Do you know the Academy’s new core values? Did you know the previous core values? Regardless of the actual words or phrases, do you have a sense of the organizational culture? Are we where we want or need to be?

The last two questions are especially difficult, but every successful organization asks them. The AAOS Board of Directors addressed these questions, as well as many others in respect to the organization’s culture, and, in the end, created the Academy’s three new core values—leading to serve, shaping our future, excellence together. They were introduced at the 2019 National Orthopaedic Leadership Conference and highlighted in the AAOS Now article “Academy Develops New Core Values,” which was published in the July issue. These values serve as a foundation for developing a high-performing culture. Our organization’s culture must be carefully and intentionally developed in order to successfully execute the Academy’s new Strategic Plan (www.aaos.org/strategicplan).

The new core values will drive behaviors and actions and serve as guideposts for volunteer leaders on day-to-day interactions, relationships with key stakeholders, and strategic decision-making as we work together to achieve the Academy’s vision. They will serve as values related to board and volunteer service in the organization and are not statements about individual members’ personal values. However, members who act in accordance with these values will likely thrive as AAOS leaders.

The Board worked with THRUUE, Inc., a Washington, D.C.-based consultant group, to assess the current culture and declare new core values, as well as supporting behaviors for each value (see sidebar).

However, simply setting new core values is not enough to enact culture change. There needs to be change at the individual, team, and system levels within AAOS in order to truly live into the stated values.

In a 2002 Harvard Business Review article by Patrick M. Lencioni titled, “Make Your Values Mean Something,” he cautioned that developing and adhering to strong values for an organization requires “real guts,” change, and constant vigilance. He also noted that many groups laud the initial rollout of new values as a “check-the-box” event and do not focus on the authenticity of the content or its meaning. The path ahead for AAOS is to eliminate the gap between what we say and what we do. Finally, Mr. Lencioni described different categories of values, and I believe AAOS’ values fit into his “core” and “aspirational” categories.

Leading to serve

Note the behaviors that underlie this value. I believe “leading to serve” is a “core” value, as AAOS enables members to best serve patients by equipping them with the most up-to-date tools and resources in education, quality, practice management, and advocacy. AAOS is currently focused on delivering an improved member experience (AAOS Strategic Plan Goal No. 1) and supporting members to drive excellence in musculoskeletal health (i.e., AAOS’ vision: The trusted leaders in advancing musculoskeletal health). To that end, a new leadership offering will be announced early next year. Skills learned in this program will be primarily focused on leading within the AAOS volunteer structure but may be applicable to other leadership roles. We, as volunteer leaders, recognize that all members, stakeholders, and patients do not share the same levels of education, experience, or perspective, and we are committed to engaging them where they are and leading them forward whether the topic is hip arthritis, understanding value-based health care, or change management.

Further, decision-making about AAOS issues and programs will occur within the volunteer structure in a transparent way in alignment with the Strategic Plan and our governance principles. Diverse and personalized communication to the membership is critical and ongoing so that the rationale for any change is clear.

Shaping our future

The behaviors that support this value are currently part “core” and part “aspirational.” The Board and volunteer leaders will prioritize proactive decision-making that benefits members and patients. This effort requires data, rather than opinion, in order to understand what members need from AAOS and whether they are satisfied with the programs and offerings. To that end, many of you will soon receive the annual AAOS Member Value and Satisfaction Survey, and I encourage you to contribute your “data” and voice.

To further support this value, AAOS has dedicated time and substantial resources to developing quality tools and assimilating evidence about common musculoskeletal conditions and treatments to benefit our patients. For example, the burgeoning field of regenerative medicine is an area where data and evidence are sorely needed to help members and patients better understand what treatments in the biologics arena are or are not reasonable for a specific musculoskeletal condition. Further, many of AAOS’ advocacy efforts are now tied to the promotion of quality and access in specialty care.

In order to stay relevant, AAOS will need an innovative mindset and will have to embrace disrupters in the education and healthcare spaces.

Excellence together

The behaviors underlying this value are likely seen by many as “aspirational.” The Board is committed to its partnership efforts with specialty societies and other collaborators. The Joint Commission and United Healthcare have partnered with AAOS to designate hospitals and practices that submit data to AAOS clinical registries as Centers of Excellence. AAOS will soon communicate the details of a plan focused on evolving the Board and volunteer structure to become more diverse (i.e., AAOS Strategic Plan Goal No. 3). A critical aspect of this initiative is implicit bias training for AAOS volunteers and staff. There will also be a new education speaker policy that defines a set of expectations for those presenting at AAOS courses, webinars, and meetings and also outlines a process to manage complaints about inappropriate content. Finally, the majority culture within AAOS is not overwhelmingly diverse in terms of race, ethnicity, sex, religious affiliation, sexual orientation, disability status, or income. To embrace this value is to empower and seek input from all members, not just those who have traditionally been in decision-making roles.

Change management

How do we keep these values from being just words on a page? How do we actually change behavior?

Note the stages of behavior change illustrated in Fig. 1 and take a moment to think about where you are on the path as an AAOS volunteer leader or member.

Change starts at the top with the Board, councils, cabinet, and committees. We are early in the journey and must keep these values top of mind in order to change the culture. If these values are going to take hold throughout AAOS, they need to be integrated into every member-related process. It will require difficult decisions in order to update governance structures and processes that involve the Board’s decision-making, board/committee member selection strategies, strategic partnerships, and member communication.

I will promote and relentlessly repeat these new core values everywhere I speak. I ask you to hold AAOS leaders and me accountable to exhibit these behaviors and make decisions that align with these values.

Kristy L. Weber, MD, FAAOS, is president of AAOS, as well as a professor and vice chair of faculty affairs in the Department of Orthopaedic Surgery at the University of Pennsylvania.

References

1. Lencioni PM: Make Your Values Mean Something. Harvard Business Review. Accessed September 26, 2019. Available at: https://www.hbr.org/2002/07/make-your-values-mean-something.

AAOS Core Values

Leading to serve

1. We relentlessly focus on enabling our profession to better serve our patients.
2. We mentor and support our members to drive excellence in musculoskeletal health.
3. We engage members, partners, and patients where they are, and lead them forward.
4. We practice transparent decision-making and open communication.

Shaping our future

1. We use data and evidence to stay a step ahead.
2. We advocate to promote quality musculoskeletal care.
3. We proactively embrace disruptors, and develop innovative products and services.

Excellence together

1. We empower and seek input from all people, not just the majority.
2. We acknowledge unconscious biases, and seek to address barriers to inclusion.
3. We collaborate based on mutual respect and trust.

Approved: May 20, 2019