292:Culture Is the Work: How Leaders Shape Trust, Engagement, and Patient Experience, with October Ambrose

In this episode of The Human Side of Leadership in Healthcare, Dr. Pelè speaks with October Ambrose, Vice President of People Partnerships and Engagement at Central Health, about what culture actually looks like inside a mission-driven healthcare organization.

They explore why culture is not something leaders define once, but something teams build and experience every day through behavior, especially under pressure.

October shares how trust, transparency, and empathy shape engagement more than mission alone, and why even the strongest purpose-driven organizations can struggle when leaders lose sight of culture in real moments.

The conversation also dives into the gap between what leaders know and what they actually do, how teams support each other when that gap shows up, and why true empathy is one of the most important leadership behaviors in healthcare today.

This episode offers a practical and honest look at how culture drives patient experience, team engagement, and organizational performance, not through statements, but through everyday actions.

Connect with October Ambrose on LinkedIn:

https://www.linkedin.com/in/october

Transcript

Welcome And Framing Culture

Dr. Pelè 0:06

Welcome to the human side of leadership in healthcare podcast. I'm Dr. Palay. On this podcast, we explore how leadership is experienced in real moments. Not just defined in fear, how it shows up in context and pressure. And how those moments address culture and patient outcomes. Today we're talking about how leaders accept that culture through everyday behaviors and how that directly impacts engagement, growth, and organizational performance. And it's truly my pleasure to welcome October Ambrose. Now, October is the vice president of People Partnerships and Engagement at Central Health, which leads efforts to build cultures of innovation, inclusion, and growth. He's also an adjunct professor at Tulane University, helping develop the next generation of leaders through practical, measurable learning experiences. October, I'm really glad you're here. How are you doing today?

October Ambrose 1:09

I'm well. Thank you so much for having me.

Dr. Pelè 1:12

You know, it's it's awesome that we're talking, um, even though we realized right before we got started that we're both here in Austin, Texas.

October Ambrose 1:21

We are.

Culture Starts At Hiring

Dr. Pelè 1:21

Small world. Yes, this is so cool. Small world. Um, you know, I want to start really with your story. You know, obviously you lead people, partnerships, and engagement at Central Health, and your organization is deeply focused on expanding access and closing gaps in care. In a mission like that, when does culture become real to you? When does culture become a strong part of the equation?

October Ambrose 1:48

Culture becomes a strong part of the equation from the outset. So when a candidate uh submits an application until they're with our organization, our culture is what drives us. We're a mission-driven organization. So, in full transparency, we have lots of competitors locally that definitely pay much more than we do. Um, so we recognize that the people that work with us are here because of our purpose, because of that mission, um, and meeting our patients and community where they're at. So, really, the culture starts there. That has to be our differentiator, can't be pay and other things. And again, don't get me wrong, we pay well. We just don't pay as well as more national organizations or for-profit organizations. So that's when it starts. The day someone comes in the door and we tell you, here's the culture that you're becoming a part of. Can we live up to that?

Dr. Pelè 2:47

Wow, and what a what a high bar that can be sometimes, because we know that I obviously it's not just the leader saying it, it's everyone in the organization has to say that, you know, in chorus, that that's the culture and act it out every day. I wonder what uh brought you into this world? What in your background uh led you to follow this path? It's a fascinating career path.

From Patient Care To HR

October Ambrose 3:10

Yeah, absolutely. So I started as a direct patient care provider some odd years ago. I was accepted to a nursing program, thought that's the life I'm gonna live. It was natural coming from an acute care center, being inpatient to all types of in-between, from home health to Alzheimer's homes. And then there's something that said, you should be a nurse. And then I took an elective course in human resources just because I had an elective to burn and gave up my spot in the nursing program. The skill set needed to care for people is pretty similar in the HR field. And I really think the alignment, though, is when you're a direct patient care provider, I have the opportunity to impact a small core group of people. So the patients I'm taking care of that day or future state or those I've impacted. But when you sit in an HR seat, it just broadens your scope. So it allows me to impact those who are touching our patients in our community every day.

What Leaders Miss Under Pressure

Dr. Pelè 4:15

Yeah, and and you know, it's interesting because when you look from the outside, you see culture working. But when you're on the inside, what you're really experiencing are these moments. Sometimes moments of high intense urgency and pressure. Um, you know, when you look at that, what do leaders maybe let me ask a tough question here. What do leaders misunderstand about the culture as it's happening when they're inside of it?

