Each week, my Inc. column is dedicated primarily to issues around culture and employee engagement.  Good and bad company culture exists everywhere in business.  But you'll also find both in many other institutions, like schools, churches, and even hospitals.  Because my company serves more than 500 hospitals across the country, I get to see the "backstage" operations of many of these organizations.

You might not think about it often (how often do you muse about the hospital), but if you or a loved one ends up at the hospital, you should consider many of the same questions you ask as a customer of any other type of business.

The sad reality is that although hospitals are chock full of dedicated people who have a heart for service and caring, they work in some of the most dysfunctional cultures around.

Think about it--physicians are highly trained technicians, administrators are highly-educated executives, and nurses are taught to be compassionate caregivers.  But none of these groups were taught about how to collaborate to serve a common customer: the patient.  They spent years in their silos learning trades, but were never taught the basics of customer service, or how to treat each other.

As a result, there is tremendous inconsistency among cultures at hospitals--or whether they are even committed to culture at all.  Why does this matter to you and your employees?  Because you are now in a world of high-deductible health plans and increased personal and financial responsibility for our own health care.  You have more information and more choices than ever before.  So as your employees start to do more "shopping" for their health care, they should take advantage of their right to evaluate all aspects of a good experience: cost, quality, and service.

You can now go online and compare hospitals and physicians, and see ratings from clinical outcomes to patient satisfaction. But you don't see ratings about the cultures of hospitals.

That's why I wrote my latest book, Patients Come Second: Leading Change by Changing the Way You Lead.  I realize that I'm courting some controversy by not saying patients come first.  The fact is that no one can fix the patient experience if you don't fix hospital culture and start to care about each other first.  Let's shake up the industry a bit, and get everyone involved to realize that improving patient service starts with improving employee engagement.  There is already plenty of data that hospitals with happy employees have better clinical outcomes and better patient experiences.  And, not surprisingly, better financial results as well.  

So how can you assess the culture of a hospital?  The same way you would any other business.  Do the employees smile?  Do they seem engaged and committed to their work?  What is the vibe when you walk in the door?

Remember, you're not buying a pair of jeans here.  You're talking about services that are critical to your personal health, and often, the well being of loved ones.  Make sure your employees are considering everything that goes into the health care choices available to them--including culture.