A field guide to real-time culture change: just "rolling out" a training program won't cut it.

Presented as a representative case of how to handle the disruptive behaviors of professionals in healthcare, this article describes the strategies of a systems approach with a five-phase model for culture change. The "large-scale, real-time" culture change process, based on our own evidence-based research on toxic behaviors and the research of others, has been demonstrated to be more effective than one-on-one feedback to change these behaviors. The real-time approach has been applied to other organizational situations--strategy formulation, change management, or service improvement--with more sustainable effects than simply training alone. This article will help your organization with four outcomes: understanding the rationale for a five-phase model for cultural change, describing the advantages of a real-time versus nonreal-time approach to change, identifying the how-to's for application within a systems approach, and articulating a clear evaluation process to sustain successful organizational culture change.