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Best-Practice Healthcare Business Culture

Best-Practice Healthcare Business Culture 


Does the culture of a nonprofit hospital matter? The answer, according to an article by Mannion and Davies (2018), is a resounding yes. The authors found consistently positive correlations between hospital cultures and their patients’ outcomes. They explored many studies, settings and even countries to reach this conclusion. Cultures are defined as a balance of worker relationships, leadership strategies and the influences on the organizational environment as a whole (Mannion, & Davies, 2018).  

Although there is no best culture for every nonprofit hospital organization, a culture that at least curbs employee stressors and improves employee support is always optimal (Mannion, & Davies, 2018). Stressors can be generated in multiple ways, not just by patient care. Hospitals have complex cultures because they not only have an over-arching culture but they notoriously have subcultures (Mannion, & Davies, 2018). The mixture of specialties and professional hierarchies ensures the presence of subcultures (Mannion, & Davies, 2018). Countercultures exist as those subcultures sabotage one another (Mannion, & Davies, 2018). Every aspect of  workplace cultures, subcultures and countercultures must be reviewed and reorganized with holistic employee health and well-being in mind to ensure cultural best practice for the benefit of the employee and optimal patient care.  

The Problem 

A review of the hospital culture topic is necessary because a hospital workplace environment is capable of increasing or decreasing stress and affecting worker’s well-being (Hartney, 2018). Due to the high levels of stress already generated by patients and their families, hospital workplace cultures must focus on their ability to minimizing stressors and increase positive workplace well-being culture (Hartney, 2018).  

Work-related stress reduces fronto-temporal cortex activity which is also observed in depressed people (Kawasaki, Nishimura, Takizawa, 2015). If this is prolonged it causes brain atrophy which is not ideal for workers who must make life and death choices (Soares, Sampaio, Ferrira, 2013). Additionally, workers under stress have longer cognitive function processing times, poor memory retrieval, anxiety problems, mood swings, and emotional hyperactivity.  (Raistrick, Russell, Tober, & Tindale, 2008). All of these impede decision making skills needed for hospital work.  

The current hospital workplace culture hails and thrives in long work shifts, professional life superseding personal life and stoic attitudes towards human suffering (Hartney, 2018). A change in the nonprofit hospital’s culture would need to occur to improve the previous conditions. A best practice culture needs to be developed and applied for employee holistic health and well-being. 

Research Question 

How and to what extent does applying a best practice nonprofit healthcare organization’s culture improve worker’s holistic well-being. 

Literature Review 

Gone are the days of corporate focus on using people to make a profit (Culture, 2018). Corporate culture solutions are even advancing past just health and fitness into a more wholistic approach of bringing one’s best self to work. This involves creating an intentional organizational culture (Culture, 2018). 

A 2018 literature review of 62 quantitative studies, 27 qualitative studies and 10 other study approaches considerably supports a strong positive correlation between cultural health elements and health/safety of employees for organizational focuses (Flynn, Gascon, Doyle, Koffmen, Saringer, Grossmeier, Tivnan, & Terry, 2018). The studies’ most frequent health elements involved environment, policies/procedures and communications.  

Providing an irresistible organizational culture has six key elements: purpose, opportunity, leadership, success, appreciation and wellbeing. Employees should be enabled to do innovative and meaningful work while connecting to fellow workers. The organization is responsible for guiding and providing employee support in these directions (Experience, 2018).  

A 2018 article by Global Culture Study reports on organizational culture trends for 2019. The top five topics are social and emotional well-being, technology integration, peak employee experience not engagement, millennials as leaders, continuous performance management (Five culture trends, 2018) and utilizing newcomers (Nordsteien, 2018). This paper will examine all six aspects, beginning with emotional well-being. 

Emotional Well-Being 

According to the following data, businesses are falling short of supporting emotional well-being in their work-forces. Simple changes in coworker relationships can make huge differences in worker well-being. 

  • 21% of employees report that their organization considers workers to be their priority with only  

  • 56% feeling a sense of belonging and inclusion among their coworkers 

  • 40% of workers report their employers are trying to cultivate a happiness-oriented culture for their workforce (Five culture trends, 2018).  

An article by Sharone Bar-David (2018) reveals that workplace incivilities can degrade and quickly cripple any workplace culture. Incivilities include sharp looks, sighs, skipping greetings, gossip, social exclusion, sarcasm, silent treatment, rude use of mobile devices, stern facial expressions, muttering and eye rolling. Any seemingly insignificant rude, disrespectful, discourteous or insensitive body language or comments count. Here the intent to harm is passive/aggressive, unclear or ambiguous. The results of workplace incivility show… 

  • 60% percent reported their work declined  

  • 48% of the incivility victims intentionally lowered their work effort  

  • 80% lost time worrying about it 

  • 25% admitted they took their frustration out on a customer afterward  

  • 39% of 4047 hospital staff perceived that their own incivility resulted in violent incidences (Bar-David, 2018).  

Uncivil health professionals or health supervisors exacerbates mental and physical health problems (Bar-David, 2018). Worse, incivility breeds more incivility. Research concludes that just witnessing rudeness decreases the observers’ performance on creative tasks (Bar-David, 2018).  

