Safety, social capital, and the courage to lead: Reflections from HX26

By Thomas H. Lee, MD, Chief Medical Officer, Press Ganey.

In February, Press Ganey held HX26—our annual Human Experience conference. More than 3,000 healthcare leaders from around the world convened in Orlando to exchange ideas, challenge assumptions, and advance the industry. In scheduled sessions and interactive workshops, informal conversations and sideline discussions, they shared practical strategies, forged new partnerships, and learned from one another’s successes and setbacks.

The insights shared were in no way theoretical. They were grounded in data, in lived experience, and in the hard-earned lessons of organizations navigating extraordinary complexity. And, as I continue to reflect on the sessions, six ideas, in particular, rise to the surface.

1. ‘Safety first’ is more than a slogan or program

Safety is not some initiative to be layered on top of operational priorities. It must be the very foundation of our work in healthcare, from which all performance rests. When safety culture is strong, patient experience gets better. Workforce engagement rises. Outcomes improve. Trust blossoms.

The data is encouraging. Across every domain, safety culture is trending in a positive direction—a hopeful sign in an otherwise turbulent environment.

Yet the work remains urgent. Psychological safety—the belief that one can speak up without fear of humiliation or retribution—is the bedrock of high reliability. When people feel safe, they identify risks sooner. They challenge assumptions. They’re better able to prevent harm before it occurs. Safety, in this sense, is not just about avoiding adverse events; it is about enabling candor, learning, and continuous improvement.

“If you don’t feel safe, nothing else matters.”

2. Social capital is the accelerant of healthcare transformation

Healthcare transformation rarely fails for lack of strategy. It falters when organizations underestimate the role of social capital in turning that strategy into sustained action.

Trust. Mutual respect. Teamwork. Psychological safety. A sense of belonging. These are often dismissed as “soft” cultural attributes. In reality, they constitute the hard, though invisible, infrastructure of healthcare.

When clinicians and staff feel safe to share incomplete ideas, question prevailing norms, and admit uncertainty, organizations adapt more quickly and perform more reliably. Social capital accelerates improvement because it reduces friction. It allows teams to move from intention to execution without the drag of distrust or misalignment.

Importantly, the patient sits at the center of that social capital. Shared purpose—anchored in the needs of those we serve—binds teams together and reinforces why trust and connection matter in the first place.

The organizations making the greatest gains today are not simply deploying new tools, trying out new technologies, or redesigning processes. They are investing in relationships that make meaningful change possible.

“When you take care of the team, patients will thrive.”

3. Kindness is essential and measurable

Kindness is often misunderstood as being “nice.” In reality, it reflects a set of intentional, observable behaviors that convey dignity, respect, and humanity, gratitude and love.

In high-performing systems, kindness isn’t left to chance. It is both intentional and measured. It is embedded in leadership competencies. It is modeled by executives, and reinforced at every level.

I am not merely speaking of kindness toward those in our care; I am speaking of the moral architecture of our organizations. We must make kindness the operating standard of how we lead, collaborate, and hold one another accountable. The reason is straightforward: If clinicians and staff do not experience kindness—from one another and from their leaders—they can not consistently deliver kindness to patients. Emotional contagion is real. Culture is transmitted in moments.

Kindness, then, becomes a system capability—no less important than clinical competence or technological sophistication.

“When we’re kind to each other as caregivers, we are more likely to be kind to our patients. It’s that little bit of ‘extra’ that patients are recognizing. It’s caregivers seeing a patient as a person in front of them. Not a problem to solve. Not a diagnosis. It’s not just being nice. It’s doing that little bit extra.”

4. Drift is the enemy of patient experience

Most often, healthcare struggles because sustaining behaviors is hard.

Drift—small, often unnoticed deviations from best practice—is one of the most underrecognized threats to patient experience and safety. Turnover, competing priorities, and cognitive overload make drift inevitable. The question is not whether drift occurs, but whether leaders detect it early and quickly correct course.

High-performing organizations share three capabilities:

1. A common language around key behaviors
2. Systems to monitor performance in real time
3. Coaching cultures that continuously reinforce expectations and excellence

They do not simply implement best practices; they actively and persistently “keep “best practicing.” They understand that reliability is dynamic. That it must be renewed every day. And that sustaining excellence requires both vigilance and humility.

“Failure isn’t final. You can make mistakes; you just can’t keep making the same ones.”

5. The future belongs to leaders who put people first

Across healthcare, a unifying insight continues to emerge: Teams come first.

Experience, quality, and outcomes improve when organizations take care of the people providing care. Empowerment, visibility, recognition, coaching, and leadership development are not optional. In today’s environment, they are the strategy.

Recognition, in particular, remains a powerful yet underused lever in healthcare, fueling employee engagement, psychological and emotional safety, and sustained excellence. When people feel seen and valued for both what they achieve and how they achieve it, they bring more discretionary effort, creativity, and compassion to their work. They extend that same sense of dignity and respect to patients and families.

This is the most reliable path to patient-centeredness.

“The patient doesn’t come first. The team comes first. When you take care of the people providing or enabling the care, patients will thrive.”

6. Technology in service of humanity

The next era of healthcare leadership is not about choosing between technology and humanity. It’s about using technology to enable that humanity. To strengthen trust, connection, and reliability at scale.

Artificial intelligence, advanced analytics, and so many other innovative digital tools can help us identify risk earlier, personalize care, and reduce administrative burden. But their ultimate value lies in strengthening trust, connection, and reliability.

Technology should make it easier to be present. Easier to listen. Easier to learn. Easier to lead. Easier to keep patients safe.

The leaders who will define this next chapter are those who align healthcare’s priorities—safety, experience, workforce, technology, and human kindness—and refuse to treat them as separate agendas. They will lead shoulder to shoulder with the people doing the work. They will measure what matters and flex with change. They will invest in social capital. And they will sustain excellence every day.

As adventurer and entrepreneur Debra Searle reminded us in her keynote: “We’ve all got our own oceans to cross. We’re all going to face massive waves at times. Waves of change. Waves of challenge. But we can learn to surf. It doesn’t matter if they don’t believe you’re going to make it. It matters if you believe you can make it.”

Healthcare is navigating waves of technological disruption, workforce strain, and rising consumer expectations. The question is not whether the waves will come. They will. The question is whether we have the resilience and confidence to ride them together.