Organizational Grit

Turning passion and perseverance into performance: the view from the health care industry

by

Thomas H. Lee

and

Angela L. Duckworth

by

Thomas H. Lee

and

Angela L. Duckworth

From the Magazine (September–October 2018) · Long read

Hulton Archive / Stringer/Getty Images

Summary.

Grit, a combination of passion and perseverance, predicts success in many demanding fields. A perfect example is health care, where the grit of individual doctors and nurses has saved many lives. But today providing superior care is so complex that no lone practitioner can do it all. Great care requires gritty teams that never stop striving for improvement and institutions that exhibit grit across entire systems of providers.

In this article Duckworth, the author of the best seller Grit, and Lee, a clinician and health care leader, describe health care’s new model of organizational grit. It begins with hiring people with grit—who love what they do, always want to get better, and are resilient in the face of setbacks. Their single-minded determination stems from a clear personal-goal hierarchy, in which shorter-term objectives support a top-level goal that gives direction to everything they do.

To be gritty, organizations must have a similar clarity about priorities, and their top-level goal and their employees’ must be aligned. If everyone is pursuing a separate passion, a culture won’t be gritty. The gritty health care organizations the authors have seen (such as Mayo Clinic and Cleveland Clinic) all make “putting patients first” their overarching goal and use it to guide every decision. They also work to cultivate grit by, for example, setting high expectations; offering the resources, support, and trust people need to keep learning and growing; and establishing strong social norms that promote their top-level goal.

While the objectives of organizations in other sectors may differ, they can apply the principles the authors outline here to become gritty, too.

Idea in Brief

The Problem

Health care has long depended on the passion and perseverance of individual doctors and nurses. But with the advent of modern medicine, providing superior care has become so complex that no lone caregiver, no matter how gritty, can do it all.

The Solution

Hospitals and health systems must develop grit at the individual, team, and organizational levels. That requires ensuring that all participants are committed to pursuing a shared high-level goal. Putting patients first is a common and effective objective.

How It Works

Sustaining a gritty organizational culture requires clear communication of values by leadership, programs that celebrate successes, and the promotion of a “growth mindset” that embraces continuous improvement and learning from setbacks.

High achievers have extraordinary stamina. Even if they’re already at the top of their game, they’re always striving to improve. Even if their work requires sacrifice, they remain in love with what they do. Even when easier paths beckon, their commitment is steadfast. We call this remarkable combination of strengths “grit.”

A version of this article appeared in the September–October 2018 issue (pp.98–105) of Harvard Business Review.

Thomas H. Lee, MD, is the chief medical officer of Press Ganey. He is a practicing internist and a professor (part time) of medicine at Harvard Medical School and a professor of health policy and management at the Harvard T.H. Chan School of Public Health.
Angela L. Duckworth is the Christopher H. Browne Distinguished Professor of Psychology at the University of Pennsylvania and the founder and CEO of Character Lab. She is the author of Grit: The Power of Passion and Perseverance (Scribner, 2016).

Organizational Grit

Idea in Brief

The Problem

The Solution

How It Works

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