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14 Signs You Have a Great Clinical Unit Culture

Are you among the majority of clinical leaders who knows how important culture is for achieving best in class patient outcomes, but you aren’t doing anything about it?

Many of the leaders I encounter know that culture is the most influential factor driving their staff and provider behavior, yet few are actively working on it due to its perceived difficulty.

Contrary to popular belief, culture change doesn’t have to be a hard all-consuming initiative. Small steps can be taken each day that over time will result in a noticeably improved and highly effective culture.

What is Clinical Unit Culture Anyway?

Clinical unit culture is the system of values, beliefs, and behaviors shared by the people who work in it and it shapes how the work gets done. Having a thriving culture has both tangible and intangible benefits, including improved patient experience and outcomes and higher levels of worker joy and engagement.

A study that underscores the importance of culture is the Deloitte Center for Health Solutions’ report on the value of patient experience and how hospitals with better patient-reported experience perform better financially. Among the factors contributing to boosting patient experience was a highly engaged staff. Likewise, a Deloitte Insights article on the impact of culture on business reported that more than four-fifths of the CEOs and HR leaders they surveyed now recognize that it is culture that drives people’s behavior, innovation, and customer service.

Is This Something My Clinical Unit Can Achieve?

Given the importance of culture – as well as the idea of shared values and practices by the entire clinical unit workforce – it may seem daunting. Where do you even start?

The good news is that you most likely already have some aspects of a great culture in place in your unit. The list below is a quick way to determine where your strong points are and where you could make improvements. Rate your clinical unit’s culture by assigning a 1, 2, or 3 next to each element according to the following scale: a 1 (doesn’t exist), 2 (we do that sometimes), or 3 (we’re awesome at this!):

14 Signs of Great Clinical Unit Cultures

  1. Multidisciplinary meetings include everyone on the team impacted by the decisions that are made in them, including unit clerks and housekeepers.
  2. Influence is determined by one’s character and knowledge of the subject matter, not placement in the status hierarchy.
  3. When someone makes a mistake, others flock to the person to offer support.
  4. Managers have open doors and make it a point to spend time “hanging out” with their staff.
  5. There are many informal leaders.
  6. People have close ties to their colleagues.
  7. Respectful disagreement is encouraged.
  8. Leaders talk openly about their failures.
  9. People frown upon discrediting others behind their backs.
  10. People ask each other for help.
  11. Medical and Nursing/Administrative clinical leaders have strong partnerships and shared responsibility for the performance of their units.
  12. Front line workers are taught how to address conflict effectively at the point of conflict rather than elevating to management.
  13. Individual contributions are regularly showcased in public forums.
  14. Individual and team development is valued and resources are put toward it.

If you are like most clinical leaders who are starting their journeys towards making improvements in their unit’s culture, you probably have a few 1’s, lots of 2’s, but not too many 3’s. If this is the case you may be experiencing some doubts that things could change. The truth is, they can change and it doesn’t have to take a lot of effort.

Visualizing Cultural Change

In keeping with the adage “energy flows where attention goes” to create something new and different in our lives, we need to keep our focus on what it is that we want.

In the context of workplace culture, this means that you and your team need to create a crystal clear vision of the kind of culture you want and then keep that vision front and center every day. To help you do that follow these steps:

6 Steps to Your Desired Culture

  1. Share the 14 signs of great clinical unit cultures with your team.
  2. Discuss which of the signs are present in your environment and which ones aren’t.
  3. Decide which sign you want to cultivate in your unit.
  4. Discuss actions everyone can take to move toward that goal.
  5. Visit the action plan regularly to see how you are progressing. Iterate if necessary.
  6. Once you’ve achieved your goal and that sign is now apparent, move to another one.

Great leaders cultivate and manage their unit cultures because they know it is the vehicle for providing optimal patient care and positive worker experiences. All it takes is a clear vision and small steps each day and before you know it you and your team will be reaping the grand rewards..

Receive my Thriving Work Environment Scorecard to assess the areas that have the most impact on whether workers feel ease, joy and success at work.


Kaplan, M., Dollar, B., Melian, V., Van Durme, Y., & Wong, J. (2016). Shape culture. Drive strategy. In Global Human Capital Trends 2016. The new organization: Different by design (Section 4). Retrieved from https://www2.deloitte.com/insights/us/en/focus/human-capital-trends/2016/impact-of-culture-on-business-strategy.html

Betts, D., Balan-Cohen, A., Shukla, M., & Kumar, N. (2016). The value of patient experience. Hospitals with better patient-reported experience perform better financially. Retrieved from https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-dchs-the-value-of-patient-experience.pdf

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