Karnieli-Miller, OritTaylor, Amanda C.Inui, Thomas S.Ivy, Steven S.Frankel, Richard M.2025-05-052025-05-052011-10-31Karnieli-Miller O, Taylor AC, Inui TS, Ivy SS, Frankel RM. Understanding Values in a Large Health Care Organization through Work-Life Narratives of High-Performing Employees. Rambam Maimonides Med J. 2011;2(4):e0062. Published 2011 Oct 31. doi:10.5041/RMMJ.10062https://hdl.handle.net/1805/47686OBJECTIVE: To understand high-performing frontline employees' values as reflected in their narratives of day-to-day interactions in a large health care organization. METHODS: A total of 150 employees representing various roles within the organization were interviewed and asked to share work-life narratives (WLNs) about value-affirming situations (i.e. situations in which they believed their actions to be fully aligned with their values) and value-challenging situations (i.e. when their actions or the actions of others were not consistent with their values), using methods based on appreciative inquiry. RESULTS: The analysis revealed 10 broad values. Most of the value-affirming WLNs were about the story-teller and team providing care for the patient/family. Half of the value-challenging WLNs were about the story-teller or a patient and barriers created by the organization, supervisor, or physician. Almost half of these focused on "treating others with disrespect/respect". Only 15% of the value-challenging WLNs contained a resolution reached by the participants, often leaving them describing unresolved and frequently negative feelings. CONCLUSIONS: Appreciative inquiry and thematic analysis methods were found to be an effective tool for understanding the important and sometimes competing role personal and institutional values play in day-to-day work. There is remarkable potential in using WLNs as a way to surface and reinforce shared values and, perhaps more importantly, respectfully to identify and discuss conflicting personal and professional values.en-USAttribution 4.0 InternationalValuesWork-life narrativesAppreciative inquiryNarrativesArticle