How CAK’s cultural shift led to more satisfied employees and better service
Improving an organization’s service starts with its employees. With this in mind, the Central Administration Agency for Healthcare Costs in the Netherlands (CAK) has been working on strengthening its organizational culture in recent years. Their goal was to become a learning organization and to inspire employees to take initiative. The results show they’re on the right track. Employee surveys conducted through InternetSpiegel, the leading measurement tool for the Public Administration and Safety sector, reveal that in 2024, an impressive 73% of CAK employees felt engaged in their work, marking a 5% increase from three years prior. We spoke with Maartje Neuteboom–Berger, Program Manager for Culture & Strategic Communication Advisor at CAK, about how these employee surveys have contributed to positive changes within the organization.
CAK carries out statutory tasks for the Ministry of Health, Welfare, and Sport (VWS) with a team of about 1,000 employees. Since 2021, CAK has been using InternetSpiegel’s employee surveys, conducted by Effectory. The results indicate that CAK has made significant strides in improving employee happiness. Over three consecutive years (2021–2022, 2022–2023, and 2023–2024), CAK has shown consistent improvements in almost every category measured.
CAK serves 1.5 million citizens each year, meaning their processes and services must constantly evolve and improve.
While change often involves updating systems, real progress comes from engaging employees. That’s why, in 2021, CAK launched a cultural program that is fully integrated into the organization.
Motivated by a commitment to improving service, CAK operates under the motto: “Better every day together.”
The organization is evolving into a learning organization centered around four key themes: ownership, craftsmanship, collaboration, and customer focus.
To achieve this, CAK is creating an environment where employees feel encouraged to learn and improve.
“Using these insights, we developed our cultural approach and determined annual focus themes. The key is to listen and gather input. The second goal is to monitor and adjust the cultural shift as needed. The surveys allow us to track whether our efforts are making an impact and where we need to make further improvements. We provide activities and resources to support the key themes, but employees take ownership of applying them. When ownership is placed where it belongs, cultural change has the best chance of success.”
Maartje Neuteboom–Berger, Program Manager Culture & Strategic Communication Advisor
Between 2021 and 2024, CAK conducted four organization-wide surveys focused on employee engagement. As a result, their scores improved in key areas such as:
In addition to the standard engagement survey themes, CAK included additional questions on customer focus. As a service-oriented organization, it’s essential to assess how employees perceive and prioritize customer needs.
The organization-wide employee surveys have been a driving force for change at CAK. Feedback from employees has led to a structured cultural approach and a sharper focus on customer service. Managers have adopted a dual approach: collecting and listening to feedback and taking meaningful action. InternetSpiegel has supported managers by providing training on how to facilitate effective conversations.
All survey results are accessible to CAK employees. This transparency allows teams to learn from one another and ensures that cultural change is led by both teams and managers.
“Each team is free to decide how they will work on culture moving forward. That is essential because every team has different themes they want to work on.”
The employee survey results show that CAK scores higher than the benchmark when it comes to workload. However, workload management—along with role clarity and responsibilities—remains a key focus area for the organization. Encouraging a sense of ownership is also a priority. The InternetSpiegel dashboard provides managers with valuable insights, which serve as a starting point for conversations with employees.
“We started by creating clarity around tasks, responsibilities, and authority. What are you responsible for? What aren’t you responsible for? Encouraging ownership is equally important. This requires open conversations about what ownership means to each person and how they can take more initiative. To support these discussions, all employees had the opportunity to attend a ‘Good Conversations’ training, ensuring we all have a shared foundation for effective communication.”
Maartje Neuteboom–Berger, Program Manager for Culture & Strategic Communication Advisor
