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.

Improving Staff Morale in Healthcare Organizations

In 2009, Healthcare Finance News reported that twenty percent of more than 350 healthcare employers reported low morale among employees. Meanwhile, thirty-eight percent of healthcare workers cited lack of motivation and nearly twenty-five percent reported no loyalty to their employers! Nearly fifty percent of healthcare workers surveyed cite increased stress on the job, and fifty percent noted an increase in their workload in the last six months. Most would agree that these numbers will not go down in the next coming years but will go up.

Staff morale can make or break any organization. When employee morale is low, decreased productivity or little collaboration to support organization goals and objectives can result. Unfortunately, there is no magical formula in boosting employees’ morale. The challenge in improving employee morale is complex as it involves the organization’s culture and environment. Healthcare organizations should “prepare and support” their employees appropriately in this healthcare challenging time. As more new technology applications are introduced in healthcare , employees are faced with more complex accountability. It is crucial for healthcare organizations to reassess each employee’s “task alignment” whenever introducing new technology into the work environment.

Task alignment is an approach to employee behavioral change that starts with the identification of key issues in the work units within the organization and asks employees to realign their roles, responsibilities and relationship to perform necessary tasks. Training encourages dialogue and feedback among employees. This feedback should focus on what needs to be improved from both the employee and the management perspectives.

According to Harvard Business Review (April 2014) in its article “Stop Trying to Control Employees or Make Them Happy,” the traditional management “hard” approach started in the 80s; however, this approach is not effective in the 21st century when dealing with digital communications and managing the “X” and “Y” generations. Management should try the “soft” approach by understanding and clarifying what employees do through dialogue and feedback loops; reassessing task alignment; increasing employee power; improving organization transparency; increasing employee reciprocity; and improving the working environment. That would in turn increase employee accountability. Give frontline employees more autonomy to do their job—for instance, by empowering them to make critical judgments and encouraging them to cooperate with each other. When there are dialogues and shared purposes among employees, challenging situations become less complex and employees can work collaborate together to create mutual engagement.

Scheduling regular “social events”, such as monthly /quarterly birthdays, ice-cream social or holiday potlucks can boost morale. Through social events, employees can strengthen their working relationship. Congruence between organizational values and individual values should be nurtured to create an organizational culture comprised of employees who have the desired traits in supporting the success of the organization. Increasing feelings of ownership among employees will boost employee morale and productivity.

Some healthcare organizations have focused on employee perks to increase morale and productivity. One company in Phoenix, Arizona built shower rooms to encourage its employees to bike to work and exercise; large healthcare organizations in California implement walking meetings across the organization and built walking tracks inside the building. Many managers find that walking meetings have strengthened relationships with their team members. However, not all meetings should have this type of structure. It is not the time for employee discipline or other formal business operations requiring lots of documents for the meeting.

At this time, Google, Inc. is probably at the top of all organizations to provide perks for its employees to boost their morale, productivity, loyalty and creativity; these include free meals, onsite day-care, fitness room, game room, free shuttle to and from work, etc. Not many organizations can compete with Google, Inc. for the employee perks and morale boosters; however, investing in flexible work schedules, organized work environment, day care program, comfortable break rooms, game room, family fun nights, discount programs, social clubs, and other amenities would be worthy investments for boosting employee morale.


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.