, the hospital has been shifting towards more collaborative and patient-centered care practices.

These departments function as integrated units where different specialists work together to provide holistic care.

The hospital's journey towards Teal principles involves fostering a culture where every team member's contribution is valued, and decisions are made collaboratively, ensuring that patient care is always at the forefront.

Read about St. Olavs Hospital's innovative practices

Practical Steps to Embrace Teal Culture in Healthcare


Adopting Teal culture in healthcare is a journey that requires a strategic, phased approach, involving several key steps:

1. Leadership Buy-In:


- Engage with leaders at all levels to communicate the benefits and vision of Teal culture.

- Organize workshops or seminars with Teal culture experts to deepen understanding.

Example: At CareMore Health, leadership workshops focusing on Teal principles helped align the management team with the new cultural direction.

2. Training and Skills Development:


- Develop comprehensive training programs to educate staff on Teal principles.

- Incorporate real-life case studies and interactive sessions for practical understanding.

Example: BuurtzorgT implemented regular training sessions, allowing staff to practice self-management in controlled environments before applying it in their roles.

3. Empowerment of Staff:


- Create a framework for decision-making that gives staff more autonomy.

- Encourage staff to form teams and take on projects that align with their interests and expertise.

Example: St. Olavs Hospital implemented pilot projects where teams operated autonomously, leading to innovative patient care approaches.

4. Redefining Hierarchies:


- Restructure teams to be less hierarchical and more collaborative.

- Promote team leadership instead of traditional management roles.

Example: Vita Health Group reorganized their team structure, allowing for more peer-to-peer collaboration and leadership opportunities at all levels.

5. Fostering a Culture of Trust and Transparency:

- Implement open communication channels for feedback and suggestions.

- Regularly share organizational updates and decisions to build transparency.

Example: Heiligenfeld GmbH holds weekly reflective meetings that foster open dialogue and trust among employees.

6. Aligning with the Organization's Purpose:


- Involve staff in defining the organization's core values and purpose.

- Align operational goals and individual roles with these core values.

Example: NHS’s Frimley Health NHS Foundation Trust engaged its staff in workshops to co-create a shared vision and values, aligning with Teal culture.

7. Continuous Improvement:


- Establish feedback loops to learn from experiences and make necessary adjustments.

- Promote a culture of experimentation, where learning from failures is valued.

Example: CareMore Health’s continuous improvement programs encourage staff to innovate and share their learnings, fostering a dynamic and evolving work culture.

By following these steps, healthcare organizations can transition towards a more empowering and fulfilling work environment.

Embracing Teal culture not only improves patient outcomes but also drives positive change, making healthcare more adaptive, inclusive, and effective.

Navigating Challenges in Cultural Transformation


Implementing Teal culture in healthcare, while beneficial, brings its own set of challenges.

Understanding these hurdles and strategizing effective responses are key to a successful transformation.

Challenge 1: Resistance to Change


Nature of the Challenge: Employees may resist abandoning familiar hierarchical structures and practices.

This resistance often stems from fear of the unknown, loss of control, or skepticism towards new methods.

Practical Solution: To overcome this, leadership should engage employees through transparent communication about the benefits and rationale behind the transition.

Create pilot programs where teams can experience Teal principles in action.

For example, St. Olavs Hospital initiated small-scale projects in certain departments to gradually introduce staff to new ways of working.

Challenge 2: Integrating Teal Principles with Existing Systems


Nature of the Challenge: Aligning Teal principles with existing systems and processes can be complex, especially in larger, well-established organizations.

Practical Solution: Start by integrating Teal practices in one department or team and use the learnings to gradually expand to other areas.

Collaborate with all stakeholders to ensure the integration is smooth and considers the nuances of existing systems.

CareMore Health’s approach of implementing team-based care in phases is a good example.

Challenge 3: Developing New Leadership Styles


Nature of the Challenge: Shifting from traditional leadership roles to a more facilitative and coaching style can be challenging for existing leaders.

Practical Solution: Provide leadership training focused on Teal principles, emphasizing skills like active listening, empathy, and empowerment.

Leaders at Vita Health Group underwent training to adopt a more collaborative and less directive leadership style.

Challenge 4: Maintaining Consistency Across the Organization


Nature of the Challenge: Ensuring consistent application of Teal principles across all teams and departments can be difficult.

Practical Solution: Establish a central Teal implementation team responsible for maintaining consistency.

This team should regularly communicate with all departments, sharing best practices and addressing challenges.

Regular check-ins and organization-wide meetings can be effective, as seen in Heiligenfeld GmbH’s approach.

Challenge 5: Measuring Impact and Performance


Nature of the Challenge: Traditional performance metrics may not align with Teal principles, making it challenging to measure impact effectively.

Practical Solution: Develop new metrics that align with Teal values, focusing on patient outcomes, employee satisfaction, and innovation.

Engage teams in creating these metrics to ensure they are meaningful and embraced by all.

By addressing these challenges with thoughtful and tailored strategies, healthcare organizations can navigate the complexities of cultural transformation.

Embracing adaptability, resilience, and continuous learning will not only facilitate the adoption of Teal principles but also ensure long-term success and sustainability of this cultural shift.

Conclusion: Shaping Tomorrow: The Strategic Change to Patient-Centric Healthcare


As we look towards the future, the transformation of healthcare through the implementation of Teal culture is not just an aspiration but a strategic necessity.

This shift, underpinned by strategic change management, holds the promise of enhancing patient care and outcomes significantly.

The journey to a Teal culture, while beneficial, is complex and requires a deliberate, methodical approach.

Central to this transformation is the role of strategic change management.

It acts as the backbone, guiding healthcare organizations through the intricate process of cultural change.

This involves navigating the nuances of redefining traditional hierarchies, empowering staff, and fostering a patient-centric approach.

The expertise of change management professionals becomes invaluable in this context.

They provide the necessary tools, frameworks, and guidance to ensure a smooth transition, helping to align the organizational goals with Teal principles.

Moreover, the support of experts in the field of Teal culture and organizational transformation is crucial.

These professionals bring a wealth of knowledge and experience, offering insights into best practices and common pitfalls.

Their involvement can be instrumental in training leaders and staff, facilitating workshops, and providing ongoing support to ensure the successful integration of Teal principles into daily operations.

The importance of strategic change management in this process cannot be overstated.

It ensures that the transition to a Teal culture is not only effective but also sustainable.

By setting clear goals, involving all stakeholders, and maintaining open lines of communication, healthcare organizations can navigate the complexities of this change.

The result is a more dynamic, inclusive, and responsive healthcare environment, where employees feel empowered and patients receive care that is both compassionate and holistic.

In conclusion, as healthcare organizations embark on this transformative journey, the combined forces of strategic change management and expert support will be pivotal.

Embracing these changes strategically and collaboratively will drive positive outcomes for both patients and healthcare professionals, shaping a future where healthcare transcends traditional boundaries to truly cater to the needs of the communities it serves.

To receive your complimentary copy of our free PDF Guide "How to change & transform your organization to succeed in a turbulent times (keeping your people on board)" for healthcare / pharmaceutical & medical devices organizations, simply click on this link.

Are you considering change or currently going through a process of change management within your organization?

Are you experiencing a feeling of overwhelm at the thought of doing this? Then, you are in the right place !

If this all sounds familiar and you need some professional guidance and support with your business, please contact us for an informal chat so that we can get started with achieving your goal !

Let's embark on this transformative journey together! Contact Bee’z Consulting today to start your transformational journey.

Together, we can drive meaningful change, improve patient outcomes, and create a healthcare environment that empowers both employees and patients alike.

Silvina Layani

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