The Ethos Multiplier: Measuring What Matters Most in Health Care
- 3 days ago
- 3 min read
“You can’t manage what you don’t measure.” Health care systems have taken this principle to heart, tracking burnout, staffing shortages, turnover and administrative burden across both clinical and nonclinical roles. A 2023 JAMA Health Forum study of 15,738 nurses and 5312 physicians confirmed what many leaders already suspect: burnout is widespread and deeply consequential, contributing to turnover and patient safety risks. Yet what stands out is not just the problem, but the solutions clinicians themselves prioritize. While resilience training and wellness programs are common, clinicians consistently point to more fundamental drivers: staffing adequacy, manageable workloads and healthy work environments.¹ But what are we not measuring that may be shaping all of these outcomes?
Accordant's ethos: Awakening Virtues in Health Care approach focuses on developing, teaching and implementing evidence-based practices to enhance well-being initiatives. These initiatives aim to empower individuals, strengthen medical teams and positively impact health care organizations and the communities they serve.
Introducing Ethos as a Multiplier
We propose that one of the most powerful, and overlooked, drivers is ethos. Ethos reflects the moral character, values and guiding principles of an individual or organization.
Yet unlike burnout or turnover, ethos is rarely defined, measured or intentionally aligned across the organization—from the foundation board and senior leadership team to individual departments. Ethos ensures there is consistency between what an organization says it values and how people experience those values every day. Ethos is reflected in:
Who gets promoted
Who feels safe to speak up
How mistakes are handled
Whether recognition feels meaningful or performative
Whether trust grows or erodes overtime
In many ways, ethos influences the very conditions that drive engagement, retention and performance. When it is measured and aligned, it becomes a multiplier for culture, leadership and organizational effectiveness.
Connecting Ethos to Outcomes
In 2025, the American College of Healthcare Executives (ACHE) Board of Governors approved and issued Creating an Ethical Culture Within the Healthcare Organization, emphasizing that executives, in partnership with governing bodies, clinical staff and ethics committees have a responsibility to model and foster an ethical culture throughout the entire organization.²
In other words, leaders must do more than ensure high-quality, value-driven care. They must actively cultivate environments that promote ethical behavior, accountability and trust at every level.
Further, research suggests that ethical and fair organizational climates strengthen trust, professional commitment and long-term retention. Conversely, perceptions of injustice, lack of recognition and moral distress are associated with greater dissatisfaction and intent to leave the profession.³
If burnout, turnover and workforce instability are outcomes that organizations seek to improve, ethos may be one of the most important upstream drivers to understand and intentionally shape.
Introducing Gratitude as Operational Ethos
This is where gratitude becomes more than a practice it becomes a strategic lever. When embedded into an organization’s ethos, gratitude helps translate values into daily behaviors and cultural norms.
As an operational expression of ethos, gratitude:
Reinforces ethical behavior through authentic recognition
Strengthens relationships, trust and psychological safety
Encourages transparency and accountability, even in moments of error
Amplifies what is working without ignoring what needs repair
Gratitude, ethics and ethos are not separate initiatives. Together, they reinforce a framework that shapes culture, influences behavior and strengthens organizational performance.
Next Steps for Executive Engagement
Convene your senior leadership team and board to define the ethos you intend to lead and the specific behaviors that will bring it to life.
Be open and transparent about what your organization is measuring, what it may be unintentionally ignoring and how aligned your leaders are in their definition of ethos.
The future of health care leadership will not be defined solely by what we measure. It will be defined by whether we are measuring and intentionally shaping what matters.
¹ doi:10.1001/jamahealthforum.2023.1809
About the Author: Linda Roszak Burton BS, BBC, ACC, is a Principal Consultant, an ICF certified executive coach and a National Board Certified Health and Well-being Coach (NBC-HWC) with Accordant. She is the author of Gratitude Heals: A Journal for Inspiration and Guidance. Her TEDx Talk on the Power of Gratitude was released in 2022. You can reach her at Linda@AccordantHealth.com for information on her well-being coaching programs or connect with her through LinkedIn.
*NBC-HWC Linda maintains an active, nationally recognized credential, follows the NBC-HWC Code of Ethics and is HIPAA compliant.
Comments