The solution according to Bar-David is for workers to admit that they themselves are involved and to lead by setting a good example and refuse to participate in uncivil acts. When people cannot own up to uncivil behavior in themselves they tend to point-fingers, self-righteousness and feeling like a victim to other people’s incivilities by judging, not forgiving, revenge and holding grudges (Bar-David, 2018). 

Recognition of an employees worth by leaders is a key contributor to an employee’s emotional well-being (Culture, 2018). With recognition the employee feels valued, appreciated, respected and accepted by the organization (Culture, 2018). Less than half of employees actually feel valued at work (Culture, 2018). If the recognition is applied in a timely and meaningful way employees feel valued for their contribution and for who they are (Culture, 2018). 

Half of employees believe their productivity is the most important thing to the organization, not people (Culture, 2018). Holistically, organizations must reach more parameters besides productivity like emotional, social, financial and physical health (Culture, 2018). Support for optimizing positive daily habits helps employees, too. Successful recognition and well-being programs produce… 

  • 19% increase in productivity 

  • 20% increase in teamwork 

  • 28% increase in innovation 

  • 38% increase in employee retention  

  • 89% job satisfaction will excellent well-being (Culture, 2018) 

Proactively, organizations can focus on peak experiences by recognizing victories, celebrating careers, building leaders, prioritizing well-being to unite the workplace to purpose. Research shows that positive peak work experiences overshadow negative work experiences (Five culture trends, 2018). Putting the peak experiences in the spotlight betters personal worker emotional well-being. Being able to accomplish the demands of the job with grace, ease and poise also plays a role in emotional well-being. Technology tools help tremendously with this aspect of well-being. 

Technology Integration 

Technological tools for increased work communication connects coworkers (Experience, 2018). Efficiency and innovation can be hindered or helped by the right tools and technology but they must facilitate employee interactions. Some technology can distance employee interactions (Five culture trends, 2018). Working in the cloud will be the future of companies. Attracting, retaining and engaging workers with new technology will become the norm but it can also be used to drive productivity and innovation within the culture (Five culture trends, 2018). The presence, integration and quality of the technology change the employee experience. The employee experience is the new employee engagement strategy for forward thinking human resource departments. 

Employee Experience 

The employee experience is the foundation of any organizations culture (Experience, 2018). Improving the employee experience is a new alternative to monitoring and supporting employee engagement and productivity (Experience, 2018). The engagement  and productivity metric alone misses the metrics of purpose, opportunity, trust, meaning and contribution (Experience, 2018).  

An employee’s experience, on the other hand, holistically includes engagement along a connection to purposes, accomplishments, others,  the organization by fostering feelings of belonging and fit (Experience, 2018).  From employee recruitment to retirement, the employees needs and goals for opportunity, success and growth are addressed and achieved. A positive work environment, tools,  are components of a good employee experience (Experience, 2018).  

A positive work environment includes places for privacy, relaxation, innovation and collaboration (Experience, 2018). Positivity not only includes physical and emotional support, but openness of  ideas and diversity of thought. The availability of leaders and their trustworthiness contributes as well (Experience, 2018). A good work to life balance as opposed to drama and stress-oriented environments also plays a role in positivity (Experience, 2018). The employee experience is also interdependent on the generation the employee is from and Millennials are aging into more leadership roles. Thus, they are changing the organization dynamics. 

Millennials as Leaders 

            Generation Z is now entering the workforce and the Millennials are aging (24-35). Generation Z is super technology oriented and they have more of a tendency to be lonely and depressed (Five culture trends, 2018). Generation Z is also very vocal about inequalities, more motivated and optimistic about change (Five culture trends, 2018). Interesting facts about the Millennials as leaders is that… 

  • 64% want to change the world 

  • 79% dislike the boss concept and embrace coaching or mentoring instead 

  • 88% would rather collaborate than compete 

  • 88% prefer work-life integration over work-life balance 

  • 74% ask for flexible work hours (Five culture trends, 2018)  

Bridging gaps between all the generations and setting purposes and change for the better type goals motivates and fulfills these groups. 

Continuous Performance Management 

            Annual performance reviews are the norm of the past but in best practice they have become a subset of continuous performance management. Regular check-ins, one-on-one discussions and daily consistent mentoring spearhead a culture of diligent coaching (Five culture trends, 2018). 

One-on one talks between employee and supervisor are particularly meaningful to employees. More positive management intervention is better and should center around celebration of  successes, identify opportunities for growth and improvement, align employee’s specific work to the purpose of the organization and provide mentoring (Five culture trends, 2018). Research shows that when two types of performance strategies are used employee’s perception of success went up 44% and when three types were used their perception of success escalated by 104% (Five culture trends, 2018). With continuous performance management implementation employees are… 

  • 20% more likely to feel successful 

  • 62%  more likely to feel fairly assessed 

  • 48% more likely to feel connected to their leader 

  • 50% more likely to feel in control of their career 

  • 36% more likely to trust their leader 

  • 88% more likely to feel appreciated 

  • 120% more likely to feel their organization inspires employees to work towards a collective goal (Five culture trends, 2018) 

Every interaction with a leadership team member either improves or hurts the employee experience (Experience, 2018). Continuous performance management is critical for all employees, but essential for newcomers to the organization. 

