The Most Important Job You Have as a Leader

Warner L. Thomas, FACHE

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Leaders of most companies, including those in healthcare, devote a lot of time and energy to developing an organizational strategy—outlining where the organization is going, how to navigate challenges and seize opportunities, and defining what success looks like.

While a solid strategy is essential to business success, it’s not enough. If leaders don’t also invest their attention and resources into cultivating a thriving culture built on clarity, alignment and trust, even the most brilliant organizational strategy will falter. Culture is the backbone of any successful organization.

The Most Important Job You Have as a Leader

Culture Begins at the Top

Leaders must nurture and shape organizational culture as thoughtfully as they develop strategy. They also must create and nurture an inclusive culture that values diversity and fosters belonging so their organization can benefit from a wide variety of unique talents, perspectives and experience. Culture doesn’t just evolve, and it shouldn’t be left for employees to build themselves.

Setting culture begins at the top, and everyone has a role to play. First, it is critical to have an engaged, aligned board of directors that sets the tone at the highest level through its governance, and each time a major decision is made. And, most importantly, while the CEO and executive leadership team help drive culture across the organization, department and division leaders and managers must own it within their areas of responsibility. That is how culture takes hold and becomes the way things get done.

Clarity as the Cornerstone

To achieve that, effective leaders set a rhythm for their team. They establish clear goals and metrics, and make sure their people know the team’s priorities and focus areas. They set a meeting cadence that keeps the team informed and in sync. I recommend daily huddles, weekly team meetings, monthly operating reviews, quarterly strategy sessions and an annual team retreat. This kind of rhythm will ensure a team knows why, how and what.

Achieving clarity is the cornerstone, and it has four components:

  1. Seek clarity: Ask questions, speak up and read back to understand what’s expected.
  2. Create clarity: Within individual teams, in support of other teams and horizontally across the organization.
  3. Cascade clarity: Communicate transparently and with two-way dialogue, help translate, support and personalize requests and new information, and track, support and hold accountable on deliverables.
  4. Confirm clarity: Ask questions and pressure test to fully understand what, why, when and how.

Prioritizing People and Building Trust

The other two critical pieces here are being devoted to people and building trust with them. A leader demonstrates devotion when they support and prioritize their people’s growth and career development, express gratitude, model organizational values and lead with empathy. Trust within a team is built by gaining alignment and working together, continuous learning and making adjustments when needed, fostering candid dialogue, sharing ownership of success and giving people the tools and support they need.

A leader’s most important job is developing people—especially in healthcare, where individuals give so much of themselves to those they serve. It’s critically important to create an environment and structure where people feel valued, energized and safe to get outside their comfort zone in the pursuit of getting better. When individuals grow and improve, so does the organization.

A Foundation for the Future

That’s the culture we’re building at Sutter Health, and here are the steps we’ve taken since I became CEO a little over a year ago.

In 2023, our first year focused on improving organizational health at Sutter Health, we:

  • Established a shared purpose.
  • Created a clear strategic framework for short- and long-term goals.
  • Developed clear system priorities.
  • Aligned the whole system under a single incentive plan.
  • Built a unified and integrated organizational structure.
  • Developed deeper connections with medical groups and physician partners.
  • Shifted organizational mindset to focus on growth and new opportunities.

We focused initially on creating a unified infrastructure that advances clarity and trust in support of our culture. This year, we’re building upon that solid foundation in even deeper ways with an evolution of Sutter Health’s culture that includes:

  • A refreshed organizational mission, vision and values.
  • Established systemwide leadership commitments and expectations.
  • Expanded training programs and leadership development to support career advancement.
  • A new system operating calendar with consistent rhythm for communications, clarity and connection.
  • Further integration of diversity, equity and inclusion into our values and leadership commitments.

Our focus on culture is already yielding results. Employee, physician and clinician engagement scores have shown significant improvement, with engagement among medical group physicians up 31%. And turnover across the organization is down by 30%.

Good culture starts with clear intent—and that starts with focus and commitment from leaders. Commitment from your leaders happens when an organization makes developing them and building talent a key priority, which leads to a healthy culture. A healthy culture is not only the right thing to do for employees, but a competitive advantage that can enable an organization to adapt, transform and find new ways to succeed.


Warner Thomas

Warner Thomas, FACHE, is president/CEO of Sutter Health, a not-for-profit, people-centered healthcare system providing comprehensive care to approximately 3.4 million patients throughout California.