International Hospital Federation (IHF): How Can Hospitals Build Trust and Better Teamwork?

Why does the IHF focus on teams as well as individual leaders?

In its 2026–2029 strategy, the International Hospital Federation (IHF) identifies developing healthcare leaders and their teams as a major goal. That distinction matters. A hospital’s working culture is shaped not only by what its chief executive does, but also by how a department head responds to a resident, how a nurse manager gives feedback and how the leaders of different units talk to one another. Publishing a set of values does not make people live by them. Employees learn what those values mean from everyday decisions and conversations. The IHF strategy sets priorities for the federation; it is not a mandatory instruction to individual hospitals. Still, it points towards a useful principle: interpersonal skills need to be developed where people actually work together, make decisions and handle disagreement. Training senior executives alone leaves many of those moments unsupported.

A manager’s reaction becomes an unwritten team rule

People quickly learn what can safely be said at work by watching how their manager responds. When a team leader thanks someone for raising a problem, asks questions and returns with an answer, staff see that speaking up has a purpose. When the response is irritation or public embarrassment, statements about openness lose their credibility. The IHF competency model emphasises listening, supporting colleagues and transparent decision-making. Research by Nembhard and Edmondson in neonatal intensive care units also points to links between leadership behaviours, professional hierarchy and psychological safety. This does not mean one well-phrased question will eliminate the risk of error. It helps explain why the response from the person in charge matters so much. A team’s culture becomes visible during handovers, in briefings and when someone has difficult news to share.

Listening to staff does not mean saying yes to everything

Good managers do not have to adopt every suggestion. They do need to hear the reasoning and explain why some options are possible while others are not. That is the difference between a genuine discussion and merely asking for opinions as a formality. In its compassionate leadership competency, the IHF also recognises shared decision-making where circumstances allow. Imagine nurses reporting problems caused by a new division of responsibilities. Their manager cannot set aside clinical standards, but can ask which part of the shift creates the greatest difficulty, discuss workable alternatives and explain the constraints honestly. Even an unwelcome decision is easier to understand when people know their concerns were considered. The skill is not agreeing for the sake of peace. It is listening, explaining decisions and following up on what was agreed.

Trust is built in conversations, not on posters

Hospitals, like other organisations, often put respect, trust and teamwork in their statements of values. Those words become meaningful when people can still speak constructively during a difficult shift. A systematic review by Braithwaite and colleagues covering 62 studies found associations between organisational culture and selected patient outcomes. Most studies were observational, so they do not establish that a single communication course will improve clinical results. For managers, the immediate questions are more concrete. Do colleagues follow up after disagreements? Are decisions explained? Does a senior specialist let a junior colleague finish a sentence? In 2026, the IHF showcased Apollo Hospitals’ Kindness Charter, which addresses how people treat one another in healthcare. It is an example of trying to turn declared values into everyday relationships.

Different departments need practice with different conversations

There is no single difficult conversation that every hospital employee needs to learn in exactly the same way. In an emergency department, the challenge may be a brief exchange under pressure. In a surgical unit, it may be feedback across professional boundaries. In administration, it could be negotiating competing deadlines and expectations. The principles of listening and explaining decisions remain similar, but the situations change. The IHF model allows competencies to be adapted to local needs. Before choosing a course, it is worth collecting examples of recurring tensions in each team. One group may need to practise raising concerns, another responding after a complaint and a third giving feedback without attacking the person. Training grounded in these situations is closer to everyday work. It also helps distinguish problems of interpersonal skill from those that require changes in how work is organised.

How can a hospital tell whether teamwork has really improved?

It is easy to count courses, participants and completed lessons. It is much harder to know whether people are actually communicating better on the ward. If teamwork is the goal, look at a few observable signs: do staff leave briefings knowing who is responsible for what, do concerns receive a response and can disagreements be discussed without humiliation? Ask both managers and staff, then look for patterns over several months. Research on organisational culture and psychological safety supports paying attention to these behaviours, but does not offer a ready-made measure of whether any particular app or course works. Working conditions matter too. If a department is short-staffed or chronically pressed for time, better conversations can help bring the problem into the open. They cannot solve the staffing shortage by themselves.

The IHF’s strategy can be translated into everyday interpersonal habits: hearing concerns, explaining decisions honestly, giving specific feedback and returning to shared agreements. Managers show teams whether those conversations are genuinely possible. Progress should therefore be measured by changes in how people work together, not just by the number of courses completed.

How Empatyzer helps hospital teams strengthen their working relationships

A chief medical officer notices tensions during briefings in two departments, but the causes are different. In one, staff rarely voice concerns. In the other, managers announce difficult decisions without explaining why they were made. Rather than prescribing the same training for everyone, the medical director and department leads choose two behaviours to practise: inviting staff to raise risks and ending meetings with clear agreements. In Empatyzer, the managers can explore their own communication preferences, while team maps help reveal differences between groups. Before each briefing, they describe the situation to Em and ask for questions that will open discussion and wording that will make decisions easier to understand. Afterwards, they return to Em to reflect on whether staff were heard and the next steps were clear. Micro-lessons reinforce those skills between formal training sessions. Managers can then collect feedback and see whether the new approach is becoming routine. This puts the IHF’s emphasis on developing leaders and teams into the context of real working relationships.