relational culture header
Marcie Hopkins, University of Utah Health
Not Sure How to Build Relational Culture at Work? Start with Signaling
Relational culture—when everyone on a team feels seen, heard, and valued for who they are—is a cornerstone of high-functioning teams. Kyle Turner shares the benefits of having a relational culture and how to apply the concept to health care.

This article is the first in a series of learning resources developed by Accelerate and
Intend Health Strategies to establish a shared language and focus on Relational Leadership practices for U of U Health leaders and teams.

The work of Intend Health Strategies is grounded in Relational Leadership (RL), a human-centric approach that cultivates authentic human connection and awareness to increase belonging, collaboration, equity, and impact across health systems – the foundation for better care and the catalyst for meaningful and sustainable change.


ealth care is a complex environment, where teams come together and disband—sometimes several times a day—all in the service of providing the best possible care to our patients.  

Working as a high-functioning team takes a purposeful effort, a series of intentional actions and shared ideas that improve our ability to work together. This process, called teaming, helps us create a positive culture for work that benefits not only ourselves as employees, but our patients. 

When you are thinking about teaming, you have to think about the outcome of our work such as the number of patients treated, the disease improvement or meeting clinical and quality goals. Just as importantly, you also have to think about the process that gets to those outcomes. If the process is difficult or miserable, it can be harmful to our teams. We may accomplish the goal but lose our people in the process.  

As we work toward a relational culture, one in which everyone feels seen, heard and valued for who they are, our goal has to be more than just the best outcomes, it has to be the best possible process to get to that outcome.

Teams with a relational culture excel in four critical areas – belonging, authenticity, integration and growth with the focus on the people at the heart of the care we provide.  

The Benefits and Application of Relational Culture in Healthcare 

As a healthcare team, we have to create a sense of belonging – the feeling that team members can show up from a wide array of backgrounds and training and be accepted and appreciated for their contribution. Teams also need to have a high level of authenticity, especially from leaders who create transparency, delegate effectively and allow team members to use their individual agency for the collective good.  

Within our healthcare system, we are very interdependent on each other. We cannot deliver good outcomes without working with other people and departments. For instance, if a patient in the ICU needs medication, we have to send that order to the pharmacy, and they must get it back to us. We rely on each other, and we must reflect on the impact we have with other members of our team and consider actions that will ensure that our impact is positive and moving the team towards our goals Finally, our team must be open to growth, innovation and constant learning. Health care evolves and changes quickly and our best teams are able to learn and adapt.  

Working through it – a place to start 

When considering a relational culture and the many steps it will take for a team to reach their potential, leaders and team members may feel overwhelmed. One way to begin is to pay attention to signaling. As social creatures, we are hardwired to pay attention to signals we get from other people. If we are sending signals, such as sighing when someone asks a question, we are sending signals that you shouldn’t speak up. If we look uncomfortable during criticism, we are sending the signal we don’t want to hear it. 

By paying better attention to the signals, we are sending (and those we are receiving from other team members), we can begin to create a relational culture and enhance psychological safety in a more efficient way. Considering our signals and those of others provides a space where we can recognize our own tendency and intentionally choose to act differently. As those signals begin to accumulate, others are invites to do the same and the basis for a culture change takes shape This is something we can work on as individuals, especially if we are in leadership positions, that can have a large impact on our ability to team. 

When we start small, with our signals within our own teams or units, we have the power to influence the larger hospital culture. As we continue to rely on one another, we can create stronger teams that give everyone a voice and a sense of belonging. 


Kyle Turner

PharmD, Assistant Professor, Pharmacy, University of Utah Health

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