SHSMD: CEOs Discuss Cultural Change Leadership

At the Society for Healthcare Strategy and Market Development (SHSMD) Annual conference in Phoenix last week, a panel of CEOs met to discuss culture – a term that is difficult to define.

Many healthcare organizations are struggling with forming a common culture, especially with the increasing emergence of accountable care organizations and multi-hospital systems.

Leading cultural change within an organization can also mean creating an atmosphere of disclosure where employees feel comfortable calling each other out on issues such as handwashing compliance.

Panelists Thomas Sadvary, president and CEO of Scottsdale Healthcare, Rebecca Kuhn, president of Arizona East Region Banner Health, and Tony Marinello, CEO of Mount Vista Medical Center, answered questions from the audience and moderator Burl Stamp, president of Stamp & Chase, about cultural changes starting in the C-suite.

Q. How do you measure culture?

Kuhn: We've looked at competencies our leaders will have. We also have an employee engagement survey where we ask, 'to what extent are you confident about your leaders? How well are they communicating to you?' Leaders are rewarded, or not, depending on how they are evaluated. It's fundamental to changing culture.

Marinello: It's about accountability; you have to be able to call people out. Coworkers have to feel comfortable and the best information comes from information on the frontline. Don't wait until you get a negative patient survey back saying that the hospital doesn't address my needs.

Sadvary: I really think the CEO defines culture. I once received an email from one of my staff about one my actions saying, 'Don't you care about employees anymore?' I appreciated she had the guts to tell me. If the nurses feel uncomfortable saying something, then it doesn't matter what types of tools and initiatives you have, it's not going to work. You have to establish a culture first.

Q. How does an organization change its culture?

Sadvary: In many ways, healthcare is more resistant to change than it should be. We'll see change on the technical side, that's easier received. The hard part is change for quality of care.

Kuhn: We tend to be on the risk-adverse side. We have to be focused on the leaders willing to change. Change management is going to be a key skill set going forward.

Marinello: We identify our stars and the tools that we give them to excel. You need to differentiate between who is truly engaged and who is there for the paycheck. Don't promote people just because they've worked their way up, that doesn't necessarily make them a good manager.

Q. How do you avoid 'flavor of the month' initiatives?

Marinello: You have to keep driving the strategy you are working to accomplish and reinforce that it's not going away. Keep bringing it up.

Sadvary: In our jobs as CEO, we are guilty of [flavor of the month initiatives]. We need to deliver the message in a consistent way.

Q. In an organization with multiple systems, how do you mix multiple cultures?

Kuhn: Banner Health recently acquired two new hospitals and there was a very structured integration program. A lot of it is having a common infrastructure; you need to have a common electronic medical record system, etc. It takes a tremendous amount of courage to get the groups and leadership buy-in from the top to make everything the same.

Q. What is the greatest value a marketing team brings to the C-suite?

Marinello: They are out there as the eyes and ears. Our regional marketing director understands ROI and what brings value to the organization.

Sadvary: Marketing intelligence is very important. We need to know what the doctors, patients, and employees are thinking. As a CEO, the more I know the more I can drive a strategy. We have a long way to go, we think we know what docs and patients are thinking. Wrong.