Creating the `Power of One` culture: A conversation

Creating the ‘Power
of One’ culture: A
conversation with
Methodist LeBonheur
Healthcare System
CEO Gary Shorb
Methodist Le Bonheur
Healthcare is an integrated,
“We knew that the missing ingredient was our
not-for-profit, faith-based
culture; that we really had to address that. You can
healthcare system in
have all the best talent, the best plans and you can
Memphis, Tennessee. An
have the best strategy, objectives and goals. But
eight-hospital system with
without the culture piece being absolutely right, we
$1.6 billion in revenue and
were not going to achieve the kind of results we
12,500 associates, it is very
needed to achieve. It is the magic, if you will, that
committed to its mission.
makes everything else work. I don’t think you can
In the spirit of continuous
overemphasize that in terms of its importance. “
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 accountability, 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 budgeting, broader system thinking, a climate
of trust and engagement and sharing of
best practices.
The Power of One serves as the touchstone for Methodist LeBonheur’s patient
and family-centered culture of compassion. At the heart of Power of One are
the MLH values: Along with the guiding
behaviors, the values help people understand how to work together to serve
patients, their families and the community by living them each day.
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.
QAnd 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?
By focusing on the Power of One,
Methodist took an already positive and
healthy culture to the next level by creating a system mindset so that decisions
are made for the greater good; building
and broadening accountability; and having more open and candid dialogues with
each other to handle tough conversations.
Gary Shorb: As a faith-based organization, 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 provider 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.
Operating as one team and one organization has given Methodist a strategic
advantage in an increasingly competitive
and volatile market. It has also enabled
the healthcare system to create a consistent brand experience from hospital to
hospital and across its corporate functions
by building on an already strong foundation to take performance to an even
higher level.
It was a number of years ago that we
really decided that the vision for the organization needed to be one that created
a health care system that was one of the
best in the country.
Regina Salvucci, Senn Delaney Partner
and health care practice leader,
recently spoke to CEO Gary Shorb
about leading the culture-shaping
journey.
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.
The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [2]
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.
So that’s when we were fortunate
enough to bring in Senn Delaney. And
that journey started about five years ago.
QWhat 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 nursing. 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 feedback surveys, we weren’t in the top quartile. We were still kind of languishing in
the midrange. And those are the indicators we were paying attention to.
QAs 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 overall 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
“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.
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 experience 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.
QWhat were the areas that you
wanted to see improved as a result
of the culture work?
Gary Shorb: To have a successful organization 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 organization 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 contributed 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 quartile, which is where the board and our
senior leader team decided we needed
to be.
QWhat 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 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. 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.
The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [3]
QWhat are some qualitative results
that you’ve seen along the lines
that connect to patient and familycentered 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.
QWhat 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 outstanding 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 hospitals 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.
QHow does it all tie back to the
mission?
Gary Shorb: The execution of the mission is dependent upon your financial
success. And the financial success is
dependent upon commercial market
share. So, the better the patient experience, 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 budget this year. We have exceeded budget
on each of the previous five years. And
as I mentioned before, our bond rating
continues to improve.
“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.”
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.
QHow 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 committed to providing that experience and
embracing the patient and family-centered care.
I got a letter yesterday – just more anecdotal evidence of how far we have come
– about an individual who was with us
last week going through surgery and talking 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.
QIf 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 expectations. 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 commitment 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.
QAnything 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 fundamentals 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 overemphasize that in terms of its importance. 
The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [4]
about Senn Delaney
Senn 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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The Power of One culture: A conversation with Methodist LeBonheur CEO Gary Shorb [5]