Leadership
Talk
Health Care’s Most Important KPI: Social Capital (17:09)

What’s one of the most common reasons people give for staying with an organization? Respect for their colleagues, says Stephen Swensen, [former] Medical Director for Leadership and Organization Development at Mayo Clinic. In other words, camaraderie. Camaraderie is the driver of social capital, and it’s the most important leading indicator of performance and our ability to deliver the best care to every patient every day within an organization.

Swensen likens it to the most profitable Fortune 500 company for 25 years ending in 2002. Despite an industry fraught with bankruptcy after bankruptcy, Southwest Airlines succeeded when essentially no one else in that business sector could. Why? It comes down to culture and “relational coordination,” which is a fancy way of saying camaraderie. It was the trust, interconnectedness, and respect that the colleagues had for each other — from the captain, the first officer, the navigator, the flight crew, the ground crew, to air traffic control.

“It’s the same thing in health care,” Swensen says, adding that you can get the same results. “The teams that had better teamwork, relational coordination, camaraderie, outperformed the others. Patients had safer outcomes, higher quality outcomes, at lower cost.”

Swensen goes on to discuss how the valuation of Fortune 500 companies today has changed from by brick and mortar to intangible assets — intellectual capital, human capital, and specifically social capital. Social capital is trust and interconnectedness of colleagues within an organization. “It makes them safer, it makes them better learners, and it makes them highly productive. It’s an admirable trait that as leaders we need to pursue if we want the highest value care for our patients, families, and the communities that we serve,” Swensen says.

So what motivates us beyond, Swensen asks? He refers to a study whereupon one of two sight variations were put by every hand sanitizer machine in a hospital. Half said “Use of hand sanitizer prevents you from catching diseases.” The other half said: “Use of hand sanitizer prevents patients from catching diseases.” There was a huge difference in sanitizer use, but which sign had more of an impact might surprise you. When health care professionals were reminded of why they went into health care, of the altruism of helping the patient have a safe stay in the hospital, they took an extra squirt of hand sanitizer. This is what we as leaders need to double-down on to engage colleagues in our mission, Swensen adds. “Not data, not the brain, but about 14 inches lower with the heart. And why we’re in health care, and why we’re going to the hospitals and clinics every day.”

“When you have teams, and departments, and organizations that have high levels of companionate love or camaraderie, you get some amazing dividends with employee engagement, productivity, commitment to the organization, accountability, better patient outcomes,” Swensen says.

“The beauty of it is, the same thing happens with patients.” There are dozens of peer-reviewed papers on kindness and the dividends it has for patients. “When you have a team with high levels of camaraderie, engagement, satisfaction, they are more likely to be kind to patients. Patients’ wounds heal faster if they’re treated kindly.”

From the NEJM Catalyst event Leadership: Translating Challenge to Success at Mayo Clinic, June 2, 2016.

More From Leadership
Health Care Organizational Culture Emphasizes Patient Care Only Slightly More Than the Bottom Line

Survey Snapshot: Who Should Lead Culture Change?

NEJM Catalyst Insights Council members feel that culture change at their organizations is heading in the right direction, but differ on who it should come from, and reveal too much balance between emphasis on bottom line and emphasis on patient care.

Culture Change Within Health Care Organizations Is Changing for the Better

Leadership Survey: Organizational Culture Is the Key to Better Health Care

Although three-quarters of Insights Council survey respondents say culture change is a high or moderate priority at their organizations, survey results show a lot of work on organizational culture remains to be done.

Metraux01_pullquote - dinners to combat burnout in the health care community

“Breaking Bread” to Combat Burnout

Can a simple dinner create community among health care providers?

IHI HPMS Visual Management Board Example

The Answer to Culture Change: Everyday Management Tactics

Adoption of a clear rhythm-of-performance measurement and communication via huddles and visual management can affect a culture of staff engagement and continuous value improvement.

ajor Themes from Cleveland Clinic Town Halls 2016

Reigniting the Passion to Practice Through a Multi-Pronged Approach

Cleveland Clinic formed the Practice Innovation and Professional Fulfillment Office to create and sustain an environment that allows clinicians and scientists to thrive through barrier removal, culture change, and support for personal well-being.

Percent in Highest Bracket in Patient Satisfaction Scores - Pre-Post Arm Differences for Hospitalists - Duke Coaching Communication Skills Study

Coach, Don’t Just Teach

The effect of one-on-one communication coaching on clinicians’ communication skills and patients’ satisfaction.

Two-Thirds of Organizations Have a Nurse Leader Career Path

Survey Snapshot: Do Nurse Leaders Need Advanced Degrees?

Though NEJM Catalyst Insights Council members acknowledge a lack of advancement opportunities for nurse leaders, two-thirds of their organizations have a nurse leader career path.

Nurse Leaders and Physician Leaders Should Be Considered Equals in Care Delivery - but Views of Nurses and Non-Nurses Differ

Leadership Survey: Nurses as Leaders: Broad Acceptance, Room to Grow

Nurses are traditionally the backbone of patient care. They form the largest percentage of the health care workforce, far outstripping physicians. But are nurses leaders as well as doers?

The CMO Role of the Future - Baptist Health Survey Results

Examining the Continuously Evolving Role of the Chief Medical Officer

Hospital and system leaders need to sharpen the focus of CMO roles to include system-wide considerations beyond the walls of the hospital.

Meyer01_header - Seven Challenges and Seven Potential Solutions for Large-Scale EHR Implementation

Seven Challenges and Seven Solutions for Large-Scale EHR Implementations

Salient lessons learned over multiple electronic health record implementations.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Leading Transformation

258 Articles

Survey Snapshot: Who Should Lead Culture…

NEJM Catalyst Insights Council members feel that culture change at their organizations is heading in…

Team Care

103 Articles

Reigniting the Passion to Practice Through…

Cleveland Clinic formed the Practice Innovation and Professional Fulfillment Office to create and sustain an…

Quality Management

169 Articles

The Answer to Culture Change: Everyday…

Adoption of a clear rhythm-of-performance measurement and communication via huddles and visual management can affect…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now