Change & InnovationHospital

Towards a culture of caring

Dialogue and meaning-making as catalysts

The manager of a University Hospital dreamt of, what he called, ‘a culture of caring’. With care as a central element, in a number of ways. Patient care, care for each other as colleagues, and self-care: resilience and personal attention.


His question was: How do we get people on board for this idea in a large organisation? How do we translate a broad concept as ‘a culture of caring’ into concrete daily work practices?



Over the course of a few years we supported this culture development with a range of activities. For example, we organised World Cafés with all managers on how they - in their role - enable a culture of caring. In sessions with the strategic management team, we searched for leadership strategies for them to include an organisation of 6,000 employees in this story. And once a year, a 'Day of Dialogue’ is organised, in which 250 employees from very different roles and departments, have in-depth conversations with each other about care, values and culture. 



We designed and supported all these activities on the basis of two central principles.


The first was ‘personal meaning’. Hospital staff were given the space to give meaning to the values in relation to their own working practices. This means that management did not opt for a single uniform definition of care and taking care. Instead, they created dialogical contexts where employees could give meaning and sense to such values and their culture in interaction with each other.


The second starting point was an appreciative inquiry approach. Working on the basis of what is already there. We regularly invited employees and managers, in various ways, to share with each other moments when certain values were highly recognisable to them in their daily work in a positive manner. By investigating these stories together, insights were created, and new ideas were developed. These in turn were used for actions and initiatives to bring the values to life even more strongly. This connection between reflection and action brought movement.




In just a few years, the hospital has developed a whole new language of care and taking care. Very important, since 'words create worlds'. The general concepts have come to life, stories have been created and shared with which people in the organisation indicate how they would like to interact with each other and patients. And this also led to action. Various departments translated the cultural themes into very concrete approaches. The HR department now organises its selection processes with the values as a guiding principle. And the dialogues inspired people to develop a game with which teams can explore the values and their teamwork. Concrete effects are noticeable also in the quality of mutual collaboration and during patient care. Hospitals are generally not in favour of epidemics, but in this case it seems as if an epidemic of care has spread through the organisation. People keep passing on ‘the care bug’.