At ISQua, we are constantly inspired by thought leaders who challenge us to think differently about quality and safety in healthcare. Today, we are pleased to share insights from Mike Domitrz, Hall-of-Fame speaker and founder of The Center for Respect, who highlights a foundational yet often overlooked element in healthcare systems: respect.
Respect: The Unseen Engine of Healthcare Quality
By Mike Domitrz
Walk into any hospital or clinic and you’ll see the same values displayed on mission statements and posters: Quality. Safety. Compassion. But there’s a deeper current, often unspoken, that determines whether those ideals truly take root: respect.
Too often, respect is labeled a “soft skill,” sitting quietly behind protocols, technologies, and compliance measures. Yet in working with leaders across the U.S. military and education, one truth has become unmistakable: Without a culture of respect, systems collapse, even when intentions are high.
When respect is missing, psychological safety erodes. And without psychological safety, communication breaks down. Staff hesitate to raise concerns, challenge a decision, or ask for help, not because they don’t care, but because they don’t feel safe. That silence isn’t neutral; it’s dangerous.
We’ve seen the consequences in sentinel events, errors that trace back to a moment when someone didn’t speak up. Often, they wanted to. But they didn’t believe their voice would be heard or welcomed.
So what if respect wasn’t just an aspiration, but a strategic priority?
That shift would look like:
- Leaders actively ask, “Who here might feel invisible, and why?”
- Open-door policies that don’t just invite feedback, but reward it
- Daily modeling of vulnerability and humility, especially by those in charge
- Training all staff, not just leaders, to set boundaries and give feedback with clarity and care
Respect isn’t about being “nice.” It’s about setting a foundation where safety, innovation, and collaboration are possible. Teams that feel respected show lower burnout, higher engagement, and fewer preventable errors. Patients notice, too. Research links respectful environments to stronger trust, better treatment adherence, and improved outcomes.
This doesn’t happen by default. It takes consistent, intentional practice:
- Managers acknowledging when they’re wrong
- Teams holding space for hard conversations without retribution
- A workplace where speaking up isn’t brave, it’s normal
At its core, healthcare is human. And when we treat each other with dignity, not just during crises, but in every interaction, we create systems where excellence becomes the norm, not the exception.
So, as you plan your next initiative to improve care delivery, retention, or patient experience, ask the tough question: Is respect embedded in this effort? If it isn’t, you may be missing the most essential catalyst of all.
