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Why We Can’t Shift the Dial on Institutional Culture

Khan, Nagina (2026) Why We Can’t Shift the Dial on Institutional Culture. . BMJ Leader, 1 pp. Website, online. (KAR id:115138)

Abstract

I often hear the same frustration: ‘why can’t we change the culture, no matter how many initiatives we launch?’ New values are drafted, consultants are brought in, workshops delivered but day-to-day reality barely shifts.

Often, the answer is in plain sight: those who have been there longest quietly shape the culture the most, not always in ways that help the organisation evolve. Over years or decades, people accumulate informal authority. They know which rules matter, which can be ignored and employees watch them closely, learning ‘how things really work.’

As organisational culture scholar Edgar H. Schein explains, culture is reinforced through shared assumptions and everyday behaviours, especially those modelled by influential insiders. Employees follow what experienced colleagues do, not what documents say.

Item Type: Internet publication
Uncontrolled keywords: Culture, Institutions, Leadership, Healthcare
Subjects: R Medicine > RZ Other systems of medicine
Institutional Unit: Schools > School of Social Sciences
Schools > School of Social Sciences > Centre for Health Services Studies
Former Institutional Unit:
There are no former institutional units.
Depositing User: Nagina Khan
Date Deposited: 14 May 2026 18:13 UTC
Last Modified: 14 May 2026 18:13 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/115138 (The current URI for this page, for reference purposes)

University of Kent Author Information

Khan, Nagina.

Creator's ORCID: https://orcid.org/0000-0003-3870-2609
CReDIT Contributor Roles: Writing - original draft (Lead), Conceptualisation (Lead)
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