Insights from Research into Establishing a Culture of Employee Well-being

Employee Well-Being

In the social sciences, we often find the audiences for our applied research in the most obvious places, and then we look back and wonder how we ever missed such a clear connection. Such is the case regarding the recent interest by healthcare organizations in employee well-being and organizational culture. At first glance, it would appear that there is little for healthcare professionals to learn from the existing research on employee well-being, largely due to an increasing focus in the United States since the 1970’s on organizational research that provides insights into efficient improvements in financial outcomes. Increasing employee well-being was not at the top of the list of favored research topics during this time.

However, starting as early as the 1930’s and lasting past the end of WWII, such well known scientists as Kurt Lewin working at MIT and the faculty at the Tavistock Institute of Human Relations in London conducted research on employee well-being. In fact, the entire Human Relations movement was based on the premise of improving work conditions in order to increase the well-being of the workers. With the exception of Lewin’s work, most of the research in this area focused on the micro level of relationships between employee behaviors and psychological outcomes. The findings provide a plethora of information for providers to use in designing behavioral interventions intended to improve the well-being of individual employees; however, it offers little to help bring change at an organizational level.

Organizational Culture

Organizational culture is as macro of a research topic as employee well-being is micro. Nonetheless, sustained well-being of employees requires understanding and changing this powerful, yet elusive phenomenon. We know that organizational culture exists, changes, and impacts the success of employees, leaders and organizations; but how is it reliably measured, altered and evaluated? One of my graduate students proposed to conduct her dissertation research on changing the culture of a hospital. As she and I considered the most appropriate design for her project, we found that much of the existing research failed to reveal any results of interest because it missed one or more of the three levels in an organization that must be included in studying the culture:

  1. Employee
  2. Leadership
  3. Organization

The employees are the only level at which data can be gathered on the culture of an organization; this is the level that includes all of the people. Leadership and organization are concepts; not human entities; therefore, we can stand in front of a hospital building and ask it questions about the culture as loudly as we want and it never responds. Likewise, we can ask the mission and strategic plan documents provided by organizational leadership about the culture, but no answers will be forthcoming. People respond, not organizations or concepts. To measure, modify and evaluate culture change, we focus on the employee level.

Employees and Culture

To establish and sustain a corporate culture, the “employees make the place.” The key to successful and sustainable change at this level is to use valid and fair measures of personal characteristics that are tied to the target outcomes; such as employee well-being. As an example, in a study of 213 Nurse Practitioners, the 25% with high fit to their jobs according to their personality, ability and performance data were 40% more likely than their peers to use wellness programs, improve on measures of employee well-being, promote the programs to their peers and sustain their improvements in wellness over a five year period.

In another example, 114 physicians who were at least five years into their careers; rated on average as “effective” by patients, colleagues, and staff; and had high fit to their jobs based on a personality profile of low neuroticism, high conscientiousness, high extraversion and high openness to experience; were five times as likely as their 154 lower performing, low job fit colleagues to use, promote and financially support employee well-being programs.

The outcomes of the programs we studied in these two examples were not only sustained, but increased over time due to the pervasive nature of the overall change in organizational culture and resulting changes in leadership approaches, values, and strategies.

Parting Thoughts

The keys to establishing and sustaining an organizational culture of employee well-being are starting with predictive models that make sense to the organization; implementing behavioral measures for employees that are fair, valid and aligned to the model; and using your employee metrics to track and evaluate target outcomes. Using these tools, build organizational capacity by placing a priority on these actions:

  1. Identify and develop organizational leaders who have good fit to building and leading a culture of employee well-being.
  2. Select, place and promote employees who have good fit to working within and promoting cultural change.
  3. Direct existing employee performance to support and sustain the culture.
  4. Evaluate, monitor and continuously improve culture at the organization level.


About the Author: Dr. Scott Davies is the founder and CEO of PointLeader, Inc., a successful talent management research and assessment development firm focused on improving target outcomes for organizations and their members. He received his PhD in I/O psychology from The Ohio State University and is well known for his work as an applied research scientist and assessment validation expert. Scott is currently working with healthcare organizations to reduce risks and increase value associated with employment selection decisions. You can contact Scott via email at and follow his personal blog at