Emotions Authenticity And Grace

October Ambrose 4:42

I think there becomes an opportunity that you miss the culture. Um, sometimes as a leader, when the pressures are on and people are asking things from multiple directions and competing priorities, you're like, okay, culture is whatever. So there is the opportunity that you need to reground yourself. We've all been there. I'm a little more mature in my career that I can reset quickly. But the reality is cultures are evolving every day. Um, I think there used to be a belief that culture is owned by leadership. Um, I always say culture is led by all of us. We all make withdrawals and deposits into it. And if you don't like your culture or you want to shift it, then that's up to everyone in our organization, down to our most junior team member, to ensure that that's there. So I believe that's what happens. And the less mature you are in your career, so as an individual contributor all the way up to a leadership role, you sometimes let culture go by the wayside because we got to get this done, and that work is important. But I think it's extremely important to always go back and ground yourself in what is our culture? Why am I here? What is the next step on how I still meet this moment, where it's at?

Dr. Pelè 6:03

You know, one of my uh cultural gurus and and and persons of inspiration, one of my favorite people is Maya Angelo, who said um, a person can uh you can forget what a person does, you can forget what a person says, but you can never forget uh how they make you feel. And what I love about that quote is uh if we go into the definition of culture, it's really a bunch of shared behaviors and what's a behavior, what people do and what people say. So I'm wondering, in your view, uh the the role of just emotions and feelings in culture, as you have to deal with it. I mean, it's one thing to write the culture on the board and everybody says, yeah, we're gonna do that, but do emotions get in the way? Do you how do you see the role of feelings in all of this?

October Ambrose 6:50

Your feelings are a key grounding. So I think it's acknowledging it. We're in the midst of a huge cultural shift and some other things going on in our organization. And I think it's allowing people to show up and be authentically themselves. So it's acknowledging it, letting authenticity take way. So change and transformation doesn't stop because October hasn't bought in. But as long as I acknowledge that and keep it moving, so it's not telling someone, well, here are our behaviors, this is what you need to do. We definitely need to hold ourselves and each other accountable to our behavior expectations, but also give grace because there are days, to your point, right? There's lots of competing priorities, things are shifting, this is urgent. That might not be impactful for every person in our organization, but for the team that that's happening for, how do we give them grace to be authentic, to be themselves, to be in the moment? So it's not shielding or pretending like emotions don't happen. They happen. It's acknowledging them and then allowing people to get through them in the requisite amount of time. It can't go on forever, but there is an opportunity to allow people to be where they're at.

Trust As The Engagement Driver

Dr. Pelè 8:03

That's that's just so awesome. And especially in a mission-driven uh environment like yours is I mean, you guys have a clear mission, it's purposeful, it's heart-driven, if I might even add. Um, but I think there's a tendency for maybe some leaders to think, yeah, our mission is enough and uh it'll drive itself. Engagement will happen, you know, within the culture and all that stuff. What have you learned about what actually drives engagement, even within such a strong, highly driven, mission-driven environment?

October Ambrose 8:40

What currently is driving our engagement and a gap we've identified really is trust. So being transparent. Our team members are here definitely to support the mission, but ultimately they want to know can I trust this system? Are we being transparent? Are we sharing enough information? I think there's oftentimes that leaders hold back because we're like, well, we don't want to add any undue stress. Well, then that leads our team members to believe, well, they're being dishonest. They're not sharing everything. And though our intent is, we don't want to burden you and add one more thing, the impact to them is losing trust in the system, how decisions are made. So I think it's again being extremely intentional about how we are sharing the why changes are happening, things are happening that will then allow people who are already connected to this mission driven of them work, they're here in spite of us. The people who are here are here for our patients. Um, quick thing um, we have uh dental care. And we have a team member who said, I'm I'm not leaving pediatric dental. You know, I saw the mom as a patient, and now I get to treat her children like that is a meaningful connection to watch someone grow up and bring new life and really stay connected in the community. And again, I think that's where we have the opportunity as leaders to ensure we're sharing the why and staying connected so that our unintended consequences of maybe shielding lots of things that we balance what's important for our team members to know to remain connected and trust us, and what are the things that don't really impact them on a day-to-day basis.

Closing The Knowing Doing Gap

Dr. Pelè 10:34

Wow. You know, I just love your positioning of trust as a central driver of you know, not only engagement within the culture, but just success overall. I think it was uh I can't remember, oh, I think it was um I can't remember who said this, but uh success moves at the speed of trust. You know, I can't remember exactly where I heard that, but uh, you know, it's it's so important if you guys are able to uh make trust such a powerful motivator. I wonder, though, if uh there's a gap in your view between what people know. Okay, so they know that there's this environment of trust, they know how they should behave, they know what the culture should be. There's a gap between knowing and doing in the real world, in those moments. I mean, we know that in healthcare, everything's urgent. People's lives are at stake. Um, you know, so when those moments show up, are they able to take what they know and actually do it? What's your perspective on that?

