Understanding Values in a Large Health Care Organization through Work-Life Narratives of High-Performing Employees

Abstract

Objective—To understand high-performing frontline employees’ values as reflected in their narratives of day-to-day interactions in a large health care organization.Methods—A total of 150 employees representing various roles within the organization were interviewed and asked to share work-life narratives (WLNs) about value-affirming situations (i.e. situations in which they believed their actions to be fully aligned with their values) and value-challenging situations (i.e. when their actions or the actions of others were not consistent with their values), using methods based on appreciative inquiry.Results—The analysis revealed 10 broad values. Most of the value-affirming WLNs were about the story-teller and team providing care for the patient/family. Half of the value-challenging WLNs were about the story-teller or a patient and barriers created by the organization, supervisor, or physician. Almost half of these focused on “treating others with disrespect/respect”. Only 15% of the value-challenging WLNs contained a resolution reached by the participants, often leaving them describing unresolved and frequently negative feelings.Conclusions—Appreciative inquiry and thematic analysis methods were found to be an effective tool for understanding the important and sometimes competing role personal and institutional values play in day-to-day work. There is remarkable potential in using WLNs as a way to surface and reinforce shared values and, perhaps more importantly, respectfully to identify and discuss conflicting personal and professional values.

Nurses’ professional values and attitudes toward collaboration with physicians

“…17,21,23,24 Exceeding service expectations was a characteristic of high-performing frontline employees in a large healthcare organization in a qualitative study. 25 The American Nurses Association (ANA) Code of Ethics and its provisions for patient-centeredness were considered important by practicing nurses as well as nursing students in other descriptive studies in the United States. 26,27…”

Medical students' experiences and needs from written reflective journal feedback

“…This process was repeated several times until saturation and consensus were reached. 84‐86 . Later, we analysed the interviews using the same process with the focus of understanding students' experiences, feelings and thoughts about receiving feedback, in general, and about the specific components identified.…”

From Patient to Therapatient

“…We used the immersion/crystallization narrative analysis method to hear and understand the students’ personal stories and experiences during their studies (Crabtree & Miller, 1992; Karnieli-Miller, Taylor, Inui, Ivy, & Frankel, 2011). This allows the presentation of students’ perspectives regarding their feelings, thoughts, and experiences concerning their social work studies (Clandinin, 2006; Clandinin & Huber, 2010).…”