In Healthcare, Culture is Where Margin Meets Mission

By Byron Jobe, Vizient Chief Executive Officer

'I'm Byron Jobe, and I'm glad to be here.' Most people probably don't think this way every time they go to work. But before the Blue Angels take off for each flight, they repeat this mantra to demonstrate their dedication, trust and respect for one another.

The Blue Angels represent the U.S. Navy and Marine Corps through public flight demonstrations that require extreme precision, flying in formation just 36 inches apart. This requires a commitment to excellence and teamwork with very little room for error—something healthcare teams are confronted with each day.

A 'glad to be here' culture means everyone approaches their work with a shared sense of purpose, a commitment to excellence and a belief in their ability to deliver exceptional care. The implications are important, because teammates become accountable to each other as well as the larger organization. And that makes for a much more resilient environment.

The need for strong organizational culture in healthcare is nothing new, particularly with burnout and turnover headlining much of 2023. But in my conversations with leaders this year, high-performing organizations are doubling down on connecting financial strategy and people strategy. Merging margin and mission.

Here's what I mean.

In a strong culture, mission meets margin

Much has been written and discussed about the challenges health systems are facing—thin operating margins, persistent workforce shortages and increased lengths of stay.

But these concepts aren't mutually exclusive—the environment health systems create for employees directly impacts their bottom line and the communities they serve. When providers invest in a strong culture, they enable employees to do their jobs better, ultimately improving the sustainability of their operations and the care patients receive. The challenge is determining what that culture looks like, and I believe the principles of high reliability provide the best starting point.

High reliability mitigates risk and maximizes performance

High reliability organizations (HROs) are teams that constantly perform at a high level with small margins for error, like air traffic controllers, nuclear submarine operators and the Blue Angels. HROs have cultures, systems and processes in place to effectively manage unexpected events and mitigate the risk of human error.

And what more complicated system is there than U.S healthcare? That's why Vizient Safe and Reliable Healthcare identified a framework that brings HRO principles into the healthcare space, with culture at the forefront. If employees don't feel valued, respected or accountable, they won't feel comfortable speaking up when they identify a problem. We want our people to know they can have difficult conversations or talk about what isn't going well without fear of retribution.

The four elements of culture—personal accountability, teamwork and collaboration, healthy environment, and connections and alignment—weave together to create the conditions where groups can identify and understand weaknesses, test ideas and improve.

Better communication yields better culture

Even before the pandemic hit, more than half of doctors and nurses were already experiencing burnout—a statistic that's worsened in recent years. However, for every 10% increase in trust in local leadership, there's a remarkable 28% reduction in the odds of burnout, a correlation that was also seen in a 2022 Vizient survey of more than 1,700 clinicians. This highlights the critical need for healthcare system leaders to prioritize building trust and fostering positive relationships within their organizations.

But traditional methods of communication can be inefficient and limit engagement, especially for teams working remotely or in different shifts. One way we've seen organizations improve their communication—and ultimately their culture—is through Vizient's Learning and Engagement System (LENS) tool. LENS is a centralized platform for voicing concerns, tracking progress and resolving issues, leading to faster problem-solving and more focused attention on patient care.

The Queen's Health System in Hawaii implemented LENS to improve morale and engagement for their employees, who work varying schedules and don't have contact with the same leaders at each shift. By using LENS, The Queen's Health System has been able to distribute staff recognition and foster a sense of community among team members. The system allows staff to share personal content like pictures of their pets and families, which creates a supportive environment, while also highlighting operational and care delivery issues that need immediate attention, which combats burnout.

The bottom line

A 'glad to be here' culture is more than a motto. It's the mindset required to merge margin and mission. Imagine a healthcare team that approaches each day with a shared sense of purpose, a commitment to excellence and a belief in their ability to deliver exceptional care. The results are a net positive for the culture and the bottom line.