The Sixth Characteristic of the Ideal Healthcare Organization: Trust, Teamwork and Cooperation

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We’ve been having a series on the ten key attributes of the ideal healthcare organization.  The most recent, characteristic five, was on employee involvement.

The sixth item on our list is that “there is trust, teamwork, and cooperation, with high morale, motivation and enthusiasm.”  That’s a pretty long list; and starting with trust is appropriate, because without that other organizational desiderata are unobtainable.

In healthcare, patients have to trust doctors and nurses, who also have to trust one another.  (Nurses, by the way, are of all professionals the most trusted by the public.)  In all organizations, leaders need to trust employees and vice versa.

Teamwork is based on trust and is an absolute requirement in the healthcare environment.  In the operating room, results depend on the team trusting and cooperating with one another.  Patient care is a team effort, with the patient being a member of the team; indeed, patient centered care is currently a watchword of best practices.

Cooperation between the various organizational units is equally important.  The whole organization should work together as a team.  Beyond that, there should be a partnership and cooperation between the healthcare organization and the community.

Trust, teamwork and cooperation in themselves produce positive morale and motivation, which in turn generate enthusiasm.  When interactions between employees are positive and helpful, they become energized and enthusiastic.  Organizations cannot be successful in their results if they do not create, promote and exemplify these norms.

The responsibility for achieving this result rests at all levels and in all places of the organization.  But leadership behavior is crucial.  Leaders need to create trust not just by talking the talk and walking the walk but by showing that they trust employees.  To that, they must create an environment in which all are able to say what they think and to contribute ideas, with communication balanced between upward and downward forms.

Leaders should support initiatives that promote teamwork across the organization.  They must provide ongoing training and learning opportunities in these areas and utilize practices such as dialogue and medical improv that stimulate trust and teamwork.  Organizational systems for personnel selection, rewards, and mentoring must reflect the goal of a cooperative culture.

Unit managers have to trust the leadership and their employees – as well as other unit managers.  Cooperation between units will not exist if managers don’t work as a team, and the leadership needs to monitor relations and communication among the different departments to ensure that cooperation, not rivalry, is the guiding force.

Individual healthcare workers must, despite the inherent stresses of the healthcare environment, maintain a cooperative attitude and act in a way that promotes trust.  That’s very hard to do and may require strong skills in assertiveness.

As any nurse would note, patients should be cooperative, too!  The most effective method to obtain such behavior is for nurse and other staff to treat the patient as the key member of the team. And since we are all likely to be patients at one time or another, we should resolve in that event to balance self-advocacy with trust in the interest of cooperation – good practice in life generally, actually!

jim murphyJim Murphy has a solo consulting practice called Management 3000, focusing on organizational development and change management. Being semi-retired, Jim is willing to provide very reasonably priced consulting, coaching or  project work for organizations aspiring to improvement in organizational culture, effectiveness and employee engagement.

Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium.  His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices.  Having produced newsletters for several organizations  and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as well as consulting and coaching. or email

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7 Responses to The Sixth Characteristic of the Ideal Healthcare Organization: Trust, Teamwork and Cooperation

  1. Jim Murphy says:

    I quite concur in Terri’s diagnosis. I would also note two points illustrated by her story. First, when trust is broken it is very hard to regain it. Second, breech of trust has long-lasting negative effects on individuals. I myself have worked for organizations that were mistrustful and dishonest. We can only hope that we don’t get too discouraged from finding organizations that can be trusted and from doing our best to improve the organizations that we do work for or with. Good luck in that quest, Terri!

  2. Beth_Boynton_RN_MS says:

    I SO agree, Jim. Trust is essential and add that it can be hard to rebuild once broken. Not impossible though. In many healthcare systems trust between leaders and staff (including docs and nurses) has been broken and this contributes to behaviors that undermine a culture of safety, i.e. the passive, aggressive, and passive-aggressive stuff that plagues toxic cultures. It is key to acknowledge this for any culture change work and a huge leap for any organization when leaders do so with ownership and an apology. Moving on from this with a clear vision and expectations for respectful behavior and effective training in giving and receiving constructive feedback are also essential.

    • terri arthur says:

      I agree with Jim and Beth here. I was fortunate enough to have worked in a hospital where trust and respect were the norm. When that management changed, trust was lost and the morale plummeted. What happened next is a well documented phenomenon that often happens in a workplace environment where there is no trust. A secondary system developed with their own rules, leaders and code of behavior. Much of it was centered around the union which became a mobilizing force. It was a survival mechanism for the nurses and staff. Management then got into a blaming mode. Nurses weren’t organized enough or didn’t move fast enough or were lazy. It’s a great example of human behavior in organizations. Trust is the key because with that comes respect, collegiality and open communication which benefits everybody including the patients.

      • Beth_Boynton_RN_MS says:

        Well, put, Terri and I so appreciate your contrasting experiences. I have worked in teams where trust is solid and creativity high, but sadly not in direct care.

        • You would think that of all places, trust and respect would be the norm in direct care facilities. If it is expected from the front line caregivers, why would it not also be from the managers of those caregivers? But sadly, when hospitals changed to a business model of management, the culture changed to one of being hard-lined and punitive.

          • Beth_Boynton_RN_MS says:

            Exactly. In my loftiest of visions, I see healthcare organizations leading the world in providing compassionate, affordable, innovative, safe care and role-modeling social values that will sustain us. BUT we have a long ways to go! 🙂

What are your thoughts?