How The CDC Can Restore Trust And Credibility – Forbes


ATLANTA, GEORGIA: Outside the Centers for Disease Control and Prevention headquarters on August 06, … [+] 2022. (Photo by Nathan Posner/Anadolu Agency via Getty Images)
All managers make mistakes sometimes—even big mistakes. The bigger the mistake and the more people it impacts, the more critical it is to acknowledge to those people that you made a mistake. When the manager is entrusted with safeguarding public health, mistakes and bad management practices can be disastrous. In my last column I gave Rochelle Walensky, the Director of the Centers for Disease Control and Prevention (CDC), credit for doing something that is, unfortunately, all too rare in management, especially in large bureaucracies. In her public remarks, she outlined the many missteps her agency made during the Covid-19 pandemic followed by a promise to reform the agency into an effective and trustworthy institution. Indeed, repairing the credibility hole the agency dug for itself should be a top priority. As I wrote in that column, the first critical step—acknowledging errors—though difficult would be the easiest along the journey of regaining the public trust. Her stated goal included the creation of a more nimble, responsive culture focused on accountability, collaboration, and strong communication.
Changing the culture of any complex organization is difficult and requires intentional, disciplined, systematic action over time. It is difficult because culture permeates an organization. Culture is reflected in the goals, roles, structures, decision-making, processes, reward structures, and the norms of engagement throughout an organization that become so engrained they are ‘just the way we do things here.’ Culture change is not for the timid. It takes persistence, and it’s not the result of a set of well-crafted and well-intentioned memos. It requires significant behavior change. We know that behavior change at the individual level is hard. Changing behavior at scale—throughout an organization—is a monumental, but doable undertaking.
Such change begins with a clear understanding of a ‘desired state,’ an articulation of how the future will be different from what exists today, and a plan for what it will take to close the gaps. At a basic level, culture change requires setting new expectations about goals and performance throughout the organization consistent with a clearly articulated vision and then ensuring performance consistent with those goals matters. Making goals matter means setting clear expectations and highlighting performance that is and is not aligned with those goals. Shining a spotlight on what matters and recognizing it is one of the easier actions that helps move the culture along. Public examples of performance consistent with new directions and suitable acknowledgement of those examples helps to reinforce the desired direction. Similarly, selected examples of performance inconsistent with that direction carry enormous weight, saying in essence we will not tolerate ‘x’.
Walensky will need to ensure that the organizational and management practices critical to building a strong culture of responsiveness and accountability are in place. While the task is daunting, there is extensive research and practice experience on the essential ingredients for success and conversely, what leads to failure. A good starting place is understanding the impact of management practices on overall organizational performance and workforce engagement.
Based on research conducted by Numerof across industries for several decades, consistent with findings of others, there are a select set of management practices that accurately predict organizational performance (including financial) and positive employee identification with the organization. These practices include:1) strategic role clarity, the extent to which employees understand how they make a difference in accomplishing the organization’s goals and objectives; 2) performance emphasis, the extent to which employees are expected to deliver consistently high quality outcomes that are strategically relevant; 3) feedback, the extent to which employees receive regular, meaningful, positive, as well as constructive negative feedback on performance; and 4)interpersonal effectiveness reflecting the extent to which employees believe they are able to meaningfully disagree with their manager. These four crucial management practices set the stage for creating a healthy dynamic and an accountability focused organizational culture. Let’s unpack each in the context of the CDC.
Most people want to make a difference and be part of something bigger than themselves. The CDC’s commitment to monitor and determine where disease outbreaks might happen and what can be done to prevent them presents a mission many would rally to support. CDC employees who understand how their role fits into that mission are likely motivated to ensure its success. But whether or not that happens depends on the next set of management practices.
The best organizations demand superior performance of their teams, expecting them to stretch their capabilities. The best managers help staff accomplish more than they believed possible. And those expectations, if they’re clear are likely to cause some discomfort on the path to achieving them. But it’s this tension that drives professional growth and enables an organization to tackle more difficult challenges down the road.
Stretch performance demands feedback—timely, positive and constructively negative feedback in service of the mission along with clearly articulated expectations. Unfortunately, effective feedback is a relatively rare commodity in most organizations. Too many people don’t like sitting down and having tough conversations. Which relates to the fourth practice—interpersonal effectiveness and the ability of managers to create the environment in which staff are expected to engage in constructive debate with their manager—feeling comfortable disagreeing. It is in large part the absence of this practice which was at the heart of the Challenger disaster I described in my last column.
How different demographic groups within an organization view the impact of management practices is obviously critical to building a robust culture focused on the mission. Evaluating the ‘state’ of management practices on a regular basis, for example, annually or semi-annually, and taking action to continuously close gaps and improve managerial effectiveness is hard work but job one to achieving cultural improvement along the lines of what Walensky committed to do. Evaluating these practices through the eyes of different subgroups is also important in keeping a finger on the pulse of the company. In the strongest organizations where merit is the basis for advancement and recognition, we don’t find differences between demographic subgroups. Where disparities do exist they get addressed systematically. This is hard work, and in most organizations, it just doesn’t get done.
The most successful organizations will have multiple layers of leadership that are optimized in a way that inspires good performance while also allowing for the push and pull of competing ideas. If done correctly, a robust and effective culture can emerge throughout the entire organization.
It is management practices that shape and reflect organizational culture. In organizations where competing ideas get aired and evaluated, where employee input is valued along with a fulfilling mission, we see employee retention, commitment, and the conditions that materially advance the organization.
Doctrinaire adherence to certain ways of thinking will prevent the development of such a culture. Silencing or canceling differing viewpoints will sow discord throughout an organization and undermine the required diversity of opinion that is so critical to achieving excellence. This played out during the pandemic when government and social media companies coalesced to shut out informed, but countervailing, views from epidemiologists and disease management experts who didn’t toe the approved line, like the authors of the Great Barrington Declaration. In so doing, the public health managers of the pandemic, including Anthony Fauci, took hits to their credibility.
Organizational leaders need to create a work climate where challenging ideas is not only allowed—it is expected. Virtue signaling and hitting empty ‘diversity’ metrics will distract agencies like the CDC from accomplishing the reforms they have set out to achieve. Martin Luther King Jr. saw a day in the future in which people will not “be judged by the color of their skin but by the content of their character.” Organizational success depends on leaders’ ability to do just that.
The CDC has an opportunity to dramatically change the culture that has proven so ineffective and caused such distrust among Americans. Because of their essential public safety role, the need for change is an urgent one. New and significant threats to public health could and likely will emerge again. Despite the labyrinth of bureaucratic processes that often impede their effective operations, real reform is achievable. It will not happen overnight, but it is critical that they succeed. After all, when it comes to public health, their success is critical to our own.

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