Culture permeates all activities in an organization—it’s the attitudes, beliefs, actions and values of the people who make up the organization. It is the unspoken element that often unconsciously drives decision making and is manifested in the way staff members relate to each other and respond to the circumstances they face. Simply put, culture is the way things get done. And, more importantly, culture eats strategy every single time.

Further, In the last few years, since the studies published about the effect of gratitude on health and well-being have hit the mainstream, the conversation has shifted from a culture of philanthropy to a culture of gratitude. We know patients are grateful—we all have the grateful patient programs that prove this every day. Right? But, what about the staff that provides the source of that gratitude? Are they grateful? Can philanthropic professionals instill a sense of gratitude? So, what does that mean for our grateful patient programs?

I think we have to seriously understand that you can’t have one (philanthropic) without the other (gratitude).

It takes time, patience, education and persistence to really achieve a culture of gratitude. Then, as if that weren’t challenging enough, you then have to marry it to philanthropy.

I love to tell the story of a donor who was being stewarded by the organization’s philanthropy professionals. They had spent a lot of time understanding this donor’s values and beliefs and figuring out how to match that understanding with the donor’s philanthropic interests. It was a very sincere approach to ensuring the donor came first.

Well, this particular donor was admitted to the hospital. Nothing serious but this was a huge opportunity to show gratitude and hospitality to one of the organization’s best friends. However, the donor’s most intense interactions were with the physicians and, most importantly, the nurses. The donor really wanted to thank them for all they did for him and his family, “You’ve all been magnificent. I’m so grateful for everything you’ve done for me. How can I thank you?” The response could have been, “It’s our privilege to care for you. We have so many fabulous programs here that our friends support. May we have someone from our Foundation speak with you about those? We definitely need partnerships to make this level of care possible for everyone.”

Nice. Sadly, the actual response was, “Well, we do need a new microwave for our lounge.” Guess what? He gave a microwave. It’s tough to come back from that with a major gift proposal.

The lesson here is that a culture of gratitude and philanthropy has to start with the people in your organization rather than your grateful patients or donors. This is where it gets a little tricky because none of your colleagues signed up to be a “fundraiser” and they visibly cringe when you mention it. You’ve got to help them understand from the patient’s perspective. Patients often wish to express their gratitude in a meaningful way. And this expression has to be allowed—one way or another. It’s entirely up to the philanthropic team whether that’s a microwave or a new wing. That’s where a culture of philanthropy comes in. Your organization has to be given the opportunity to understand the philanthropic process—not fundraising, but philanthropy. There’s a very big difference.

It’s our opportunity and obligation to educate our colleagues about the proven and powerful impact gratitude has on patients’ recovery and well-being. It’s also important to provide a way for those who directly provide care to feel comfortable in responding to a patient’s need to actively express gratitude. Our colleagues have to be able to sincerely and authentically hear that need and respond by connecting patients to the natural link between their gratitude and the philanthropic possibilities it can unleash.

In developing a culture of gratitude based on philanthropy, it’s critical to emphasize a positive experience for colleagues and clinical professionals as well as donors. Developing mutual trust is vital to ensuring this critically important relationship between the organization and its foundation is successful.

As an example of this in action is found in one of my most memorable and meaningful conversations with a donor couple:

I was leading my team and organization in the biggest campaign of in its history. So, one of my first gift invitation calls was with a wonderful couple who had done some very nice things for the community through our organization. I was sure their gift to our organization’s new medical campus would be huge. I felt pretty confident. My CEO and I sat down with them and went over the project, explaining the positive impact it would have for the community and for patients. We asked for a six-figure gift. And waited. And waited.

Then, they finally spoke, “You know we love what you’re doing. It’s important and we want to help and make it happen. But, here’s where our hearts are. We had this incident in our family where one of our nephews was burned very badly in a house fire. It was such an awful experience for all of us. It was excruciating. We were hoping the new medical center would have a burn unit. We want to make a difference for kids and families who are going through that painful experience.”

Guess what? We did not have a burn unit. We did not plan to ever have a burn unit. We had nothing that would express this couple’s particular passion. I looked at my CEO, took a deep breath, and said, “We’re just not equipped as an organization to operate a burn unit, but I know of a stellar, highly reputable burn unit that is achieving ground-breaking results. Would they like me to set up a meeting?”

Yes, of course they did. I paired them with my colleague and walked away. They gave a very significant gift to my colleague’s organization—larger than the one we had suggested (they also made a smaller gift to our new campus.) Was I bummed about not getting this large gift for my organization? You bet. Was I worried about getting fired. A little! Fortunately, my team and I had spent a lot of time working with a very supportive leader to create a culture of gratitude through philanthropy. We had painstakingly built a philanthropic program that truly put the donor first and exemplified trust, authenticity, truthfulness and love of mankind. We (and I definitely include myself in the royal, “We”) can forget this in the day-to-day activity that never seems to end.

But when it comes down to it, never let the work get in the way of job--which is to inspire joy and gratitude expressed through giving.