When hospital culture affects financial performance

Health systems often strive to build a positive culture and increase employee engagement. But does it translate to a stronger bottom line?

Many CEOs think it does, and continue emphasizing culture to rebuild from the pandemic and transform healthcare delivery in the future.

David Berger, MD, became CEO of University Hospital at Downstate in Brooklyn, N.Y., in September of 2020, and the hospital was emerging from the first wave of the COVID-19 pandemic. Brooklyn was "ground zero" for COVID-19 in New York during the first wave with a very high rate of incidence and mortality. UHD was designated a COVID-19 only facility.

"This devastated our clinical programs and clinical volumes," said Dr. Berger. "As an incoming leader, I felt it was crucial to rebuild our culture."

UHD partnered with Press Ganey to elevate culture by focusing on patient safety and quality. Over the last three years, the hospital developed initiatives to return patient volume to pre-COVID levels, improve Vizient Safety scores from 2nd percentile to 54th percentile and passed a Joint Commission triennial survey with no condition of participation.

The patient volume return had a clear impact on the bottom line and quality care is important at any institution. UHD reported an 84% reduction in annual operating deficit after rebuilding their culture.

UHD isn't alone.

Heidrick & Struggles, a global leadership advisory firm, released a report in July 2023 showing 71% of the 500 global CEOs surveyed said culture was a top factor for positively influencing financial performance, which was a 26% increase from 2021. The CEOs focused on proactively engaging employees' mindsets and ways of working to achieve business outcomes and drive financial performance. Thirty-three percent of the respondents said culture was the most important factor overall.

Additional findings from the survey include:

  • 49% of CEOs think focusing on company culture significantly improves financial performance
  • 54% of CEOs think focusing on company culture increased employee engagement
  • 53% of CEOs said zeroing in on culture significantly improved employee retention

Much like UHD, Newman Memorial Hospital in Shattuck, Okla., also reported growing its patient volume by 73% over the last fiscal year through advancing outpatient services and surgeries, executing revenue integrity initiatives, expanding clinics and adding women's health. But those weren't the most important success drivers, said Tom Vasko, CEO.

"The emphasis on culture, physician relationships and cultivating a community ownership mentality of our hospital has catapulted its growth and stability for years to come," said Mr. Vasko. "It is my job to ensure our team of physicians, clinical and administrative staff have the tools to accomplish their goals…While we focus on expansion of access and quality, we equally focus on our culture and partnering physician relationships."

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