Insigniam: How one company regained perspective on healthcare management

Can an organization be spoiled by its own success? A regional healthcare provider that’s operated for more than 50 years asked itself that question recently. The answer: Yes.

The healthcare company has grown steadily since opening its first hospital in the early fifties. Today, the organization has more than 100 locations, including five hospitals, two medical centers, three urgent care centers, and 55 physician practice sites. It also boasts a solid balance sheet. Revenues, which have grown steadily in recent years, are now more than $1 billion annually.

But when executives got together to talk about their company’s future more than a year ago, they decided that something still wasn’t right. Something important. “We’d always been successful in terms of financial performance,” the president says. “But we had lost sight of the patient as the center of everything we do.”

Healthcare management complacency?

This healthcare provider was hardly alone in finding complacency issues. Healthcare companies nationwide have been nursing their balance sheets as much as — and in some cases more — than they’ve been nursing their patients for years, thanks to the mounting costs of healthcare service.

The Institute for Healthcare Improvement reports that the U.S. healthcare system is now the most costly in the world, eating up 17 percent of the nation’s gross domestic product this year. That bite out of GDP will only get bigger, the IHI says, reaching 20 percent by 2020.

That’s why IHI has developed a framework to help healthcare providers reduce costs while boosting patient services. Called “Triple Aim,” the framework was the primary benchmark that the provider used in realigning its corporate culture and its mission — not around the bottom line, but around patient care.

Top-tier healthcare performance

The organization had been in the middle of the pack of the nation’s healthcare providers in Triple Aim, and its executives wanted to become a top-tier performer.

“But they realized their existing corporate culture wasn’t going to get them to that goal,” says Shideh Sedgh Bina, one of the founding partners of Insigniam, an international management consulting firm, which was brought in to help the healthcare organization achieve its new goal. “So they decided to pursue a cultural transformation that was tied into the elevation of performance. That is the best kind of transformation. Because culture is actually in service to performance — not the other way around.”

The transformative goals were simple: Focus on patient’s needs, improve patient care, and better control costs. But achieving those goals involved a complex, coordinated series of initiatives. For one thing, 18 of the organization’s top leaders committed to a leadership development initiative custom designed by Insigniam aimed at driving a culture change.

Redefining hospital values

In addition, a leadership coalition was created to develop a new mission statement and redefine the company’s core values and operating practices. The organization also established a team that defined the operational objectives needed to move them up to the top tier among healthcare corporations. That team called upon the entire organization to achieve multiple, specific objectives, including decreasing the average length of a patient’s stay, boosting patient safety, and increasing physician engagement. Finally, and importantly, a campaign was launched to engage the workforce.

Within months, the vast majority of the 9,000 employees had one-on-one discussions about the new corporate mission and objectives.

That coordinated effort produced quick results. “Within just eight months, they saw significant, measurable outcomes from these efforts,” says Insigniam’s Bina.

Improved patient outcomes

Among them: Patient mortality rates and complications have declined while patient safety ratings have increased. One example: Patient falls, common in hospitals, have declined 38 percent in just one year.

And, in the past 12 months, patient satisfaction scores, as measured by Thomson Reuters, have jumped six times more than the average hospital nationwide.

“Not only is the substance of the care we provide getting better, but the patients’ perception of that care is also going up,” says one of the vice presidents.

Structured marketing

The culture assessment also revealed an absence of a structured marketing plan. A year and a half later, the provider won nine national awards in recognition of the new branding campaign, including magazine ads, radio commercials, and an employee wellness calendar.

The key to changing the culture and the company’s performance, Bina says, is that the top executives conducted an honest assessment of what they wanted to change — including their own leadership styles. “The leadership bought into this process entirely,” she says.

Employee satisfaction increases

So, too, did the company’s employees. Survey results show the company is now in the 88th percentile of healthcare firms nationwide in terms of what the industry calls “employee partnership.” A year ago, it ranked near the middle.

“This culture work has helped us refocus on the fact that patients are at the center of everything we do,” the vice president says. “And refocusing on patients has really brought back the passion of our workforce.”