October Ambrose 11:27

I think again, it takes maturity, it takes accountability, it takes being in it as a team. So ensuring that on the day where I can't stand in my own here's what I know and I need to do, someone gently reminding me, someone picking up that slack for me if I've missed, but hey, we're in this together, we're a team. There's the opportunity for me to fill in the gap for you because we're all at different places and we all bring different things into work and are going through different things. So maybe in that moment, everything I know, I just don't have the capacity to deliver on it. So, how does my team have my back to ensure we're still remaining aligned and that we're moving the work in the direction through the culture that is extremely important to us?

Teaching Across Five Generations

Dr. Pelè 12:18

Wow. You know, you're also uh an adjunct professor. Uh sometimes, you know, I as a teacher myself, uh I always find the classroom influencing what I do in the professional world. And I just love the two going back and forth. How does your work in the classroom influence how you think about developing leaders inside your organization?

October Ambrose 12:39

So I actually call my students learners because I'm learning as much from them as they are from me. So I sit in an extremely unique um place in the program that uh I'm adjunct in is I have the opportunity to teach early careers to those doing transformations, transitions, adding on a certification who have already been there. And how I take from there is we have five generations in the workplace now. So I get to bring a different perspective, not the, you know, I hear the, well, the baby boomers are this and Gen Z is that. All the generalizations, but I have the opportunity to really explore and ask questions that aren't generalized, but allow me to have a different perspective of how do I show up and meet those folks where they're at. Because the reality is, is they all want different things, right? My baby boomer is likely thinking about retirement at some point. My Gen Zer is like, I don't want to retire in 30 years from now. I want a micro retirement where I'm gonna work here for two years, take a year off, and backpack Europe. And hopefully I leave in good standing and I get to come back either at the place I'm at, or I've gained some life or work experience that will allow me to promote to the next level, that it is not a linear career path that someone else had, that we are open to what does learning and leading and career pathing look like? Um, so that's what I spend time doing through reading the responses to um to the discussion questions and papers, really having their perspective give me the opportunity to say, hey, let me bring this back to my organization on what that thought process might look like.

One Behavior To Practice Now

Dr. Pelè 14:34

Wow. So so if a leader or a learner, let's go interchangeably between those two in your world, um, if a leader or learner is listening today, right now, um, to the things you're saying, how would they improve access, equity, maybe even um you know, outcomes because of those things? If they're listening, what is one behavior that you would suggest they should focus on immediately?

October Ambrose 15:03

The behavior I would say you should focus on immediately is true empathy. So no one is looking for you to be sympathetic. But are you able to put yourself in another person's shoes? If that's our patient, if I'm a direct report, can I put myself in the shoes of my leader and a difficult decision they might need to make or something they're asking me to do? That I may not understand the full why. Um, but I do believe it's being truly empathetic. And that is truly putting yourself in someone else's shoes and then asking those questions from that perspective, what decisions might I make in that moment? Um, so again, as a HR professional that you've been, I often have thoughts or an idea, and I might fully agree even with a decision that my team has made. I still ask them questions. I'm often playing the devil's advocate. What about the other side? What have we missed? Have we asked all the questions that are appropriate to ensure we're there? And to me, that's where the empathy comes in. Am I judging this fairly based on looking at all aspects of a decision or situation that has happened?

Balancing Empathy With Fast Decisions

Dr. Pelè 16:25

You know what I love about your answer is that you have you managed to say all of that without using the words diversity, equity, or inclusion. And I think that's really I think that's the genius of what people like you and and those of us who care about culture, we have to do those things. We we cannot uh think that just because some uh government ideas are changing, uh the the no the actual human beings are changing. People need to be listened to, they need to know that they're included, that people care about them in order for them to do their best. So I just tip my hat uh to you and to the way you explain that. But in that light, uh what does real growth look like for a leader uh who's working in a system like yours that's trying to drive both outcomes, patient outcomes, uh, you know, performance, and issues of equity and you know, inclusion and you know, empathy and things like that?

