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Creating the ‘Power of One’ culture: A conversation with Methodist LeBonheur Healthcare System CEO Gary Shorb

The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [2]

Q And as a faith-based organization, you do have a strong mission and vision. Can you tell us about those? And how does that connect? How do the mission and vision connect to the culture work?

Gary Shorb: As a faith-based organiza-tion, that commitment to mission really shows itself in a number of different ways. We have a great commitment to the underserved. We are the largest pro-vider of health care to the uninsured as well as the Medicaid population. We care for a huge poor population that we care for. We take a lot of pride in that.

It was a number of years ago that we really decided that the vision for the orga-nization needed to be one that created a health care system that was one of the best in the country.

And that dialogue was one that kind of started with Jim Collins, the author of Good to Great. We got with Collins and tried to follow his roadmap of disciplined people, disciplined thought, disciplined action. We did that for a number of years, yet we still weren’t really moving the organization as quickly as we thought we could. I mean, we were good, but we were certainly not great.

Methodist Le Bonheur

Healthcare is an integrated,

not-for-profit, faith-based

healthcare system in

Memphis, Tennessee. An

eight-hospital system with

$1.6 billion in revenue and

12,500 associates, it is very

committed to its mission.

In the spirit of continuous

improvement, Methodist

began partnering with

Senn Delaney, a Heidrick

& Struggles company, in

2010 to drive a “Power of

One” culture throughout the

organization.

The goals of the culture transformation included creating a system mindset so that decisions are made for the greater good, building and broadening account-ability, and having more open and candid dialogues with each other to handle tough issues.

As a result of this focus, the executive team has seen improvements in strategic alignment, annual planning and budget-ing, broader system thinking, a climate of trust and engagement and sharing of best practices.

The Power of One serves as the touch-stone for Methodist LeBonheur’s patient and family-centered culture of compas-sion. At the heart of Power of One are the MLH values: Along with the guiding behaviors, the values help people under-stand how to work together to serve patients, their families and the commu-nity by living them each day.

“We knew that the missing ingredient was our

culture; that we really had to address that. You can

have all the best talent, the best plans and you can

have the best strategy, objectives and goals. But

without the culture piece being absolutely right, we

were not going to achieve the kind of results we

needed to achieve. It is the magic, if you will, that

makes everything else work. I don’t think you can

overemphasize that in terms of its importance. “

The Power of One is based on MLH’s organizational values: Service, Quality, Integrity, Teamwork and Innovation; and connected to their goal of putting patients and their families at the heart of everything they do.

By focusing on the Power of One, Methodist took an already positive and healthy culture to the next level by creat-ing a system mindset so that decisions are made for the greater good; building and broadening accountability; and hav-ing more open and candid dialogues with each other to handle tough conversa-tions.

Operating as one team and one organi-zation has given Methodist a strategic advantage in an increasingly competitive and volatile market. It has also enabled the healthcare system to create a consis-tent brand experience from hospital to hospital and across its corporate functions by building on an already strong foun-dation to take performance to an even higher level.

Regina Salvucci, Senn Delaney Partner and health care practice leader, recently spoke to CEO Gary Shorb about leading the culture-shaping journey.

The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [3]

We knew that the missing ingredient was our culture; that we really had to address that. You can have all the best talent, the best plans and you can have the best strategy, objectives and goals. But with-out the culture piece being absolutely right, we were not going to achieve the kind of results we needed to achieve. It is the magic, if you will, that makes everything else work. I don’t think you can overemphasize that in terms of its importance.

So that’s when we were fortunate enough to bring in Senn Delaney. And that journey started about five years ago.

Q What did you want to specifically change about how the system operated and you worked internally?

Gary Shorb: We had a reputation of being good at nursing, probably the best in the community with the bedside nurs-ing. And we had a reputation of being very committed to the entire community and providing value.

But when you compared us with national standards on the clinical quality front or with HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, the way of measuring patient satisfaction, or even our own internal measures from associate feed-back surveys, we weren’t in the top quar-tile. We were still kind of languishing in the midrange. And those are the indica-tors we were paying attention to.

Q As you started thinking about the culture journey for your system, what were some goals you had in mind?

Gary Shorb: Well, as part of the over-all vision to be nationally recognized, we certainly wanted to be recognized in journals like the US News and World Report. We also did not have a consistent experience in every one of our branded sites of service. Getting a system in place

that ensured that we were having some consistency in the patient experience was very important.

We also wanted to really have some quantitative measure that our associates were satisfied. And we knew culture shaping was key to that. Patient experi-ence is not going to be any happier than the level of satisfaction of the associates who you are working with. So, it’s really critical to get that piece right. And we knew culture was just key.

As your founder, Larry Senn, says, “all organizations have culture; it’s a matter of you shape it or does it shape you”. So we made the determination we had to shape it if we were going to achieve the goals that we laid out.

Q What were the areas that you wanted to see improved as a result of the culture work?

Gary Shorb: To have a successful orga-nization you need outstanding financial results or at least achieve your financial goals. So, that was very important, and that is tied to market share, especially commercial market share. Our organiza-tion wasn’t really thinking as a system. We had a lot of siloed decision-making going on. Our communication processed needed to be improved, which contrib-uted to that silo thinking.

