Healthcare leaders who want to improve the work environment can home in on one issue: trust and respect between team members, and between clinical and nonclinical staff.
At NewYork-Presbyterian Hospital, executives found that cultivating a “culture of respect” among staff meant simply listening to employee concerns, Laura L. Forese, M.D., the hospital’s executive vice president and chief operating officer, said in an interview with NEJM Catalyst.
“We asked people what would really make a difference, and the word ‘respect’ came up over and over and over again,” Forese said. “That’s when it started to click for us that we needed to take that on and make that a priority in everything that we do.”
NewYork-Presbyterian first spelled out what exactly defines the hospital’s respect culture—treating everyone as a “valued human being” and honoring their contribution to patient care—and then gathered feedback on whether that made sense and if the hospital was living up to that goal. From those discussions, hospital leaders were able to fine-tune their approach to cultivating respect and trust, Forese said.
Success in this area requires buy-in from the top down, she said, and executives must make it clear to staff that the culture shift is important to them. NewYork-Presbyterian also posts reminders across the hospital, both at the individual unit level and at each level of management. Leaders also include nonclinical staff in discussions when appropriate; for example, Forese said ER executives spoke with a housekeeper about her thoughts on a patient’s care, as she had watched the patient throughout the day.
Thus far, results have been positive. Recent surveys suggest that 75% of staff see efforts to improve respect and trust between employees, though Forese said there is more work to be done in engaging physicians on the issue.
Improved teamwork, trust and communication between clinicians can reduce mistakes in the emergency department and improve patient safety. Recent research suggests that improved teamwork between physicians can save patients’ lives. CEOs who want to implement a culture change in their organizations should set a clear direction for change and challenge employees to examine processes.