What ancient wisdom and science know about drivers to high performance in organisations

First principles are foundational building blocks from which all other knowledge, decisions and actions flow. In medicine, this means starting with the most basic, undeniable reality: the human body seeks homeostasis and healing. Regarding performance and relationships, virtue is the foundational truth that drives excellence. The seven classical virtues are trust, compassion, courage, justice, wisdom, temperance and hope. This perspective cites experiential evidence that adherence to the seven classical virtues drives high performance in organisations including in healthcare. The virtues provide a common language that leaders can espouse to release discretionary effort in their organisation—people will do the right thing when no one is watching. Examples are replete in healthcare. Trust among team members undergirds high performance in the Intensive Care Unit. Surgical outcomes are enhanced when team members know and care for one another, exemplifying compassion. At the same time, virtue-based leadership is not about sainthood. Practising the virtues is a lifelong aspiration and is action-based. It is not a virtue until you act. The perspective offers practical tools by which the virtues can be enacted. Creating a common language of the virtues can cascade awareness through the organisation. Deepening trust by practising gratitude can enhance psychological safety, which is associated with high performance. Finally, defining and weakening restraining forces like pressure to perform, time limitations, focus on short versus long-term actions and fear can then be weakened by integrating virtue habits into daily operations.