Improving Transparency in Healthcare

In December 2013, Forbes reported a new study that found that “organization transparency” (candid and open communication by management) plays crucial role in maintaining an engaged, motivated work force. The study results were based on analysis of over 40,000 survey responses. Three key findings were:

  1. The top factor when determining employee happiness is transparency of management,
  2. Managers did a solid job outlining employee roles and responsibilities, and
  3. Management did not do a good job outlining the organization’s vision, mission and values to their employees.

The survey respondents also said that they would work harder at work if they could “believe and trust” their management.

Failure to communicate can lead to disastrous consequences in an organization, including disengaged employees, non-congruence of employee interests, and organizational goals that could negatively affect the organization. Carlos Ghosn (CEO of Nissan and Renault) is known as a “Transcultural Leadership” and “Turnaround Specialist.” He has helped turn around three different companies from losses. Under Ghosn leadership, Nissan went from an annual loss of $5.5 billion at early fiscal 2000 to a stunning $2.7 billion profit at the end of the year 2000. Ghosn emphasized transparency across the organization and consensus among management in decision making. He based job promotions on talent and expertise instead of experience and age. He stated that “Once you set the direction for the company, you have to start heading that way. Success is 5 percent strategy and 95 percent execution … motivation of the employees was the greatest tool that led to the Nissan turnaround.”

On the other hand, John Chambers ( CEO of Cisco in Silicon Valley, CA) is known for his “Collaborative Leadership” that states: “There are three characteristics that make a good leader: first is producing results, second is building a quality team, and third is the ability to communicate direction.” Chambers helped grow the company from $70 million when he joined Cisco in January 1991 to $1.2 billion when he assumed the role of CEO to record revenues of $48.6 billion in FY13. Cisco has encouraged all employees to participate in the organization’s product development through blogs, YouTube, and videos that promote upward communication, feedback, and shared values as well as tying the executive bonuses to cross-functional team accomplishments.

Could the healthcare industry adopt the organizational successes in other industries? The New England Journal of Medicine published healthcare organization transparency successes by the adoption of disclosure, apology, and offer (DA&O) programs among healthcare organizations. In taking a principled approach to addressing medical errors, organizations instituting these programs commit to fully investigating adverse events and implementing interventions to prevent their recurrence. The organizations also openly admit their errors to patients (and make offers of compensation, when appropriate), letting the chips fall where they may when it comes to reputation and liability. Contrary to many predictions that DA&O programs could result in the proliferation of legal claims and costs, data from two pioneering programs have revealed improved liability outcomes, including a 60 percent decrease in legal and compensation costs in one program. University of Utah has started posting its Press Ganey patient satisfaction results online. Their physicians’ ratings have been boosted almost 10 times in less than a few years.

A clear and consistent sense of purpose when handling employee issues, such as removing or correcting employee behavior inconsistent to organization goal and objectives, would help shape a collaborative environment. Increasing transparency at the workplace could help healthcare organizations nurture a collaborative work environment, shared values and mutual engagement, which are all important key concepts in obtaining high commitment and motivation among all employees.

Kachalia, A. M.D., J.D (2013). Improving Patient Safety through Transparency, N Engl J Med 2013; 369:1677-1679, October 31.


Information on policies or practices are solely from my personal experience ONLY and have NO relation to my affiliation with any regulatory or government agency.


-Caroline Satyadi, MT(ASCP), SM, DLM, SLS, MBA, MS, CQA (ASQ) has been a laboratory management professional for over 25 years. She has worked with several different medical industries for CLIA/CMS, FDA/ICH/ISO, TJC/CAP/COLA/HFAP accreditation survey readiness.

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