Helping an east coast regional health system improve more than its HCAHPS patient experience scores. 

Helping it transform its culture.

The Challenge

This large regional east coast health system had built a reputation in its community as being deeply committed to its patient’s experiences of care, yet it recognized that its own patient experience efforts weren’t performing as well as they could despite considerable effort from teams across the system. A testament to the passion of its people, teams remained committed to the goal of improving patient experience, but despite best efforts and well-intentioned strategies, lackluster results were eroding team confidence and engagement.

Through an initial assessment, HXF uncovered that existing institutional structures in place limited leader, staff, and physician collaboration, often resulting in isolated and siloed initiatives. While teams were committed to making improvements, inherent inter-departmental barriers further stalled progress, hindered a unified approach, and prevented consistent and cohesive results across the continuum of care.

Adding to the complexity, this system was also experiencing a significant senior leadership transition and turnover. While the work was focused on improving patient experience scores and employee engagement, navigating these challenges revealed a deeper need to activate organizational values, re-engage employees to their authentic practice, and ultimately build trust and confidence with teams to serve as a catalyst for organization-wide cultural transformation.

HXF was engaged specifically to provide a third-party, outside perspective on improving patient experience scores for Inpatient and ED during a pivotal moment of change within the organization, and implement practical strategies and tactics to map the organization’s trajectory forward, and equip its teams for future success.

The Solution

Our team worked closely with the CMO, President/CEO, and the CHRO to co-create and implement a full-scale coaching program with focus on comprehensive culture change.

Core to this work included engagement of teams across multiple levels—from senior leadership teams, to frontline staff, and physicians—to understand and celebrate strengths in how they were approaching patient experience and team member engagement, as well as identifying limitations to overcome and opportunities to explore.

Our coaches conducted a comprehensive analysis across people, processes, and environments, and executed a series of discovery sessions, listening sessions, performance reviews, operational observations, and facilitated leadership retreats to inform action areas and a two-year roadmap focused on creating substantive improvements in patient experience, quality, and safety.

Armed with an approved action plan, roadmap, and baselines, HXF coaches, advisors, and specialists worked across the whole health system and interdepartmental teams to implement a series of trainings, one-on-one, and group coaching sessions to align senior leaders on common language, clarify non-negotiables, solidify shared commitment to the design and execution of standards of behavior/performance, as well as strengthen senior leader and relationship rounding throughout the system.

The Result

Over the course of 18 months, HXF achieved its goal. The system saw dramatic cultural shifts among work teams, resulting in measured improvement across Overall Ratings for their ED (30 percentile point increase from baseline), and improvements in HCAHPS Domains for Nurse Listened and Nurse Courtesy by 50% and 26% respectively and Doctor Listened and Doctor Courtesy domains by 52% and 58% respectively.

But this work also resulted in residual impact: Employee Engagement rose by 6.5 percentile points from baseline, Employee Voice and Trust increased by 7 percentile points, trust in Leadership & Management rose by 9 percentile points, and despite senior leader turnover, the system was nationally recognized and designated as a Great Place to Work (which is sustained for 5 straight years).

HXF’s comprehensive training programs and employee development curriculum sustained continued growth and results through ongoing train-the-trainer programs, as well as activation of tactical work teams that served as internal champions for sustaining momentum.