How to inspire a change in culture – two essential ingredients

‘You need to develop that sense of shared consciousness…so we all know what the picture is, what we’re striving collectively to do and we’ve got permission to get on and do it.’

Joe Jenkins, Director of Fundraising and Supporter Engagement, The Children’s Society and formerly Friends of the Earth
One of the findings that stands out from the research we have conducted into outstanding leadership as part of the Commission for the Donor Experience, is how hard the outstanding leaders work at reinforcing the vision of what success looks like. Though I have found many would nod and say they know this, there is often a big difference between ‘knowing’ something (ie intellectually) and relentlessly doing it in practice.

In the following excerpt from my draft report on outstanding leadership, I share the story of the extraordinary change in the culture achieved at a hospital in the US. It contains two fundamental techniques I believe any charity leader must master if they are to inspire a donor-centric culture.

Step 1. Focus on the WHY

When Dr David Feinberg became CEO of the UCLA Health System the organisation was facing a tough challenge. Though it had a very strong track record for the quality of the surgery people received, too many patients were unhappy with their experience of the hospital. In fact, two out of every three patients said they would not recommend the hospital to others.

Go and truly listen

Dr Feinberg wanted to find out what was going on, so one of his first moves was to ask the patients how they felt about their experience at the hospital. He interviewed one lady who had had a very traumatic experience at the hospital, including receiving surgery for a part of her body which was in fact healthy and should not have been touched.

To cap it all, when the time came to go home she realised she was short on cash, but when she asked for a voucher from the receptionist to cover the taxi she needed to get home, she was told that according to the hospital rules, she did not qualify for the taxi voucher scheme.  As a result, she took a taxi as far as the change in her purse would allow and then painfully limped the remaining miles to her home on foot.
This harrowing story brought home to Dr Feinberg what was going wrong. Most staff were just ‘doing their job’. Though the receptionist’s behaviour is inhumane from the reader’s point of view, she probably reasoned that following protocol was all she could do in the remit of her busy job. And that, concluded Dr Feinberg, was the problem. Everyone was so focussed on what they thought their role was, they did not realise that in fact every time they interacted with a patient, they were the ‘keeper of the flame’ for the entire hospital.

The UCLA health care system is a vast organisation, including over 50,000 doctors and nurses, let alone numerous other roles, and is split across several sites. Doubtless most were good people, working very hard in spite of numerous challenges.

How did they help everyone feel they had to do things differently?

They created opportunities for the staff to meet patients like the woman we mentioned earlier and hear what they had experienced. In so doing, he helped everyone to not only understand, but also to own the mistakes and learn from them.

The result was that everyone started to feel they had messed up if a patient was not taken care of.

Step 2. Make clear what success looks like, in concrete terms.

Another challenge was, with so many different roles in the huge workforce, Feinberg and his team needed a way to help people work out what they should do, no matter the situation. The solution was the motto ‘how would I treat this patient if they were my own mother?’. Furthermore, Dr Feinberg repeatedly stated, this meant that if in doubt, you should ‘make the decision. Do what’s right.’ So when certain doctors came up with excuses, their colleagues would now say ‘I can see this is difficult situation, but as it stands my mother wouldn’t appreciate the solution you propose’.

Within a few years, the culture at UCLA Health Care System changed completely, and this shift made a demonstrable difference in their measurable results. For example, the average waiting time in the Emergencies department went from over three hours to 18 minutes; and in terms of patient satisfaction the Centre became one of the highest performing hospitals in the US.

Leadership starts with vision – Define and champion what success looks like, and why it matters. If you would like to help your charity increase its impact by creating a truly donor-centric culture, focus attention on why changing the way you work with supporters is something you must do, not just something you should do.

Change is usually hard, however much you personally may think it is the correct thing to do. Your colleagues will not do things differently unless they connect to reasons for the change (that make sense to them).

How concrete and clear is your organisation’s purpose? Explore ways you could help your colleagues become clear what positive change your charity is aiming to achieve?

  • Find ways to continually reinforce why this purpose matters. For example, create regular story-sharing opportunities (for example in all team meetings) and regular opportunities for interaction between fundraisers and those on the front line.
  • How concrete and clear is your organisation’s purpose? Explore ways you could help your colleagues become clear what positive change your charity is aiming to achieve?


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