In every era of healthcare, leaders have been taught to think first about strategy — the ability to map the future, anticipate challenges, set priorities and deploy resources with discipline. Strategy matters. But the longer I lead, the clearer one truth becomes: even the strongest strategy will fall short without a healthy culture that embraces change and adopts the strategy.
Culture isn’t the soft stuff. It’s the system of behaviors, expectations and beliefs that determine how teams collaborate, solve problems, respond when the unexpected happens, and care for one another — and for the patients who rely on us.
At Sutter Health, we’ve formalized this belief through what we call The Sutter Way — a shared understanding that culture is not what we say, but what we consistently do: how we lead, how we show up for patients and for one another, how we uphold accountability, how we create an operating rhythm to drive speed and alignment, how we communicate and how we reinforce expectations. It’s reflected in the daily behaviors we expect of leaders and in the practices we’ve built across a large, complex system to sustain alignment and momentum and achieve measurable progress in recruitment, retention, access and quality.
A Purpose-Driven Culture Starts With People, Not Plans
When I arrived at Sutter in 2022, I spent my first months listening — to community leaders and payers and to our nurses, physicians, frontline teams, leaders and staff across our hospitals, clinics and medical groups. I heard deep commitment to community, pride in our mission, and a desire for clearer alignment and connection.
However, like many health systems emerging from the pandemic, our workforce was fatigued. Fragmentation — operational, cultural and geographic — made it harder to move quickly.
The work ahead wasn’t about repair. It was about unlocking potential.
One of the early commitments we made was to increase transparency at scale. Through regular virtual town halls — where we intentionally opened the chat and held live Q&A — we surface difficult questions rather than avoid them. Admitting mistakes, being candid and honest and addressing the hard topics openly builds trust and reinforces that leadership is willing to listen and engage directly.
We purposely centered our culture on a simple goal: to be the best place to work and build your career, and the best place to give and receive care.
That aspiration comes to life through intentional forums like our ONE Sutter Power of One (PO1) gatherings, where thousands of leaders and team members from across our footprint come together to reconnect around purpose, celebrate progress and align on priorities. More than 25,000 teammates have participated across these events, where every conversation, every cheer, every moment of connection reminds us why we do this work. The vibe is unmistakable: optimism, momentum, and the collective pride of a team committed to making a difference every single day.
This is where leadership matters most. Culture improves not because a CEO says it should, but because leaders at every level, every day, model trust and shared purpose — and believe!
Trust & Alignment: The Foundations of Execution
The toughest barriers to executing on a solid strategy are rarely technical — they are cultural: lack of trust, unclear ownership, competing priorities and insufficient communication.
When leaders model transparency, establish clear expectations and create space for candid dialogue, teams build trust. When leaders align teams to a shared purpose and show how each role contributes to that purpose, execution accelerates. People understand not just what they’re working on, but why it matters. They feel responsible for outcomes, not just tasks. And they move as one team, not a collection of independent units.
A critical part of this is establishing a leadership rhythm. At Sutter, we start the year with our annual Management Team Kickoff (MTKO) and follow it up with a cadence of leadership meetings throughout the year. Strategy is translated into clear expectations, progress is reviewed transparently, and leaders recommit to shared values and behaviors. That approach is pulled through each layer of our organization through quarterly strategy sessions, weekly team meetings, daily huddles and an operating rhythm that is needed to build clarity, consistency and connection and help teams move together rather than in parallel.
When Culture Strengthens, Performance Follows
Over the past two years, as alignment and engagement have strengthened across Sutter, we’ve seen meaningful improvements in workforce stability, team performance and organizational health.
Better than eight out of 10 of our employees recommend Sutter as a great place to work, with overall turnover down to 9.8% and nursing turnover at 8.4%, well below national benchmarks. We’re continuing to invest in inclusion, belonging and leadership development while expanding access to care statewide. We’ve also earned national recognition from Becker’s, Forbes, Fast Company, Newsweek and U.S. News & World Report for our culture, innovation and commitment to our people.
We’ve also deepened our partnership with our medical groups. Over just the last two years, physician turnover has declined from 4.5% to 3.3%, and we’ve recruited nearly 2,200 physicians and advanced practice clinicians. That stability reflects more than recruiting success — it reflects a culture of alignment, respect and optimism about where we are headed.
These results didn’t come from one initiative. They came from sustained, visible leadership behaviors, including initiatives like leadership “Grati-tours,” where we travel to teams at different locations across the system to listen, learn and express gratitude in person.
We also reinforce this through sustained investment in leadership development to build the next generation of leaders. Robust formal training, mentoring and clear behavioral expectations prepare current and emerging leaders to build trust, create clarity and lead with optimism to communicate direction clearly, acknowledge challenges honestly and reinforce belief in our collective ability to improve.
Culture Builds Momentum and Resilience
Healthcare is facing a multitude of pressures: aging populations, rising acuity, persistent workforce shortages, shifting reimbursement models and the rapid integration of AI. These forces make culture more — not less — critical.
At Sutter, a strong culture has enabled:
- Strengthened recruitment and retention, reflected in improving workforce stability
- Improved quality and safety
- Better patient experience through more connected, compassionate teams
- Greater readiness to adopt new capabilities, because teams trust leadership and feel – safe testing new approaches
- Stronger performance, because aligned teams execute with discipline
If the system is healthy, strategy is executable. To execute well is essential — but to adapt, improve and lead through constant change, organizations must also build curiosity into their culture as it’s one of the most powerful forces in healthcare. Strategy tells us where we’re going, and alignment helps us move in that direction. But curiosity is what propels us forward.
What Healthcare Needs Now
At Sutter, we’ve learned that culture is sustained through discipline — through practices, transparency, leadership development and visible presence. Many organizations talk about culture. Fewer reinforce it consistently over time. That consistency is the difference.
Healthcare is, and will always be, about people. When we invest in them — and in a culture that supports them — everything else becomes possible.
