Enabling Joy and Meaning – Contributing to Safety and Quality

There is another element of leadership that relates very poignantly to the concept of authenticity I raised in the January commentary.1
This is the relationship between hospital culture and the workforce experiencing joy and meaning in what they do. Everyone wants to experience joy, meaning and professional satisfaction. Commitment to a healthcare profession is particularly driven by this as it is both an honor and privilege to care for others. Frankly, if I did not experience a sense of joy and meaning in my work, I could never have remained engaged in clinical medicine for so many years. The responsibilities of clinicians are great, the workload is often demanding and stressful, and the impact on family life can be substantial. Joy and meaning is the payback that really counts, knowing that one’s efforts as a clinician have made a difference in improving someone’s well being.
The responsibility for developing and sustaining a hospital culture that nurtures joy and meaning resides with leadership. Where leadership is lacking, things can go wrong very quickly. Sadly, morale amongst healthcare professionals is at a low point, with many retiring early or leaving the profession for other opportunities. Though there are many reasons for this, the fact is that experiencing a lack of joy and meaning is a major contributor to this trend. If healthcare workers are unhappy, feel disregarded, undervalued, powerless and/or when bullying and unprofessional behavior is tolerated, then the stage for error and harm, both for patients and staff.2
Case Study:
A highly respected nurse omitted a dose of antibiotics for patient recovering from pneumonia. When she realized this she alerted the medical house officer that the dose had been omitted, apologized for this oversight, and explained that task saturation had affected her judgment and attention to detail. The patient was actually in the recovering phase of treatment, so the likely outcome of the missed dose was inconsequential.
Unfortunately, the house officer, who had a reputation for intolerance and condescension to nursing staff, openly chastised the nurse, calling her, “a fool and a disgrace to your profession.” This house officer had verbally abused the same nurse in the past, although she was a highly regarded professional held in great esteem by other nurses and doctors.
Though the house officer had been previously counseled, his behavior towards this nurse and others had continued to be abusive and no meaningful intervention was applied.
The nurse wanted to tell the patient about the missed dose but the resident ordered her not to do so. Still, the nurse felt badly about what had happened, shared this information with the patient and apologized. The patient suffered no ill effects from the missed dose and was discharged 48 hours later. She thanked the nurse profusely for her care and her honesty.
His advice was to “buck up, get smart, not be so sloppy next time.” The nurse became more despondent and anxious, finally sharing her concerns with the chief nurse of the hospital, who advised her to, “Straighten up and laugh it off.”
The nurse subsequently resigned.
The leadership of this hospital failed miserably in its efforts to create and sustain a culture that was supportive of staff, one that encouraged joy and meaning. The culture of the hospital did not encompass the concepts of respect, collegiality and teamwork. The behavior of the house officer was outrageous and he should have been appropriately disciplined. Furthermore, the senior physician and nursing leadership contributed to the dysfunctional attitude, resulting in further suffering of a respected professional.
When the culture of the hospital does not specifically address deficiencies that may degrade joy and meaning, then aberrant behavior, especially bullying by professionals and condescension by management, becomes pervasive. This deviant behavior becomes normalized feeding complacency and tolerance of such behavior in the workplace.
Improving healthcare and patient safety is all about professionals working together collaboratively to provide patients with the best care. Things will certainly go wrong from time to time, but there is never an excuse for bullying and unprofessional behavior. We all have an obligation to recognize the risks of unprofessionalism and the degrading impact this has on joy and meaning. Specific mechanisms must be put in place to counter this behavior when it occurs.
We can and must do much better!
  • 1. Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. Cambridge, MA: Institute for Healthcare Improvement; 2013. (available at
  • 2. Through the Eyes of the Workforce – Creating Joy, Meaning, and Safer Health Care. Boston, MA: Lucian Leape Institute and the National Patient Safety Foundation; 2013. (available at


Leave a Comment

Terms of use

Welcome to our website. If you continue to browse and use this website, you are agreeing to comply with and be bound by the following terms and conditions of use, which together with our privacy policy govern Health Matrix’s relationship with you in relation to this website. If you disagree with any part of these terms and conditions, please do not use our website.
The term Health Matrix or ‘us’ or ‘we’ refers to the owner of the website whose registered office is Al Taown Business Center, Office 17, Riyadh, Saudi Arabia. The term ‘you’ refers to the user or viewer of our website.
The use of this website is subject to the following terms of use:

