In February, St. Joseph Hospital was named one of the “Best Places to Work in Indiana” for the sixth consecutive year. Hospital President Kathy Young firmly believes that it is St. Joseph’s “corporate culture that has made this achievement possible.” It has built a model BRAVE culture.


Getty Images via @daylife

The BRAVE framework can be used to determine the true culture of an organization underneath the surface or stated culture. The key elements of BRAVE are behaviors, relationships, attitudes, values, and the environment. Through examining each we get a unique glimpse into what underpins the hospital’s success, providing clues for how other organizations can establish a similar sustainable corporate culture.


Behaviors involve how people act, make decisions, control the business, etc. St. Joseph prides itself on putting patients first and driving everyone’s behaviors from that premise.

As Young wrote in a recent article,

Having the right group of people, who deliver on our mission, makes our ED (Emergency Department) a special place. In the ED, things can go very well, and then in a second, it all changes and the patient and their loved ones face grave challenges. Our responsibility is to be prepared to give patients the best care, without exception. And we do. – Monette Allen, RN, Manager of the St. Joseph Emergency Services department


Relationships entail how people communicate with others (including mode, manner and frequency), engage in intellectual debate, manage conflict, assign credit and blame, etc.

The patients-first mantra at St. Joseph Hospital carries through to the way associates relate to each other. In my interview with Young, she shared that as her associates invested in “understanding each other’s work and building relationships, the silos fell away. If we all own the problem, we all own the solution.”

Again from Young’s article:

Once (nursing associate) Dana realized there was a patient in need of her nursing skills, without question and without hesitation she responded, ‘If she needs me, I will be there.’

St. Joseph’s Director of Marketing Sandy Herman pointed out to me that “It’s not just Kathy preaching from the mountain top. Every associate knows the same thing.” Witness this quote from Young’s article.

Judy Lauderbaugh, RN, Manager of Day Surgery, said, ‘Our associates ‘own’ their caregiver role. We take care of people, and that is our passion. Listening to what a patient says and doesn’t say, yet communicates with their body language, shows how tuned in our associates are. People who come to Day Surgery know they are ‘cared about’ as much as they are ‘cared for.’ Surgery is frightening, and these patients know right away that our associates are committed to them from the first greeting to the last ‘see you soon.’


Attitude encapsulates how people feel about the organization’s purpose, mission, vision, identify with the subgroup, group, organization as a whole, basis for power, etc.

Young told me that when you

create an attitude that says our goal is to get patients what they need, when they need it, every time, suddenly you get more answers to the questions…(our associates) understand the importance of their work. People want meaningful work. They want input. They want ownership…Our people really take pride in the work they do. You can’t put a price tag on…the most amazingly positive, loving and caring attitude you can imagine.


Values are the underlying assumptions beliefs, intentions, approach to learning, risk, time horizons, etc. They are the bedrock of culture. Young told me that, “Our values give us direction.” The following values help the hospital “Keep healthcare human” for all:

  • Service of the Poor – Generosity of spirit, especially for persons most in need
  • Reverence – Respect and compassion for the dignity and diversity of life
  • Integrity – Inspiring trust through personal leadership
  • Wisdom – Integrating excellence and stewardship
  • Creativity – Courageous innovation
  • Dedication – Affirming the hope and joy of our ministry


Like most hospitals in the United States, St. Joseph faces a tough environment:

  • The uncertainty of what healthcare reform will ultimately look like
  • As reimbursements continue to shrink, learning how to provide more care with less money
  • Learning how to effectively integrate into a national system without losing its local flavor
  • Economic recession

Stacked against these constraints are the people of St. Joseph. Young’s perspective on this is that “people want to bring their best, their personal gift, to work.” It’s all about inspiring and enabling them to do their best, together.

A Winning Culture Is a BRAVE Choice

Since corporate culture is the only truly sustainable competitive advantage, leaders must ensure that their culture is adapting to the changing business environment. Culture is a choice, not an inheritance. Survival of the fittest means survival of those best able to adapt to changing circumstances. This is why we’re all new leaders all the time. This, in turn, is why we must continually evolve our culture. We’ll give Kathy Young the last word:

A great culture is a powerful thing. It benefits not only the organizations and communities that have it, but even more so the ‘customers’ and residents who are the focus of the effort.

This is a good example of step 2 of The New Leader’s PlaybookEngage the Culture and Your New Colleagues in the Right Context

Be careful about how you engage with the organization’s existing business context and culture. Crossing the need for change based on the context and the cultural readiness for change can help you decide whether to Assimilate, Converge and Evolve (fast or slow), or Shock.

Click here to read about each step in the playbook

Click here for YouTube videos highlighting each step