Background

Yakima Valley Memorial Hospital provides a full range of healthcare services to a diverse population in central Washington State. The 2,500-employee organization was recognized by Fortune in 2003 as one of the top 100 best companies to work for, and in 2012 as one of the top 25 U.S. hospitals to work for by Healthcare Executive News.“But we can always improve.” This from Rick Linneweh, former CEO of Yakima Valley Memorial Hospital for 37 years. “I’m excited by the opportunity to create an environment where all employees are change agents, where we further refine how we define our desired culture, and we take prescriptive steps to move toward the desired culture.”Linneweh had something else on his mind: he wanted to ensure that upon his eventual retirement, the culture he had helped build would be maintained.

“When we get in a new set of employees each month, I tell them that it is my job to make an environment where good people can do good. The Pacific Institute has given me the tools to do this.”

Challenge

“When we started working with The Pacific Institute in 2005, I realized I had a limited number of years left at Memorial. With colleagues at other organizations, I saw that when they were still there, the culture seemed to be thriving and to be a solid, positive culture. But upon their retirement, the culture changed. It turned out to be more of a veneer than a truly embedded positive culture. I wanted to be sure that the value system, culture, and healthy behaviors we had worked hard to cultivate would not walk out the door with me.”

Experience

When Memorial Hospital first started working with The Pacific Institute in 2005, its entire staff participated in a four-day facilitated seminar. This program remains available to everyone in the organization to this day. Today, 5.000 past and current employees have gone through this core curriculum, and new employees also undertake the program.“In order to have a deeply embedded positive culture, it had to be created and sustained by more than just the leadership. We had to create a common language and imagery for our culture. How do you make sure it is a constructive, positive culture and one that is deeply ingrained in your organization? This is what The Pacific Institute does.“Leadership has access to one-on-one coaching any time they want.

The staff also participate in cultural activities with The Pacific Institute, which helps to assess the current culture and determine the kind of culture the hospital wants. “In the 37 years I’ve been at Memorial, I look back at the decisions I made, and without reservation, I put the decision of instituting this cultural work as one of the most important. It has transformed our value system and how we do things. We are not yet where we want to be, but there is lots of movement out of defensive and into constructive.”

The hospital staff monitor the culture regularly, performing cultural assessments about every 18 months. “The whole idea is that if you are going to change the culture of the organization, you have to address the work unit, and in order to address the work unit, you have to address the individual – their beliefs and habits. We welcome each person and invite them to become a change agent for Memorial Hospital.”

Outcome

Linneweh reports that people at Memorial Hospital have a new understanding of capacity for excellence and capacity for quantity of performance. “Over the eight years working with The Pacific Institute, I’ve seen incredible change. At one point, we built a total hospital information system, implemented Lean Six Sigma for workflows, and remodeled the hospital while people were working, all at the same time. Yet the capacities of utilization were at high levels unseen before. Previously, we could have counted on lots of moans and groans in the face of such challenges, but that hasn’t been the case. It’s incredible. People have an ‘I can do that’ attitude, an ‘Of course we can do that’ attitude.’” The results speak for themselves:

An 80% decrease in Serious Safety events over a period of three years, including a period of more than a year with no events
A 40% improvement in room utilization by Surgical Operations in just 30 days
A 300% reduction in Percentage of Patients Leaving without being seen in the Emergency Department, even as volumes were at all-time record levels
Significantly reduced stat lab results and variance in the Laboratory
Discharge times that now better match the demand for admissions

Linneweh says that bringing in The Pacific Institute was one of his best decisions as CEO. “This process allowed the deep infusion of values, of a sense of efficacy on the part of each and every employee. There is now a common culture of building organizational capacity, a ‘can-do’ attitude, a common vocabulary, and a positive vision towards the future.” Added hospital COO Russ Myers, “The ties between our cultural improvements and the performance improvements are direct and profound.”