The Power of Thank You Notes in Healthcare

Adapted from Hardwired Results® magazine (Volume 1, Fall 2004)

Thank you notes are one of the most cost-effective ways to deliver reward and recognition, which in turn builds critical employee engagement. High-performing organizations realize that people are more engaged and more willing to go the extra mile when leaders frequently express their appreciation—verbally and/or in thank you notes.

Q: Studer Group coaches say that thank you notes are a Must Have® behavior. Why are they so important?

A: A personalized thank you note is one of the very best ways to validate for an employee that he or she is doing worthwhile work and making a difference. The note immediately connects the employee to purpose, which is important to us in healthcare. In fact, our desire to make a difference is one of the main reasons we chose healthcare.

Thank you notes re-recruit employees, a critical competency when you consider the importance of employee engagement and the cost of high turnover. We frequently hear stories about the power of thank you notes from people who have given them and received them. One Studer Group coach relayed a story from an organization about a nurse who had decided to take a new job. Just before she gave her notice, she came home to a thank you note from the CEO and decided to stay instead. She found herself valuing the culture and didn't want to leave it.

Q: How do thank you notes impact engagement?

A: Many organizations suffer from a "we/they" culture (finger pointing and shifting blame without ownership of our own actions) that blocks organizational alignment and achievement of measurable goals. Thank you notes put everyone on the same side. They also provide an opportunity for leaders to connect an employee’s behavior to organization-wide standards of behavior or to the organization’s mission, vision and values.

Imagine that Karen, a new RN, does a great job with discharge instructions for a patient and his family. Karen’s supervisor notices and shares this with the CEO, asking him to send a thank you to Karen. The impact of this thank you note benefits everyone. First, the CEO is happy to learn the supervisor has trained the RN well on discharge education. Karen is also thrilled to be recognized by the CEO, but even more importantly, she's been re-recruited by her direct supervisor. She feels valued and builds trust with her supervisor.

Q: What are best practices for thank you notes?

A: A note that is specific, hand-written, and mailed to the employee's home is best. "Thank you for doing a great job" comes off as vague and insincere. Instead try, "Bob told me you were especially sensitive to the needs of a particularly worried family last Tuesday after their daughter's surgery. Thank you for being such a difference maker." Anyone can dash off a quick thank you by email, but to receive a hand-written note in the mail is a precious gift. Employees show their parents, their kids, and their friends and neighbors. They keep them forever.

Q: If thank you notes are so valuable, why don't more of us send them?

A: Leaders report that a barrier to thank you notes is that in healthcare we are trained to identify a problem and fix it. That's why we recommend organizations assign leaders a weekly number of thank you notes to write, and then leaders validate monthly who has sent thank you notes. This thank you note tracking grid can help.

Hardwiring new behaviors takes time. Validating thank you notes prevents them from falling off the "to-do" list until leaders get to experience first-hand what a difference they make in employee engagement. The ultimate goal is to train leaders to seek out and notice the positives.

Employees should be encouraged to send thank you notes to their boss identifying employees who deserve reward and recognition. Doing so helps leaders provide meaningful reward and recognition to their team members and builds comradery and respect among co-workers.


View past editions of Hardwired Results®, Studer Group’s complementary quarterly magazine. Each issue focuses on a different healthcare topic such as communication, physician loyalty, and employee engagement and offers tactics and downloadable tools to drive results.

Download the Insight

Print Page