When Facing an Unforeseeable Future, Culture Is a Strategic Imperative

Tri-County Health Care in Wadena, Minn., experienced a cultural transformation over the past two years that significantly improved employee engagement, patient satisfaction, quality and safety, and other key operating parameters. What its leaders could not have predicted, however, was how this work also would make both the organization and hospital team members more resilient during the COVID-19 crisis and economic fallout that ensued.

Joel Beiswenger, president and CEO of Tri-County Health Care (TCHC), partnered with Joe Tye, a former chief operating officer of a large teaching hospital and now CEO of Values Coach Inc., who helps health care organizations design and build a culture of ownership on a foundation of values. Tye and Beiswenger shared insights from their work together during the recent AHA Rural Health Care Leadership Conference.

TCHC, a full-service rural community health provider, has a medical staff of 46 community-based providers along with 460 employees, and operates services at 10 distinct locations with an annual budget of $72 million.

Its goals were twofold: to overcome the gap between knowing and doing that exists in ideal vs. actual culture; and build a spirit of personal resilience, initiative, personal improvement and fellowship into the hospital’s cultural DNA to carry it through its toughest challenges.

TCHC relied heavily on its alignment of purpose, mission and vision, which has endured for 20 years. It also adhered to three basic leadership practices for volatile, uncertain, complex and ambiguous times.

1. Be there. Show up where you are most needed and least expected.
2. Assess; don’t assume. There is no such thing as survey fatigue, only fatigue with surveys that are not listened to and acted upon.
3. Instill hope. Hope is not a strategy, but without hope, even the most brilliant strategy is doomed to failure.

Throughout the 60-module course, Tye introduced 12 core action values based on life and leadership skills. To build a foundation of personal character strength, employees aspired to authenticity, integrity, awareness, courage, perseverance and faith. To achieve their goals and make a difference, they aligned on purpose, vision, focus, enthusiasm, service and leadership.

Beiswenger knew that both personal and organizational values needed to be aligned in defining Tri-County’s values (joy, integrity, ownership, empathy, innovation and humility). He said, “We had to unearth our values and expose them in a public way.”

Along with staff huddles, re-assessments, surveys, and culture and value training, the program is working: Quality metrics have risen; patient satisfaction and employee and provider engagement scores are up; margins and operating revenue per full-time equivalent have increased; and readmissions are down.