• The content of the pages of this website is for your general information and use only. It is subject to change without notice.
• This website uses cookies to monitor browsing preferences. If you do allow cookies to be used, the following personal information may be stored by us for use by third parties.
•  Neither we nor any third parties provide any warranty or guarantee as to the accuracy, timeliness, performance, completeness or suitability of the information and materials found or offered on this website for any particular purpose. You acknowledge that such information and materials may contain inaccuracies or errors and we expressly exclude liability for any such inaccuracies or errors to the fullest extent permitted by law.
•  Your use of any information or materials on this website is entirely at your own risk, for which we shall not be liable. It shall be your own responsibility to ensure that any products, services or information available through this website meet your specific requirements.
•  This website contains material which is owned by or licensed to us. This material includes, but is not limited to, the design, layout, look, appearance and graphics. Reproduction is prohibited other than in accordance with the copyright notice, which forms part of these terms and conditions.
•  All trademarks reproduced in this website, which are not the property of, or licensed to the operator, are acknowledged on the website.
• Unauthorized use of this website may give rise to a claim for damages and/or be a criminal offence.
•   From time to time, this website may also include links to other websites. These links are provided for your convenience to provide further information. They do not signify that we endorse the website(s). We have no responsibility for the content of the linked website(s).
•   Your use of this website and any dispute arising out of such use of the website is subject to the laws of Saudi Arabia.

Privacy Policy 
Your privacy is important to us. This privacy policy is intended to give you confidence in the privacy and security of the personal information we obtain from you whether you are using Health Matrix products, uploading information to Health Matrix and our products’ websites (the “Websites”), downloading our applications, or are merely visiting our Website. 
However, please note that we are not responsible for any use of your personal information you provide to third-party applications or websites that may be accessed via the Products or Websites. We recommend that you review the privacy policy of any third-party applications or websites that you use. 
When you use our Products or Websites, you may be asked for personally identifiable information such as your name, address, date of birth, email address, telephone number. 
By giving us such information, you will need to consent to our using it in the manner described in this policy. 
You may withdraw your consent at any time by emailing us at We will return or destroy your personal information within five days of receipt of your withdrawal of consent. 
Cookie information, pages you have requested and your IP address may also be recorded by us and/or third parties from your browser as set out in this policy. 
Health Matrix will use performance data, including performance statistics, bug fixes and other similar data (“Performance Data”) uploaded to our Websites or acquired through our Products. Health Matrix may use such Performance Data in any way, including, but not limited to, using, editing, altering, reproducing, publishing and/or distributing the Performance Data for any purpose, commercial or otherwise, provided that such Performance Data is stripped of all personally identifiable information. 
We use personal information to allow us to process your service requests, provide access to privileged areas of the Websites, send out newsletters, personalize your visit to our Websites, personalize your use of our Products, and enable us to improve the products and services we offer. We may occasionally carry out market research and send you details of services and offers that we think may be of interest to you. If you do not wish to receive such information, please e-mail or, alternatively, when we send you an e-mail, it will contain a provision for you to opt out of receiving any further information from us. 
We may provide information about you to our employees and agents in order to administer any accounts, products and services provided to you by Health Matrix. 
We will not disclose your personal information to any third party unless you have consented to such disclosure or where we are required to do so by law. Should you breach our terms and conditions or terms of use or if we are under a duty to disclose or share your personal data in order to comply with any legal obligation, we may disclose your information to a relevant authority. This may include exchanging information with other companies and organizations for the purposes of fraud protection and credit risk reduction. Any disclosure of personal information will be strictly controlled and made fully in accordance with current Saudi Arabia law. 
Cookies are small data files that a website you visit may save on your computer or handheld device that usually includes an anonymous unique identifier. Our Websites and those of our Products may use cookies for user authentication, keeping track of your preferences, promotional campaigns, tracking our audience size and traffic patterns, and in certain other cases. We may include small graphic images in our email messages and newsletters to determine whether the messages were opened and the links were viewed. 
Third-party advertisers may also create and access cookies, which will be subject to their privacy policies – we accept no responsibility or liability for the use of such third parties’ cookies. If you do not wish cookies to be placed on your PC or handheld device, then they can be disabled in your web browser. The option to do so is normally found in your browser’s “security settings” section. Please note that permanently disabling cookies in your browser may hinder your use of our Websites as well as other websites and interactive services. 
All security on our Websites is treated seriously. Where applicable, we undertake security steps, including use of SSL technology, on our back-end systems that store customer account information and to protect data transmissions. However, this is not a guarantee that such data transmissions cannot be accessed, altered or deleted due to firewall or other security software failures. 
If you have any further concerns about security, please email our Customer Service team at
Changes in this policy will be posted on our Websites. You are advised to check our Websites regularly to view our most recent privacy policy. 

If there are any questions regarding the private policy, you may contact us using the information below 

Powered by:HM Dev

Request a Demo

Social Media

Share this page
Follow us

Subscription Center

Service Management Portal