The Florence Prescription - The Florence Challenge

T h e F l o r e n c e P r e s c r i p t i o norganization has a culture – it is to thehospital what personality and characterare to the individual. Your culture will bedefined by what you expect and by what youtolerate. And over time, what you toleratewill dominate what you say you expect. Topermit is to promote. If you permit peopleto deviate from integrity, compassion andrespect – for example, by passing gossip inthe hallways and break rooms, whether ornot there happens to be a patient withinCulture is to the hospitalwhat personality andcharacter are to theindividual. Your culturewill be defined by whatyou expect and by whatyou tolerate. Over time,what you tolerate willdominate what you sayyou expect.earshot – you will inevitably promote a culture where those values arejust good intentions. With I-CARE you tell people that you expectthem to act with integrity and to treat people with compassion andrespect, but if you tolerate gossip and rumor-mongering you insidiouslyundermine those values.”“Well,” Myerson said, “every hospital runs on the rumor mill. AndI’m not really sure that there’s much we can do about changing culture.That’s sort of a given, at least in the short run.”“When we spoke on the phone,” Carol Jean replied, “you told methat you don’t want Memorial Medical Center to be like every otherhospital. You want it to be the best; you want it to go from good togreat. But if your culture is not consistent with your core values, youmight possibly be good, but you will never be great. And so not onlycan you influence the culture, you must if you are to achieve that goalof being the best.”Nightingale had been staring at the stained glass artwork throughwhich no light passed because it was suspended on a brick wall. Witha long blink, she ended her reverie and rejoined the conversation. “AtScutari, most of the orderlies were lazy ne’er do-wells. They wouldn’tgo near the sickest patients, they wouldn’t help change dressings onthe most hideous wounds, they wouldn’t stoop to empty the chamberpots.” She looked to Carol Jean then back to Myerson. “You have noidea the smell of a hospital where the chamber pots are not frequentlytended. That was the culture of Scutari, and it was the culture of the54