YALE NEW HAVEN HEALTH

THE SITUATION

About to embark on the acquisition of a 511-bed Catholic hospital, The Hospital of Saint Raphael (HSR), six blocks away from its main academic medical center hospital, the Yale New Haven Health System leadership team was asked “what is our culture?” They found it was a question they couldn’t easily answer. Having already gone through physician practice acquisitions, they knew well the difficulty of bringing disparate organisations together to function as one. They were looking to develop a more streamlined process. First, they needed to answer that very important question. Yale New Haven Health System (YNHHS) is a network of hospitals and a physician foundation in Connecticut, USA. At the time of the impending acquisition of HSR, each hospital’s delivery network and the physician foundation had its own separate language describing vision, mission, and values. These organisations shared certain services, but in essence, they were independent of one another in many ways.

THE PROCESS

Around this time, Jim Staten, Executive VP, Corporate and Financial Services and Chief Financial Officer of the Yale New Haven Health System, learned about Barrett Values Centre’s values assessments through Rich Ruhmann, a consultant doing leadership development work with the health system. After having a Skype conversation with Phil Clothier and getting to know the Barrett tools, Jim engaged Barrett Values Centre® to help YNHHS define and clarify a set of core values that could be embraced by a newly evolving, more integrated culture with new employees and physicians from different components of the Health System.

Jim engaged with his partner Kevin Myatt, Senior Vice President of Human Resources, and together they became the ambassadors and chief proponents to the System CEO, Marna Borgstrom. After Skyping with Phil Clothier about a half dozen times, first with Marna Borgstrom and then with her senior Cabinet, including the CEOs of the various Delivery Networks and the Physician Foundation, the group agreed to embark on what Jim calls the most important journey of his professional career.

A team of experienced consultants was brought together to support the work at Yale New Haven Health System. Susan Beck, Rob Mallick and Kathryn Weldon each brought their unique talents to the process. Along with survey design and analysis, the team guided a core group of leaders through three workshops: the first was conducted after the leadership was surveyed, the second after employees were surveyed, and the third workshop focused on the selection and definition of a set of core values.

The first values assessment was conducted among the top leaders within the system. 79 of the 111 top leaders participated in the survey, and the results revealed 15% entropy, no potentially limiting values in the Current Culture, four matching values between personal and Current Culture values, and seven matching values between the Current and Desired Culture values.

The following month, all employees were invited to participate in the values assessment. Nearly 7,500 employees responded. The results revealed 17% entropy, no potentially limiting values in the Current Culture, three matching values between personal and Current Culture values, and six matching values between the Current and Desired Culture values.

The results of each survey revealed some very positive things, many of which emphasised the desire and need to further integrate the various subsets of the hospital system. Collaboration was identified as a key area for the leadership group. It was both a top personal value and a top Desired Culture value.

The Desired Cultures were very similar throughout the hospitals in the system, with eight of the same values being requested. Some of the values in common included Communication, Caring, Teamwork, and Continuous Improvement. This was a huge “aha” for the leadership team. It showed that, despite being independent in a number of ways, the hospitals were looking to come together. As YNHHS CEO Marna Borgstrom stated at a YNHHS Joint Boards meeting, “Employees and physicians shared a true desire for collaboration and integration.”

There were also some issues that needed to be addressed. A few of the demographic reports showed high entropy among certain populations. For example, the entropy from physicians was significantly higher than in other areas of the system. As a result, physician alignment of YMG, full-time and privately practicing community physicians became a major priority for follow-up work.

OUTCOMES

YNHHS leaders spent nearly a year developing their shared values, mission and vision. As each entity was operating with different stated outcomes, it took time to create a message that adequately represented the growing and more integrated system.

“Given our rapid growth and system focus, we needed to realign and re-communicate who we were as a System. We found that our focus was not on the who, as that did not materially change, but was rather on how we went about demonstrating who we were, which boiled down to our behaviours,” said Kevin Myatt, Senior VP of Human Resources at YNHHS.

The core values were handpicked from the cultural values survey results. All five values were among the top Desired Culture values for employees. The mission and vision were updated and shared so that they would be relevant and inspirational to the whole system. As Jim often reiterates, “every lasting transformation needs to first find space inside the hearts of the individual.”

YNHHS is now in the process of learning to embrace the values in all things from the execution of all business strategies/innovations to day-to-day relational interactions. Communicating the values to all employees and physicians and building them into the induction process and performance reviews are other activities currently underway. A leadership development program for their senior leadership team is also in the works, as well as a focus on looking for ways to address those populations who showed elevated entropy. But more importantly, the question that CEO Marna Borgrstrom is likely to ask as she leads large management meetings, rounds with staff, or strategizes with her senior Cabinet is, “What are you doing to live our core values today?”