The teamwork was not where it needed to be. The interaction among the senior leaders as well as other leaders within hospitals as well as within the corporate structure needed to be improved.

We were good on the clinical quality side, but again, a lot of process improvement was needed to take us into the top quar-tile, which is where the board and our senior leader team decided we needed to be.

Q What are you seeing now today as a result of the work that you’ve done on culture? How have those metrics improved?

Gary Shorb: We have seen improve-ment on every front. We are now in the top five percent in the nation on associ-ate satisfaction. In clinical quality, almost every one of our quality scores is in the top quartile.

We have gone from a BBB bond rating to a A+ bond rating with Standard & Poors and Moody’s. Our customer satisfaction – our patient satisfaction scores – also are achieving top quartile. That’s kind of a lagging indicator that our culture work has really been outstanding, and it is translating into patient satisfaction and improvement. It’s taking a little bit longer than we thought or any of us would like, but it’s getting there and really moving in the right direction.

“We have seen improvement on every front. We are

now in the top five percent in the nation on associate

satisfaction. In clinical quality, almost every one of

our quality scores is in the top quartile. We have

gone from a BBB bond rating to a A+ bond rating

with Standard & Poors and Moody’s. Our customer

satisfaction – our patient satisfaction scores – also are

achieving top quartile.

The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [4]

Q What are some qualitative results that you’ve seen along the lines that connect to patient and family-centered care?

Gary Shorb: Patient and family-centered care is the centerpiece of this. It really has been just wonderful to use the Senn Delaney tools to achieve a mindset that embraces not just the patient, but the family and the care of the patient. I see results and demonstrated evidence of that all the time.

Q What are some examples of some external recognition that you have received?

Gary Shorb: Well, I mentioned one of our goals was to be listed in the US News and World Report as an outstand-ing hospital. And we are the best in the region on the adult side. And Le Bonheur is listed as one of the top children’s hos-pitals nationally. There were only three recognized hospitals in Tennessee – St. Jude, Le Bonheur and Vanderbilt. We take a lot of pride in that distinction. We also achieved level one trauma status at Le Bonheur. We have gotten many accolades for the work we’re doing in diversity, and especially supplier diversity. We are top five percent in the Morehead associate feedback survey.

Q How does it all tie back to the mission?

Gary Shorb: The execution of the mis-sion is dependent upon your financial success. And the financial success is dependent upon commercial market share. So, the better the patient experi-ence, the more commercial market share we will receive and have received.

And as a result of that we are benefitting greatly financially. We are ahead of bud-get this year. We have exceeded budget on each of the previous five years. And as I mentioned before, our bond rating continues to improve.

We see thousands of uninsured patients, balancing that with the commercial market share and, of course, Medicare patients. They won’t come to us unless the culture is right. We know that, and we’ve got to continuously improve it. As a result of the culture work we have done, that’s really what’s driven a lot of the volume improvement that we’ve seen over the past few years. So, it is all tied together.

Q How important is the Power of One initiative – which is what you call the culture process – right on down to the front lines?

Gary Shorb: It’s really critical. To really have the ultimate patient experience, everybody has to be aligned and com-mitted to providing that experience and embracing the patient and family-cen-tered care.

I got a letter yesterday – just more anec-dotal evidence of how far we have come – about an individual who was with us last week going through surgery and talk-ing about everyone’s smiles, everyone’s caring attitude. But particularly talking about a transporter who was moving him to surgery and how the transporter’s kind words and thoughts calmed his heart and spirit and enabled him to go into surgery in a better frame of mind.

Q If you had to narrow it down, what are you most proud of?

Gary Shorb: I think it’s the experience improvement that we have seen through-

out the system, and the fact that we have a leadership team who really do show every day a commitment to achieving that. It really has exceeded my expecta-tions. And I am really proud that now have the evidence that’s demonstrating that this journey is working, and working extremely well.

Q What are some keys to success that you would share with other healthcare CEOs on how to lead culture successfully?

Gary Shorb: First and foremost, the CEO needs to be totally committed as well as his or her direct reports. That com-mitment level has got to be what really sustains the effort and gets you the kind of results you need. Secondly, culture is extremely important. If you don’t get the culture piece right, you are not going to see the kind of results that you would like to see and achieve the goals that you’re laying out for the organization.

Q Anything else you want to share?

Gary Shorb: Senn Delaney brings to the table the best tools I have ever seen for changing mindset, addressing culture, building teamwork, getting all the funda-mentals in the organization right so the culture can transform and be one that’s very healthy and robust.

But we really almost missed the fact that culture is the key ingredient. It is the magic, if you will, that makes everything else work. I don’t think you can overem-phasize that in terms of its importance.

“Senn Delaney brings to the table the best tools I have

ever seen for changing mindset, addressing culture,

building teamwork, getting all the fundamentals in

the organization right so the culture can transform

and be one that’s very healthy and robust.”

The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [5]

about Senn DelaneySenn Delaney is the culture-shaping firm of Heidrick & Struggles International, Inc., the premier provider of Executive Search, Culture Shaping and Leadership Consulting services worldwide. Founded in 1978, Senn Delaney was the first firm in the world to focus exclusively on transforming cultures. A singular focus of creating healthy, high-performance cultures has made us the leading international authority and successful practitioner of culture shaping that enhances the spirit and performance of organisations.

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