Over the past 18 months, Durham, N.C.-based Duke University Health System has sought to improve its workplace culture through "Better Together," a workplace initiative or "movement" that aims to redefine how the health system engages with its employees, patients and the community.

Since implementing Better Together, Duke Health has seen higher productivity and less turnover. During the pandemic, Duke Health's nursing turnover rate reached approximately 25% with a higher rate of contract nurses delivering care. Now, the health system's nursing turnover rate hovers below 14%.

"Our overall turnover was close to 25% as well, and we're close now to about 16%," Rhonda Brandon, senior vice president and chief human resources officer for Duke Health, told Becker's. "We've seen, I believe, the results of the work that we have been intentionally focusing on."

To create Better Together, Duke invited thousands of its leaders and employees to participate in discussions and surveys around the current state of Duke Health's culture and what people wanted to see the culture become. The conversations and feedback led to three culture commitments that surround Better Together: putting people first, adapt to improve, and being clear and empowered.

Along with the culture commitments, Ms. Brandon said a sense of belonging was the ultimate goal of Better Together, with the health system also putting together around 10 employee resource groups called affinity groups.

"We have those across different identities, races, ethnicities, mothers, we have one for newer generational leaders, we have one for the disabled," Ms. Brandon said. "Where people can find a place of comfort, a place that's safe, a place that they can find their tribe and those that they're comfortable with. Allies can join as well."

When asked if Duke Health faced any challenges when implementing Better Together, Ms. Brandon said that it was met with healthy cynicism in the beginning and that one of the obstacles was to convince people that things needed to change.

"We needed to move from being arrogant to a place that is warm and welcoming to folks," she said. "One that people feel that they can come and continuously learn."

For other health systems looking to improve their culture, Ms. Brandon said that while it takes time and is hard work, it's important to not give up. While culture change can take three to five years to fully permeate an organization, it can also happen in an instant and leave a long lasting impression.

She also encouraged organizations to participate in culture pulses and surveys more frequently to grasp a stronger understanding of how people feel.

"You've got to lean into that," she said. "You're adapting to improve to make sure that the environment is one that you're absolutely most proud of."

Looking to the future of Better Together, Duke Health plans to put more systems, processes and policies into place to ensure it is holding people accountable. The health system also plans to ensure it is rewarding team members more effectively through total rewards programs when they are caught doing the right thing.

"Integrating our culture expectations across many HR programs and processes and practices is very critical, so that you can eventually have consistency, maintenance and sustainability over time."