18 Months with an East Coast Health System

Regional System of ~600 beds, 4 EDs and 80+ facilities

This two-hospital system had weathered the pandemic’s strain, but faced a cultural crossroads—staff were dedicated yet depleted. Leaders recognized that delivering exceptional care meant every patient needed to feel heard, respected, and truly connected.​

HXF Advisors partnered with the Chief Medical Officers, President/CEO, and CHRO to implement a full-scale coaching program with focus on comprehensive culture change. The work provided a clear reflection of where the organization was and revealed several themes:​

• Cultural Variability: Individual vs. collective accountability mindset (“I vs. We”) undermined ownership and consistency across departments.​
• Leadership Visibility Gaps: Executive rounding and communication lacked frequency, clarity, and connection to real work — often perceived as “check-the-box” activities.​
• Trust and Transparency: Concerns about openness in decision-making and communication eroded confidence between leaders and teams.​
• Engagement Decline: Great Place to Work scores fell by 8 points year-over-year; leaders cited limited follow-through on recognition and engagement plans.​
• Patient Experience Deficits: ED and inpatient PX fell below the 30th percentile despite strong clinical performance — signaling a cultural, not procedural, challenge.​

“Trust became measurable, and culture became the catalyst for performance.”

THE SOLUTION:

By making leadership visible and compassion measurable, organization leaders transformed culture from distant authority to daily presence. The focus shifted to intentional conversations, transparent communication, and shared accountability that brought leaders and frontline caregivers back into the same rhythm of care.​

Through honest dialogue and bold redefinition, healthcare leaders uncover what truly matters—and build the systems to make it real.​

OUTCOMES:

Within 18 months, courtesy and listening scores for nurses and physicians rose by double digits, and staff compassion improved by ten points. The systemwide Trust Index climbed +6.5 points as leadership presence and communication redefined everyday culture.​