The Positive Organization

The article below is adapted from the book The Positive Organization: Breaking Free from Conventional Cultures, Constraints and Beliefs by Robert Quinn, whose passion is helping enterprises transform for the better. His work centers around recognizing bright spots, learning from them, and helping organizations thrive.

Two Hospitals, Two Cultures

Here’s a story about a friend who went with a team of colleagues to visit a hospital that I’ll call Hospital 1. They were warmly greeted at the front door by a man in a top hat. Inside, they saw the usual information desk and waiting area, but also spaces available to the community for such things as weddings and cooking classes. As they toured the hospital, they got the impression this hospital was like a five-star hotel.

Then they bumped into Hospital 1’s CEO, who welcomed them and asked if he could help them in any way. He chatted with them for a half hour and shared his vision and philosophy.

During the rest of the tour, they asked the employees about the CEO. People at the lowest levels talked as if they had a personal relationship with the man. They spoke with pride about the vision and values of the hospital. There was a positive culture that seemed to focus, unify, and animate them.

My friend and his associates left deeply impressed. While they were all doctors who have spent their lives in hospitals, it was clear that they had just observed a hospital that exceeded their expectations. They had encountered a truly “positive organization.”

Shortly thereafter, my friend was dropped off at the front door of his own hospital: we’ll call it Hospital 2. As he walked in, he was met by a gruff woman who wanted to know if he was a student. He explained that he was a surgeon and was scheduled to operate. She would not grant him entry, citing hospital policy. He would have to go back out and walk around to the employee entrance. The surgeon tried to handle the situation artfully, but the woman threatened to call security. He went back out.

A few days later, he related what had happened in a meeting with a senior officer of Hospital 2. This person responded to the story by asking for the name of the woman. The executive wanted to fire her. To the administrator’s mind, firing the woman was the right thing to do. He wanted to establish and maintain order and control. He wanted to make the hospital run better. A person who seeks a predictable, smooth-running organization often focuses on disruptions and disruptive influences: the natural inclination is to fix those disruptive problems. In this case, the knee-jerk solution was to fire the woman.


When we focus on a problem, we are not seeing the whole system. Likewise, when we focus on a single person, we are not focusing on the culture of which that person is a part. When people focus on the part rather than the whole, it does not occur to them to ask a most important question: How might the entire culture be reshaped so the people flourish in their work and exceed expectations as they perform?

I had the opportunity to work on a project designed to improve over 60 nursing units in Hospital 2. The work proved to be a great challenge. Each time we surfaced some positive practice that might improve a unit, one of the directors would explain why it was impossible to employ it.

As we sought to modify their beliefs and elevate their aspirations, we began to examine the nursing units more closely. We looked for a positive exception, a unit that defied the conventional culture of the hospital. The exception was easy to find. When we asked administrators if there was such a unit of excellence, they all answered in the affirmative and named the same one, which I will call Unit 5.

Unit 5 served children who were seriously ill. This was demanding work, and yet they were usually first or second on every hard performance measure. Measures of morale were also high. In many of the other units, turnover was high; in this unit, however, the turnover rate was close to zero, and there was a long list of nurses waiting to transfer in. Why?

Other units in the hospital also served populations like Unit 5, but none performed like Unit 5, which took a unique approach to everything they did. For example, every unit had been given money to hire a hostess to greet new patients. Nearly all the units hired a nurse. Unit 5, however, hired a drama major and then sent her to clown school. When very sick children and anxious parents arrived on the unit for the first time, a very skilled clown greeted them. Within minutes, they felt they had become part of a special community in which they would be treated as full human beings.

When we interviewed the nurses in Unit 5, they told stories of people going the extra mile to take care of patients and each other. They spoke of collaboration and achievement. It seemed to be a place of high commitment and compassion.

The people we interviewed spoke of the unit director in the same way the people in Hospital 1 had spoken of their CEO. In our interviews, some nurses actually shed tears as they spoke of their leader. Their descriptions suggested that she was deeply committed to creating a positive unit, where the people around her flourished, in a conventional hospital.

This work shows that very often, survival, not flourishing, is the aspiration of conventional managers. They do not look for or expect to find excellence. When they do find excellence, they tend to ignore it rather than examine and learn from it. Everyone knew about the excellence of Unit 5, but it never occurred to anyone that it was possible to use that success as a lever for creating a more positive culture in other such units.

Unit 5 was a clear “bright spot” in Hospital 2. Why wasn’t it used as a model for the others? Learn what else Bob Quinn has to say about his work with Hospital 2 and other organizations in his book, available now.

About the Author:

Bob Quinn is currently the Margaret Elliott Tracy Collegiate Professor in the Management and Organization Group at the University of Michigan’s Ross School of Business. He is one of the cofounders of the Center for Positive Organizations at the Ross School. At the Center, he delights in learning from his colleagues who are working to understand and create organizations in which people flourish and exceed expectations. He has published 16 books, including his bestselling book, Deep Change; Lift: The Fundamental State of Leadership (with Ryan Quinn), and the 2015 winner of the Ben Franklin Award, The Best Teacher in You (with Kate Heynoski, Michael Thomas, and Gretchen Spreitzer).