Patrice Putman
Director of Employee Development, MaineGeneral Health
Under the leadership of Patrice Putman, the corporate culture at MaineGeneral Health has been transformed from a culture of silence to a culture of candid and respectful dialogue.

This culture change began in 2003 when results from the employee satisfaction survey revealed that more than 20 percent of employees felt incapable to address conflict or safely express their opinions. With this insight, Putman rallied a qualified team of influencers to build a culture of safety and cooperation—one crucial conversation at a time.

To identify behaviors that stifled candid communication, Putman analyzed survey data and observed and talked with employees. She heard about intimidating behavior toward those who confronted others—especially if there was a perceived power differential. In addition, employees’ behavior was driven by multiple, competing purposes. While everyone cared about safety, quality, and satisfaction, these priorities were shuffled in the rush to save lives.

To change these vital behaviors of intimidating and competing motivation, Putman and her team turned to six sources of influence.

Personal Motivation: Putman tapped into employees’ desire to make their jobs more enjoyable. The team reminded staff that their efforts were in direct response to a large scale request to “deal with conflict  better” as revealed in the Employee Satisfaction Survey.

Personal Ability: Putman rolled-out Crucial Conversations® Training to 800 employees, a course that taught skills to candidly and respectfully communicate in the face of high stakes, opposing opinions, and heated emotions.

Social Motivation and Ability: Putman had 12 respected VPs and managers teach the training courses directly to their employees. Consequently, the initiative became an organization-wide effort—motivating employees to adopt the new skills and receive continued coaching.

Structural Motivation: Putman developed a MaineGeneral Health Certificate in Professional Development—an award that recognizes anyone who completes eight training courses ranging from proactive listening to navigating change. To date, more than 200 employees have received their certificate and proudly display them in their offices and include it in their resumes for promotional considerations.

Putman also updated the organization’s values and standards—benchmarks used in employee performance reviews—to include clear expectations around what to do if the values were compromised. Statements were added to each value that encouraged people to respectfully tell the offender why they felt the behavior was unwarranted.

Structural Ability: Putman and her team used organization-sponsored cues and reminders such as articles in the employee newsletter that highlighted goals and emails to management relating success stories.

They also offered refresher courses at management conferences and frequently challenged employees to work towards new goals. Additionally, Crucial Conversations Training became a required part of every new manager’s training.


In just four years, Putman’s influence efforts achieved the following results:
Trained employees changed their behavior. They are 53 percent more likely to confront dangerous shortcuts and 51 percent more likely to address mistakes in providing patient care then untrained employees.

Results of the employee satisfaction survey surrounding conflict improved markedly. Today, results of 41 of the 42 questions have improved; and every question asked is now significantly higher than the state average.

However, the most impressive result is the culture transformation. Difficult conversations take both skill and courage. At MaineGeneral, under the leadership of this influential team, the expectation has been made clear, the skills have been provided, and the courage is now demonstrated in every part of the organization.

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