St. Vincent Hospital: Transforming a Culture to Become the Hospital System of Choice

Like many healthcare organizations, St. Vincent Hospital in Indianapolis was at a crossroads as it rang in the New Year of 2004. An unprecedented drop in the number of nursing professionals available to fill the ever-increasing demand was sweeping the industry. And the situation at St. Vincent was no exception. Competition for talent in this Midwestern market—for both skilled and experienced nurses and physicians—was intense. This faith-based non-profit also was about to be challenged by a rival hospital system, ready to break ground on a new facility that would add even more competition for patients and staff alike. Plus, internal survey results showed St. Vincent associates were dissatisfied with the current work environment and believed they had poor relationships with their direct supervisors.

Bravely facing both internal and external challenges, St. Vincent took stock of where they were in the marketplace, assessed their strengths as well as flaws, and embarked on a strategy to develop leadership capability, knowledge, skills and behaviors. With strong advocacy on the part of top leadership, St. Vincent set out to combat this competitive expansion and disengaged workforce with an initiative that would build a successful culture of leadership, strengthen leader-to-associate relationships, and create a fundamental change in the culture to more accurately reflect one of its key business strategies: become the hospital of choice for patients, associates and physicians.

“What was absolutely essential was that this new development program be evidence-based and demonstrate clear results tied to business goals and organizational performance,” said Education Consultant Lu Pennal, who was brought on board in 2004 to facilitate the initiative. “And after great scrutiny, we selected The Leadership Challenge because the Practices of the program were so clearly aligned with our faith-based mission and core values. They also tie directly to what we refer to as our Call To Action, which speaks to the hospital’s dedication to deliver Healthcare That Works, Healthcare That is Safe, Healthcare That Leaves No One Behind. The fact that the 360-degree tool, the Leadership Practices Inventory (LPI), is backed by solid statistics, and that the program overall was internally sustainable and measurable, also was very important,” she added.

A formal Steering Council that included senior leaders, whose front-line support was essential for successful implementation and to deliver positive and long-term results, led the program’s development and implementation. And from the very beginning, each Steering Council member promoted this new leadership initiative as a process—not a one-time workshop or set of tools to use and then discard. Starting with the organization’s president and executive team, The Leadership Challenge program rolled-out to nursing, physician, and associate leaders and now includes over 500 graduates of what St. Vincent has called its ‘Building the BEST’ initiative (the best Budget, patient Experience, Safety, Team).

Pre-session assignments, a 3-day workshop, plenty of time to apply key learnings, and a 1-year refresher were bolstered by the Steering Council’s decision to include a one-to-one coaching component that became integral to the success of the experience for both participants and coaches.

“Our goal was to create a common language and expectations of behavior in order to fully implement a complete culture change,” observed Marty DuRall, founding Steering Council member and Executive Director, Human Resources. “After 11 years with St. Vincent, and having studied several major management theories, I see a profound difference in how this model boils down all of the theoretical complexity into five very simple, very memorable steps that can be applied to everything: operational goals, process improvement, global communication, and performance reviews, just to name a few.”

“Most importantly, The Five Practices of Exemplary Leadership® ground us. These principles have set the standard and cultural norm for how we communicate. Now synonymous with our ‘Building the BEST’, The Leadership Challenge has given everyday meaning to expectations of leaders and helped us identify a way of behaving and communicating that reflects who we are and how we intend to treat each other and our patients,” Ms. DuRall added.

St. Vincent has incorporated The Five Practices into its reward and recognition programs. Promoting the practice of Encouraging the Heart, a President’s Award is given once per quarter to a St. Vincent associate recognized as having gone above and beyond expectations in demonstrating The Five Practices.

“’Leadership as a relationship’ is perhaps the most significant change in St. Vincent’s leadership culture,” according to Anne Coleman, another founding member of the Steering Council and currently Administrator of St. Vincent Peyton Manning Children’s Hospital and Women’s Hospital . “While the previous role of leader was more akin to the management of tasks, not of leadership, what we have now is an environment in which we each take responsibility for living out The Five Practices every day.”

“An added benefit of this program is the opportunity for us to participate in the experience of being a leadership coach,” Ms. Coleman added. “This internal coaching component builds relationships into the system and connects us all together. It has transformed our individual leadership styles into a more consistent and comprehensive system of enabling others to act, modeling the way, and encouraging the heart as we coach others to replicate their learning, challenge the process, and become the leaders we know they are capable of being.”

According to Lu Pennal, the results of St. Vincent’s experience with The Leadership Challenge process have been remarkable. “Following a measurement plan the Steering Council established at the outset, our survey response rates have been very impressive at 61%, with 90% of respondents noting that they had learned new knowledge and skills and 93% indicating they had applied that knowledge and those skills to their jobs. Even more significant is the feedback from our most seasoned and experienced leaders: 77% reported that their leadership skills had improved 40% or more as a result of The Leadership Challenge experience.”

“Across the organization, we have seen more collaboration and partnerships that have improved the use of resources and equipment. We have seen an increased level of engagement from associates, greater talent retention, and improved patient access. In addition, St. Vincent has been honored with a Best Healthcare Employer award (in the Indianapolis market) by a consumer choice group three years running. The Leadership Challenge has played a critical role in creating the kind of culture that brought us the success we have today. And we continue to incorporate the LPI tools and the Five Practices model into our ongoing ‘Building the BEST’ program in developing new leaders throughout the St. Vincent Health system,” she concluded.

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