March 25, 2021

How to Adopt Flexible Staffing While Maintaining Team Culture

What’s one thing you can’t see that improves healthcare quality, safety, and performance? Culture. Here’s how you can keep it strong at your facility.

By Heather Johnson

Maintaining strong organizational culture is a challenge for hospitals even when we’re not dealing with a pandemic. One hospital may have multiple cultures: executives, nurses, physicians, and various departments and units may all have their own subcultures. Some of these subcultures overlap while others clash. Harmony among cultures is crucial to operational and clinical success.

According to a survey from Everything DiSC, a personal development e-learning company, 98% of business leaders surveyed said their organization’s culture greatly impacts its success. Almost all (99%) agreed organizational culture can be improved. 

In healthcare, organizational culture has even greater meaning: studies show that positive culture is associated with improved patient outcomes. In a qualitative study that evaluated high- and low-performing hospitals for heart attack mortality rate, organizational culture (not cardiac care), is what separated the top from the bottom. 

High-performing hospitals exhibited the following:

  • A shared vision of excellence.
  • Passionate physicians and empowered nurses and pharmacists.
  • Leaders who use objective data openly and consistently to recognize both poor and stellar performance.
  • Strong communication and coordination.
  • Staff who feel safe to take responsibility for adverse events and learn from those events.

Maintaining a strong organizational culture in hospitals with a flexible staffing model is challenging but not impossible. Here are three key tips:


nurses gathering over clipboard

Clearly articulate your organizational culture during orientation. Describe your commitment to excellence, availability of senior management, communication style, and the organization’s vision and mission. CareRev streamlines the orientation process for its per-diem talent. We’ll work with you to make sure our professionals have access to your culture-related materials.

Openness to per diem help

nurses laughing and chatting

Help per-diem staff feel welcome. Because they only fill in on occasion, they can often feel like outsiders. Make sure your internal staff are trained to work with all team members equally. Help per diem staff settle in by giving them a warm welcome and letting them know you are available to answer questions. Better yet, have your team do it; ensuring effective integration with the per diem staff starts with your full time staff.


stressed nurse

Trust is essential to maintaining a strong organizational culture. Refusing to answer questions and ignoring staff concerns erodes trust. So does condescending language, overbearing management styles, me-first attitudes, and general incivility. All these things instill fear, anxiety, and resentment, which weakens culture and negatively impacts patient care. Per diem staff, in particular, are susceptible to this negativity.

So what can you do to address these challenges and to build a strong organizational culture with a large flexible staffing component? The Joint Commission Center for Transforming Healthcare suggests 3 actions healthcare leaders can take to maintain or regain trust:

  • Review your organization’s mission and values. Model those values and exhibit behaviors that instill trust.
  • Use every available medium—text, video, email, phone, huddles, rounding—to communicate with your team and instill a sense of purpose. During crisis situations (like the pandemic), schedule one-on-one conversations with clinicians. Listen, address concerns, and implement good ideas when feasible.
  • Provide support. Healthcare workers face enormous on-the-job stress. Make sure your team has resources available to help them manage stress, anxiety, and grief. In addition, celebrate accomplishments regularly. This builds confidence and helps your clinicians feel valued.

Some other tips for improving organizational culture include:

  • Make sure permanent and per-diem staff fit your organizational culture. You can get a sense of this during the interview process. For CareRev professionals, study profiles and, when they’re a good fit, mark someone as a Favorite.
  • Plan team-building events. Traditional laser tag days are hard to schedule in a busy healthcare environment; however, unit contests and similar events help build relationships and generate a positive workplace atmosphere.
  • Encourage professional development, leadership development, and education. Lifelong learning is essential for clinical and professional excellence. 

Creating, promoting, and maintaining organizational culture takes focused effort. The benefits to patient outcomes, employee retention, turnover, and engagement make culture creation time well spent.

Interested in making CareRev part of your team?

Chat with CareRev today