Changing Dysfunctional IT Culture

Workshops, leadership retreats, consulting engagements, campaigns – all are lip service approaches to jump start cultural transformation with no real expectation of achieving it.

So why do this – why put time and effort toward approaches everyone knows will quickly fade away and come to nothing?

How does organizational culture lead to dysfunctional IT operations?

Signs Your IT Culture May Be Dysfunctional

Healthcare IT dysfunction is often rooted in culture - the behaviors, incentives, leadership practices, governance structures, and decision-making patterns that shape how work gets done.  

Dysfunctional culture does not emerge overnight - it develops gradually through repeated behaviors and decision-making patterns until organizations begin accepting dysfunction as the standard operating model.  Teams work harder but accomplish less, initiatives move slowly, and frustration grows.

Common warning signs include:

• Chronic project overload
• Persistent resource shortages despite staffing increases
• Constant interruptions and reprioritization
• Limited cross-functional collaboration
• Governance meetings that approve nearly every request
• Focus on activity rather than outcomes
• Lack of alignment between strategic goals and daily work
• High levels of employee frustration and burnout

As these symptoms become the daily norm, organizations stop viewing them as problems and treat them as the standard way of working and behaving – they have become part of the culture.

The Impact of Cultural Dysfunction

Many healthcare organizations recognize operational inefficiencies and process breakdowns.  They experience duplicated work, conflicting priorities, overwhelming expectations, communication breakdowns, and governance challenges.  As outlined in MAKE’s article Identify and Address Operational Process Problems, spotting dysfunction is not usually difficult.  What proves far more difficult is addressing the cultural behaviors that create those problems in the first place.

Sound familiar: A health system invests millions of dollars in new technology to become a premier digitally driven organization, but projects are continually delayed and clinical and business involvement is a constant struggle.  The key to achieving the organization’s desired outcomes isn’t just dependent on implementing technology but requires culture change too.

As organizations pursue strategy, they often focus on technology implementation, testing, and deployment while overlooking the cultural climate in which those initiatives must operate, ignoring the silos and divergent and conflicting priorities.  New systems may get deployed but old behaviors and struggles remain.

When culture is unhealthy, organizations experience:

• Delayed initiatives
• Lower returns on technology investments
• Increased employee turnover and burnout
• Slower decision-making
• Poor collaboration between departments
• Frustration among clinicians, operational leaders, and IT teams

The result is an organization that works harder but struggles to achieve intended outcomes.

Why Healthcare IT Cultures Becomes Dysfunctional

Several common factors contribute to cultural dysfunction.

IT is Just a Support Function

IT and Informatics are often only seen as service centers responsible for technical infrastructure, ticket resolution, application support, and project delivery.   Other departments feel that IT provides low value despite the organization’s dependency on technology and data.

When this occurs, leaders only engage IT after major decisions are made.  IT is expected to constantly act in a reactive mode, implementing “demands” rather than act as a partner in aligning the organization and achieving organizational goals.

When IT is viewed solely as a support function, collaboration suffers.  The result is dysfunction.

Organizational Silos Create Conflicts 

Some experts say cultural dysfunction is a result of department and division silos. 

IT departments traditionally organize themselves vertically through their management structures, budgeting strategies, talent and skill sets, and technology platforms.  While this model creates accountability, it also creates barriers to collaboration.  Teams stay focused on achieving individual success and independence.

Healthcare systems often make this worse because governance, operations, informatics, and IT frequently report through different leadership structures, with teams competing against each other for budget and attention, while also working toward different goals.

As expressed in the CIO article, Telltale signs of IT dysfunction — and how to fix it, organizations that structure departments with a lot of verticals generally do not collaborate well - there is little desire or incentive to cooperate across verticals.  Instead, the organizational structure is designed to encourage managers to take care of their own teams (CIO. 2020. Telltale signs of IT dysfunction — and how to fix it.).

As vertical silos strengthen, directional misalignment and competing priorities grow, decreasing communication and increasing friction and conflict.  And dysfunction is the outcome.

Everything is a Priority

One of the most recognizable symptoms of cultural dysfunction is the belief that everything is urgent. 

New requests are continuously submitted and approved with the expectation they will start immediately.  Resources jump from one project to the next without finishing tasks, interrupting timelines and decreasing or delaying intended value.   Organizational priorities appear to shift constantly based on executive pressure or the loudest voice.

IT can’t successfully deliver fast or well if the organization is not moving in the same direction, with a shared method of prioritization.  Under these circumstances corners are cut, observance of processes and quality delivery declines, nobody is happy, and IT is seen as at fault.

Teams are working harder while the system becomes less effective.  Workarounds become permanent, complacency grows, morale declines, and interest in improving disappears.

Ineffective Governance Leads to Investment Decision-making

Poor organizational governance is another reason for cultural dysfunction.  When no one is comfortable saying “no” requests become rubber stamp approved even when there is no budget, resource capacity, or clear benefit from the request. 

Organizations with ineffective governance frequently experience too many open projects, conflicting direction, limited transparency, and subjective versus data driven reporting.  Decisions are made based on politics and influence rather than expected value.  This creates frustration, cynicism, and burnout, leading to a culture that rewards dysfunction.  Read "How to Design Effective Operational Governance" to learn ways to improve governance. 

Changing Culture

Successful culture change is not driven by motivational campaigns.  It is driven by everyday practices – how decisions are made, how information is tracked, who is rewarded and promoted, how leaders act and respond.

Per Economic Times contributor Anish Singh, organizations communicate new values, but continue operating with old incentives, old power structures and old leadership habits. They speak about collaboration while rewarding internal competition.  They encourage innovation but punish failure.  They talk about people-first cultures while incentivizing burnout and constant availability (The Economic Times. May 23, 2026. Why culture transformations fail: The real reason and how leaders can succeed).

Real cultural change comes down to three things:

1.  Leadership 

Often leaders tout change but then act as if the change does not apply to them, or the moment another leader challenges the change they buckle.  Leaders talk about change and strategy while continuing to approve every request, foster team silos, and over allocate resources.

Instead, leaders must consistently demonstrate and incentivize desired behaviors - practice what they preach. 

2.  Communication

People need to understand not only what is changing, but why it matters.  Delivering clear education and regularly reinforcing expectations and benefits through communication increases adoption and encourages following processes.

3.  Environment

Expected actions and practices must be supported by processes, tools, and structures within the organization’s environment.  Organizations cannot expect culture change when processes and management and service tools do not support the desired behaviors and establish accountability.

Conclusion