Culture Check Up: How to Assess Your Emergency Department Culture

Whether you are aware of it or not, your emergency department has a unique subculture within your organization. Hopefully the subculture is positive and harmonious. If there are elements of dysfunction begin by assessing your emergency department’s current strengths, weaknesses, and opportunity areas. Outlined below are steps to follow to assure your emergency department team is united and headed in a direction that mutually benefits the providers, staff, hospital or health system, and the patients and community you serve.

  1. Identify key stakeholders

When working to assess the culture of the emergency department, it is crucial to include everyone who works within or interfaces with the emergency department in your assessment. This includes:

  • Hospital administration
  • Hospital leaders and community providers who interface with the emergency department
  • Physicians and Advanced Practice Providers
  • Nurses and technicians
  1. Have face-to-face conversations with key stakeholders

Once you have identified stakeholders, talk with them to clearly understand their vision, needs, and goals. The act of asking for input is itself a great opportunity to promote a culture where everyone feels valued. Start by asking:

  • What do you love most about your job?
  • What would you change that would make coming to work each day a more positive experience?
  • How does/can the emergency department contribute to achieving your goals/meeting your needs?
  1. Summarize key challenges and opportunities

A collective review of answers to the questions in the previous section can illuminate core strengths and weaknesses of department culture. After you have this information, natural themes will emerge around which workflows, processes, and training need to be improved to promote a more satisfied staff and in turn safer, more cost-effective, efficient patient care. Your summary should include a full assessment of the following:

  • How does the community perceive the emergency department?
  • What are the abilities of the current clinical staff?
  • What is important to each stakeholder and are priorities aligned?
  • Physician turnover, how often are providers leaving and why?
  • How are physician relations with APPs, nursing staff, and techs?
  • What defines success?
  • What is the general attitude among staff?
  • Does the clinical staff feel supported?
  • Does the clinical staff feel invested?
  • What are the primary communication issues within the department?
  • Where does efficiency/throughput break down? Why?