How staff find value in their healthcare organization’s culture
Involving non-patient-facing workers in decision making and emphasizing communication are key pathways to improvement.
Non-clinical staff have often unexplored but influential experiences that are rarely examined. Better understanding these hidden influences can impact their willingness to stay at their jobs and how they interact with patients and visitors, just to name a few key areas.
That's why careful understanding of the impact of corporate culture on behind-the-scenes employees is crucial.
To investigate the perceptions of organizational culture among non-patient-facing staff, I designed a mixed-method study. The 31-question survey was distributed to health system employees across the country, with help from professional healthcare networks and trade organizations. The survey asked about various aspects of workplace culture, querying respondents on topics such as leadership support, teamwork, communication, workload and how valued they felt.
We received 67 responses, and after filtering out a few that didn’t fit (such as responses from people in strictly clinical roles or external consultants), we had 61 complete surveys to analyze.
Next, I conducted 23 in-depth interviews with respondents who volunteered to talk further. These were semi-structured interviews, which employed a rough framework of designed questions, but there was flexibility to let the conversation flow so employees could freely express their thoughts and stories about their workplace culture. By combining quantitative survey data with rich qualitative interviews, I hoped to get a broad and deep understanding of their experiences.
Survey findings
The survey results painted an encouraging picture overall. Perhaps surprisingly, most non-patient-facing employees reported a predominantly positive outlook on their organization’s culture.
Many rated aspects of their workplace highly. For instance, a majority said their supervisors support them well, listening to their job-related problems and inspiring them to do their best. In fact, in my analysis, I found that when employees agreed that their supervisors listened to them and provided honest feedback, those employees were far more likely to say the overall organizational culture was positive.
Supervisor support also correlated with employees feeling involved in decisions at work. This makes sense – when leadership listens and responds, people feel valued and included.
Another strong point was patient orientation: even though these staff aren’t clinical, they widely believed that their organizations prioritized high-quality patient care. Many said that their coworkers, and they themselves, go out of their way to treat patients and visitors with courtesy and concern. They believe that patients ultimately receive excellent care in their system. This finding was encouraging; it suggests that non-clinical teams see themselves as part of the patient care mission and take pride in it.
However, not everything was perfect. One area that came out a bit lower was involvement in decision-making. On average, employees felt they were only “somewhat” involved in decisions affecting their work. Some interviewees echoed that they wished leadership would solicit more input from staff at all levels when making changes. Importantly, the survey data showed that when employees do feel involved in decisions, they are more likely to say “This is a great place to work,” and “We have a positive culture of teamwork.” In short, being heard matters because it boosts morale and teamwork.
Driving staff perceptions
The interviews really revealed what drives non-patient-facing staff’s perception of culture.
Communication and transparency. “We need to know what’s going on.” Virtually all interviewees stressed the importance of open, honest communication from leadership. When information is shared in a timely, transparent way — whether it’s about organizational changes, COVID updates or daily operations — employees feel trusted and safe. Several respondents noted that regular huddles or updates where everyone hears the same message help create a psychologically safe environment to voice concerns. Conversely, when communication lapses (for example, when staff learn about layoffs or policy changes through rumors or late memos), it breeds anxiety and erodes trust.
Coordinated teamwork. “We’re all in this together.” A strong theme was the value of teamwork across departments. Many interviewees described instances of colleagues stepping up to help in areas that were outside their formal job scope — “Operations helped IT, IT helped Nursing” — or the like. When people collaborate and break out of silos, it reinforces a positive culture. One interviewee gave an example of an understaffed team where employees from different roles rallied to support each other, preventing a collapse in service — a story that highlighted a high degree of teamwork even under pressure. On the flip side, if teamwork is lacking and departments operate in silos, employees start feeling isolated and less committed to the organization’s goals.
Supportive leadership. “Good leaders walk the talk.” Leadership behavior was repeatedly cited as a make-or-break factor for culture. Employees notice when managers and executives are supportive, meaning they listen, advocate and recognize staff contributions. When supervisors show genuine concern for employees’ well-being, it cultivates a culture of recognition and value. Interviews revealed praise for leaders who had employees’ backs during tough times, whether by pushing for needed resources or publicly acknowledging hard work. But frustration was expressed over instances where that support failed to materialize. Unfulfilled expectations led to disappointment and some turnover. This indicates that leadership actions need to match their words. A manager who advocates for their team and follows through inspires loyalty and a positive culture.
The impact of COVID-19 (external change). “Crisis reveals character.” The pandemic was a major theme that cut across the discussions of culture. Interviewees shared how COVID-19 changed their workplace culture in both positive and negative ways. In some cases, the crisis brought people together — one director said employees all rallied to support one another, describing how teams innovated and communicated more than ever at the pandemic’s outset. Leaders who rose to the occasion by communicating frequently, allowing remote work or adjusting policies earned a lot of appreciation. Rapid problem-solving and empathy improved, showing that a crisis can catalyze positive cultural shifts. But there were also negatives: some described how the pandemic exposed cracks in the culture. For example, pre-existing issues like understaffing became dire and created a culture of constant stress and urgency. One interviewee said that the pandemic created a culture of isolation in certain units that had to lock down. Communication sometimes faltered, leading to fear and uncertainty. COVID-19 was a pressure test for organizational culture, amplifying the strengths or weaknesses that already existed. The study confirms that the pandemic affected non-patient-facing staff in profound ways, altering how they viewed their leaders and workplace.
Everything comes together
These four themes — communication, teamwork, leadership and adapting to external crises — are deeply interrelated. Together, they paint a picture of what matters most in shaping a positive culture for non-clinical healthcare staff.
Effective communication builds trust, which enables teamwork. Good teamwork and inclusion in decisions make employees feel valued, which is often driven by supportive leadership. And strong, empathetic leadership is especially crucial when external challenges like a pandemic hit, to maintain trust and cohesion.
In the third and final part of this series, we will explore what these findings mean for healthcare organizations and leaders. How can hospitals and health systems act on these insights? What practical steps can be taken to improve communication, strengthen teamwork and support every employee so that the culture sustains both staff well-being and patient care excellence?
The research indicates that investing in a healthy culture for all staff isn’t just the right thing to do, but will pay off in better retention, less burnout and even better outcomes for patients.
Teray Johnson, PhD, MS, MBA, FACHDM, is a director of healthcare analytics and operations. She drives organizational transformation by facilitating data-driven decisions.
This article is the second in a 3-part series.