October Ambrose 17:21

It all takes balance. Um I like to say leadership is an art, not a science. Um, so there are days that you definitely need to be more grounded and firm in decision making. There are days that you can uh be more relaxed, and I think that's no different than all of these other things. Assessing the situation, the things that are factors in most decisions any leader has to make, right? Timing, cost, resources. When did the decision need to be made? There are days that I say, I am not a micromanager. My team will tell you it's very rare that I say do it because I said we have to do it. But in my career, I've had to do that because the decision needed to be made, and we got to start executing this tomorrow. I don't have time for additional inputs for whatever reasons. It could be regulatory, compliance, so really understanding that again, going back to grace, how do you allow yourself to make that and making the decisions, not in a vacuum in all one way. I've always done it this way, but really having an assessment of when does this decision need to be made? Why, and how do I balance these things? How do I balance with empathy? And maybe part of empathy is I have to make this decision today, but maybe I need to have a core conversation with a smaller team of people who it's gonna impact the most first before I share it globally. Doesn't mean the decision doesn't change, but maybe the empathy is when they find out, the likelihood of their impact might be greater than the person who's farther away from the impact of my decision.

Culture That Patients Can Feel

Dr. Pelè 19:10

No, I totally get that. And and I wonder if leaders truly got culture right, which is really uh a focus of what we're talking about within your system or without, outside of your system, or maybe even specifically in a healthcare environment. I wonder if we flip this and talk about the patient experience side. You know, what would feel different for the people receiving care if people got it right, if leaders got this right?

October Ambrose 19:37

Culture is what uh informs your patient care. So you can tell that through multiple engagement surveys on units that have high patient experience. They also have high team member engagement and experience, leadership and team trust, collaboration. So there is the data and the science that go with when that happens, this happens. We don't have to spend tons of time coaching those teams on how do you ensure the patient experience is appropriate. I also, we mentioned that I'm in HR. I also used to lead ambulatory clinics. So I'm highly experienced with patient experience. And one of the things I started with wasn't talking to my team about our patient experience scores needed to go up. I started talking to them about, hey, we need to answer these patient messages within four hours because that patient that is waiting for the message behind the computer is as important as the patient that is here in front of us. So again, going back to that why and connecting my team to you do understand the work that you do is important. This is why it's important. We're we're saving someone a trip to waiting in the ED because we didn't get back to their question, which was simple. So again, connecting that across. And I think it started internally, and patients can tell when it's genuine and authentic. So I can say, go out and change and smile with everyone, except for when I'm having a bad day. That is not gonna happen. And then the patient's gonna say, Well, they were nice for two times, but now it appears they're not. So again, it really starts, I think, internally with your team living your culture and wanting to be there because I'm gonna give the best patient care if it's in a space I want to be in.

Book Launch And Where To Connect

Dr. Pelè 21:44

You know, I have to say, I really enjoyed how you talked about uh, you know, the patient experience scores on the one hand, but you're like, listen, that's fine, but it's the behaviors over here that create those scores. So let's talk about these behaviors, you know, purpose. Statements by themselves don't create those behaviors. Culture is something we do each of us in the moment. So I love that focus that you have from the patient experience side of things. So what are you excited about? Any projects, anything going on that we could we could share? And how can people find you, especially on LinkedIn, which is where we connected?

October Ambrose 22:23

Absolutely. So a project that I have, I am excited to announce that I'm a contributing author in a book called In Relentless Pursuit: The Evolution of Me. I am fortunate to be paired with nine other authors for this book about evolving. The stories are individual, they're our own unique voices. It will launch July 14th as an ebook on Amazon. Super excited about that. Our hard copy will launch over Labor Day Weekend. And we have a Relentless Pursuit Summit that will happen over Labor Day weekend in New Orleans. So bring your goal friends, come join us and hang out. We like to say it's day party meets conference, is really what the vibe is, but it's really connecting the individual authors with the participants and you connecting with other folks that are there. You can find me on LinkedIn. I have an open account. I am the www.linked slash in slash October just like the month. So obviously I've been on LinkedIn a long time that I was able to just get my first name uh similar to Prince and Share. Um, and it's October Ambrose, A-M-B-R-O-S-E. And I'd be excited to connect with anyone and exchange any ideas.

Dr. Pelè 23:59

I just love that. And by the way, we have to tell all of our goal friends. I love the way you position that.

Thanks And Final Notes

October Ambrose 24:05

Goal friends.

Dr. Pelè 24:06

Yes, our goal, our goal friends. Well, uh, October, thank you so much for joining me on this conversation. It's been a pleasure. I've learned a lot, and I hope that everyone listening uh will go check you out. In fact, if you send me a link to the Amazon uh connection for your book, I will make sure I place that in the uh in the show notes for this episode. Thank you so much, October.

October Ambrose 24:28

Thank you. I appreciate you having me.

Dr. Pelè 24:31

All right.