From the 12th Percentile and Climbing: How Precision Coaching Helped One Health System's Leaders Improve Engagement at Four Times the Rate

Coached leaders improved 32 percentile points. Uncoached leaders improved 7. The difference is HXF.

The Challenge

For a mid-size not-for-profit community health system in the southeast with more than 70 years of service to its region, the commitment to excellence in patient care has always been inseparable from the commitment to the people who deliver it. The organization understood that employee engagement was not a peripheral concern — it was a foundational driver of quality, safety, and the patient experience it aspired to provide. And yet, despite that understanding and the genuine desire of its leadership to build a thriving workplace culture, the system found itself in the 12th percentile nationally for employee engagement. The gap between aspiration and measured reality was real, and closing it would require more than good intentions.

The challenge was not simply a matter of scores. A workforce that is not fully engaged is a workforce whose potential is being left unrealized — clinicians and staff who are showing up but not fully connected to the mission, managers who are working hard but not yet equipped with the tools to unlock the people around them. The organization's leadership recognized this, and recognized that the path forward was not a system-wide reset but a targeted, evidence-based intervention focused precisely where it could produce the most meaningful change. They engaged HXF to help them find that path.

The presenting problem was clear: employee engagement rankings at the 12th percentile nationally, with specific divisions identified through survey data as the highest-priority opportunities for improvement. The deeper challenge was equally clear: leaders in those divisions needed not just motivation, but practical development — a structured coaching experience that would give them the skills, the language, and the confidence to engage their teams differently. The Chief Human Resources Officer partnered with HXF to design exactly that.

The Solution

HXF began with the data. Using the organization's employee engagement survey results, HXF and the CHRO identified the specific divisions that — based on both score results and workforce size — would benefit most from targeted coaching. Rather than applying a blanket intervention across the entire system, HXF took a precision approach: concentrate the development energy where the evidence pointed, and measure the impact against those who did not receive the same level of support. It was a disciplined, outcomes-oriented design that would ultimately produce one of the most compelling proof points in the engagement.

For each selected division, HXF worked directly with senior leaders on a 3-to-4-month virtual coaching roadmap. The program helped leaders communicate and cascade their engagement survey results transparently to their own teams — turning data from a top-down report into a shared conversation about what needed to change and why. HXF facilitated leadership development sessions focused on each division's key engagement drivers, building practical skills in areas most directly tied to the engagement gaps the survey had surfaced. Directors and managers within each coached division were also invited into the development work, extending the reach of the coaching deeper into the organizational structure.

Action planning was built into the fabric of the engagement, not treated as an afterthought. Leaders were supported in developing concrete, division-specific plans that their teams helped shape — creating genuine ownership of the improvement effort at the unit level. Throughout the process, HXF provided ongoing coaching support to ensure leaders could sustain their momentum, navigate obstacles, and continue developing between sessions. The result was a development experience that was both rigorous and deeply responsive to the specific needs of each leader and each team.

The Result

The outcomes were striking — and unusually verifiable. When the organization re-surveyed, divisions whose leaders had received HXF coaching improved by an average of 32 national percentile points in employee engagement. Divisions whose leaders had not received coaching improved by an average of 7 percentile points over the same period. That 25-point gap is not simply a result — it is a controlled comparison. It isolates the specific contribution of the coaching and answers the question that every skeptical executive eventually asks: would improvement have happened anyway? The data says yes, somewhat. But with HXF's coaching, it happened at more than four times the rate.

The improvements extended beyond the national ranking shift. The organization also saw meaningful movement in the composition of its workforce engagement. The share of fully engaged employees grew from 20 percent to 28 percent — a shift that reflects not just better survey scores, but a real change in the number of people who felt genuine ownership of their work and connection to their organization's mission. Simultaneously, the disengaged segment of the workforce decreased, a downstream signal that the culture was genuinely moving in a new direction.

What this engagement demonstrated is one of HXF's core operating principles: that targeted, evidence-led development — applied with precision to the leaders who can most benefit from it — produces outcomes that broad, unfocused efforts rarely achieve. The coaching did not simply teach skills in isolation. It built leaders who could bring their teams along with them, turning individual development into organizational momentum. For a health system that began this work at the 12th percentile, the trajectory was clear: with the right support, in the right places, sustained improvement is not only possible — it is measurable.