Utilizing Newcomers 

            New employees to an organization are many times an overlooked resource. They bring with them a fresh look at the organizations (Nordsteien, 2018). They see the organization from a fresh perspective and quickly notice problems, outdated strategies and areas for improvement (Nordsteien, 2018). The problem is that they are new and less likely to speak up. It is imperative in the first six months to a year to make sure the newcomer is heard (Nordsteien, 2018). It is managements responsibility to pull the newcomer aside and ask questions pertaining to what they see that needs to be changed or improved (Nordsteien, 2018). 

      Also, newcomers proactively seek information and are looking to share (Nordsteien, 2018). Their practices often differ from the organization they are entering resulting in a drive toward change and collaboration (Nordsteien, 2018). This newcomer inclination for improvements and change must be nurtured by the supervisor and monitored or it will be squelched by the current employees (Nordsteien, 2018). The newcomer will succumb to the status quo of the organization and settle as the current employees have (Nordsteien, 2018). Because these statistics uncover important growth areas it is important to be able to asses  a culture’s starting point. From there, an organization can prioritize areas that need more attention.  

Assessment Tool 

The Workplace Integrated Safety and Health Assessment tool (WISH) can be used to measure best practices for workplace safety, health and well-being as a starting point to begin cultural goal setting (Sorensen, Sparer, Williams, Gundersen, Boden, Dennerlein, Hashimoto, Katz, McLellan, Okechukwu, Pronk, Revette, & Wagner, 2008). This tool measures six core cultural constructs: leadership commitment; participation; policies, programs and practices that foster supportive work conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The tool can help organizations set goal priorities for improvements.  


The research gathered for this paper consisted of quantitative and qualitative research. Much of the human resources qualitative information came from currant business advisory websites in order to present the most recent and forward-thinking ideas for best practice cultures. The quantitative research was gathered via google scholar and Harvard’s Hollis library to support the qualitative date and offer the reader solid numbers to report from academic journals. The keywords used were workplace culture and hospital culture articles were found within that search. 

The culture information was limited to  2018 in order to present a 21st century outlook on what present day workers expect and need from their employers pertaining to culture. Only one article was older, 2008, and that was an article defending the use of the WISH assessment tool. Due to its 2018 article parameter, this paper produced very different conclusions than articles from earlier years or even decades would have provided. 


            A culture is really just a way in which we do things or “how it’s done here”. When we add nonprofit organization to the word culture it brings in values, beliefs and relationships. It is a whole system approach where all the individuals collaborate to form and fulfill the goals, mission and aspirations of the nonprofit organization. Over the decades best practice has evolved into the components listed here. The limitations of this study is that one size does not fit all so individual organizations will have to craft their own particular cultures. Having said that, the guidelines of this paper is a good infrastructure to begin with. 

            Of all the strategies listed the most prominent asset to an organization is the focus on the employee’s holistic experience provided by well-being and recognition solutions. Organizations with the previous qualities are irresistible at attracting and retaining workers. A best practice culture greatly improves overall quality of life for individuals, teams and the management of any hospital. The strategies and tools outlined here can also be applied to any business or organization with success because the culture here addresses and fulfills the holistic health needs of a worker. 


Bar-David, S. (2018). What’s in an eye roll? It is time we explore the role of workplace incivility in healthcare. Israel Journal of Health Policy Research, 7(1), 15. 

Culture (2018). Creating a holistic workplace culture through wellbeing and recognition. O.C. Tanner. Retrieved on 5 December 2018 downloaded from 

Experience (2018). Employee experience is the new engagement. O.C. Tanner. Retrieved on 7 December 2018 downloaded from 

Five culture trends (2018). What’s new in workplace culture. O.C. Tanner. Retrieved on 10 December 2018 downloaded from 

Flynn, J. P., Gascon, G., Doyle, S., Matson Koffman, D. M., Saringer, C., Grossmeier, J., … & Terry, P. (2018). Supporting a culture of health in the workplace: a review of evidence-based elements. American Journal of Health Promotion, 32(8), 1755-1788. 

Hartney, E. (2018). A three-step model of stress management for health leaders. In Healthcare Management Forum, 31, 3, 81-86.  

Mannion, R., & Davies, H. (2018). Understanding organizational culture for healthcare quality improvement. BMJ, 363, k4907. 

Nordsteien, A., & Byström, K. (2018). Transitions in workplace information practices and culture: The influence of newcomers on information use in healthcare. Journal of Documentation, 74(4), 827-843. 

Sorensen, G., Sparer, E., Williams, J. A., Gundersen, D., Boden, L. I., Dennerlein, J. T., … & Pronk, N. P. (2018). Measuring Best Practices for Workplace Safety, Health, and Well-Being. Journal of occupational and environmental medicine, 60(5), 430-439. 





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