They have come into a Canadian hospital and its the first time in 26 yrs of being there that frount line high achieving managers who have been very successful (receive awards, done amazing research, respected with staff etc) have been laid off....they cite ridding organization of low achievers but are getting rid of high achievers...fear and intimidation..I'd say.....never experienced such a poor culture as a result. Staff want to get on with their work, and appreciate the rounding but managers who have always valued staff feedbk and input say its not worth the added cost to have them there..upper management needs to walk the talk & support what is being brough forward or its useless...and frustrating....Canadian hospitals are also not for profit...so wasted $$