Leadership in Healthcare: Organizational Culture

Have you worked in different healthcare organizations and noticed a variation in how they felt? Not all organizations are created equal. An organization's culture is the foundation of how everything else will function within it. A positive organizational culture makes employees feel connected and fosters collaboration, open communication, and innovation. 

What is Organizational Culture

Organizational Culture Definition Consists of the following:

• Beliefs

• Expectations

• Behaviors

• Procedures

• Common Norms

• Values

• Perspectives

All of these things connect and guide how employees function within the organization. It is like the humming of a well-functioning car that can navigate any terrain, holding steady on the organization's mission, vision, and values to provide quality, safe care to those it serves. Without a clear understanding of the cultural expectations, employees will lack the purpose and cohesiveness to achieve the organization's goals and find self-actualization in their career aspirations (Harb et al., 2025; Chalmers et al., 2025).

Question related to Organizational Culture and You?

Q) What organization did you feel the most connected to? 

Q) Did you find the staff feeling a sense of positive engagement with the organization and a willingness to participate in unit governance to drive a unified, healthy work environment? 

A study conducted by Kasmai Kiptulon et al. (2024) found that a positive organizational culture had a positive effect on the nurse’s “happiness and joy at the workplace and lower levels of work-related stress…” (p. 1). An organizational culture that promotes a safe and respectful environment where a nurse feels empowered to speak up and engage with leadership can facilitate the delivery of safe patient care (Lee & Kwon, 2024). For the organization to thrive, nurses must feel engaged and empowered to create a culture that fosters open communication, creativity, and teamwork without repercussions of punitive actions to help drive the organization forward.

Who sets the stage/tone for the organizational culture in healthcare?

Leadership sets the stage for organizational culture. 

Creating an environment for nurses to excel begins with leaders characterized by purpose, self-discipline, and demonstrating behaviors of respect, trust, empathy, and balance (Kasmai Kiptulon et al.,2024, pp.10-11). Being transparent and authentic produces a collaborative, honest, and engaged culture. The leaders of any organization have the most significant impact on OC (Masionis, 2023). Leaders who do not demonstrate the above behaviors and attitudes need coaching or to be relieved of their duties, as they set the tone for the work environment (Masionis, 2023).    

Values that Leaders Utilize to Support an Organization and Promote Sustainability

1. Altruism - The leader is willing to work to help others and is genuinely interested in what others have to say about the organization. This type of behavior can create a healthier work environment. 

2. Empathy—The leader can set aside their feelings and interests to hear and respond to the staff’s concerns, experiences, and thoughts. 

3. Reciprocity—The leader can help staff. There is trust and an organized framework that links the leader and employees. This network champions a positive leader-employee relationship. 

4. Self-Effacement—A leader who lacks arrogance but is humble, modest, straightforward, and demonstrates a strong affiliation to the organization creates an environment that supports employee and patient safety.

(Whitehead et al., 2017)

What can an employee do to foster a thriving organizational culture?

Employees must also be active participants in creating a positive organizational culture. The leader will set the foundation, but a successful organizational culture will not be achieved without the employees actively engaging with the leaders. 

Actions a Nurse Can Take in the Process of Creating a Positive Organizational Culture

1. Communicate 

   1. Be clear and concise - Plan ahead on your key talking points.

   2. Remember to use active listening skills.

   3. Be cognizant of your non-verbals.

   4. Watch your tone.

   5. Build your Emotional Intelligence - Understand your feelings behind the discussion, practice empathy, and be respectful. 

2. Collaborate 

   1. Participate in shared governance, unit meetings, or huddles (McNight & Moore, 2022).

   2. Integrate the Core Competency of Team and Teamwork (IPEC, 2023).

3. Competent 

   1. Be open to change. Healthcare is constantly evolving as new advancements in treatment are made, patient needs evolve, disease patterns change, and technology advances (Nilsen,2020).

   2. Stay competent through lifelong learning and evidence-based practice (Connor et al., 2023).

A thriving organizational culture begins with intention and grows through consistent effort. Everyone must work together to achieve the mission, vision, and goals. When values are lived, communication is open, and trust is built, organizations don’t just thrive—they inspire. Let’s commit to being the kind of leaders and colleagues who make culture our strongest asset, ultimately creating an environment that delivers the best care possible. 

What type of organizational culture do you work in? Is there anything you want to help change, and how would you see yourself doing that?

References

Bayot, M.L., Tadi, P., & Vaqar, S. [Updated 2024 Aug 11]. Work culture. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542168/

Chalmers, R., Marras, A., & Brannan, G.D. (2025, January 3). Organizational culture. In StatPearls. StatPearls Publishing. Retrieved April 8, 2025 from  https://www.ncbi.nlm.nih.gov/books/NBK560543/

Connor, L., Dean, J., McNett, M., Tydings, D.M., Shrout, A., Gorsuch, P.F., Hole, A., Moore, L., Brown, R., Melnyk, B.M., & Gallagher-Ford, L. (2023).  Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews Evid Based Nurs, 6-15. doi: 10.1111/wvn.12621

Harb, S., Abushosha, G., Ali Oweidat, I., Al-Mugheed, K., M.alzoubi, M., & Mohammed Farghaly Abdelaliem, S. (2025). Exploring organizational culture and its association with standard precaution practices among nurses. BMC Nursing, 24(260), 1-6. doi.org/10.1186/s12912-025-02879-3

Kasmai Kiptulon, E., Elmadani, M., Mbaabu Limungi, G., Simon, K., Toth, L., Horvath, E., Szollosi, A., Adi Galgalo, D., Mate, O., & Ujvrine Siket, A. (2024). Transforming nursing work environments: The impact of organizational culture on work-related stress among nurses: A systematic review. BMC Health Services Research. 24(1526), 1-16. doi.org/10.1186/s12913-024-12003-x

Lee, E. & Kwon, H. (2024). Cluster of speaking-up behavior in clinical nurses and its association with nursing organizational culture, teamwork, and working conditions: A cross-sectional study. Journal of Nursing Management, 2024, 1-11. doi.org/10-1155/jonm/9109428

Masionis, A. (2023). Understand and improving company culture. Achievers. Retrieved from Understanding and improving company culture - Achievers

McKnight, H., & Moore, S.M. Nursing. [Updated 2022 Sep 19]. Shared governance. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549862/

Nilsen, P., Seing, I., Ericsson, C. et al. Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC Health Serv Res 20, 147 (2020). https://doi.org/10.1186/s12913-020-4999-8

Whitehead, D., Welch Dittman, P., & McNulty, D. (2017). Leadership and the advanced practice nurse: The future of a changing health-care environment. F.A. Davis Company.