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June 12, 2017

Scripps CEO's 3 tips to change a health system's culture

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When Chris Van Gorder joined Scripps Health as COO in 1999, the health system had just 55 days cash on hand—six months later, he became the CEO, and today Van Gorder helms a $3.1 billion system that for 10 consecutive years has ranked as one of Forbes' top 100 employers in the country. Here are his three tips for leading transformation.

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1. Earn employees' trust

According to Van Gorder, leaders must establish proper communication with employees to foster trust and build a foundation for change.

To do so, Van Gorder developed an advisory body he called the "Physician Leadership Cabinet" to act as a liaison between the clinical staff and the administration, fostering greater transparency throughout the organization and enabling physicians to take part in making key decisions. In turn, physicians' greater responsibilities in managing the system's limited resources helped them appreciate the system's difficult financial situation—and improved communication between them and Scripps' leadership team.

"It's really easy to say, 'I want, I want, I want' when you're on the outside," said Van Gorder. "But when you're on the inside, you realize how difficult it is to manage scarce resources." And the cabinet, Van Gorder said, continues to be a success: The system's leadership team has agreed to every recommendation the panel has made, and every vote but one has been unanimous.

2. Drive culture change from the middle up

With trust established, leaders must focus on culture change—and Van Gorder believes managers are best positioned to enact that change, as they supervise the vast majority of the organization's staff. "Leaders can't write a memo to change culture," he said. "But our frontline employees and middle management can influence culture."

So Van Gorder created the Scripps Leadership Academy, a year-long program that aims to show managers how leadership runs the organization and makes decisions. Every class begins with a two-hour Q&A session during which participants learn about the personal background of the C-suite—a key part of the program that Van Gorder says helps humanize people who might just be known by their formal titles.

Over the course of the program, each class participates in a change program designed to improve a particular part of the organization. And at the conclusion of the leadership program, Van Gorder exhorts participants—whom he calls "agents of culture change"—to use what they've learned and demand more from their colleagues.

3. Maintain regular communication

According to Van Gorder, transformation isn't a single event—rather, leaders must continue to foster a positive relationship with staff to maintain any improvements in trust and culture.

For his part, Van Gorder says he issues a daily newsletter to the managers and employees who've asked to receive it. The newsletter features key news for the health care industry, as well as updates and photos for Scripps itself.

"Even if they just read the titles, they'll start to understand the external factors impacting our organization," said Van Gorder. "The more they understand this, the more they'll accept the changes we're trying to make in our organization. They'll see it's not something forced on them from management—it stems from the changes in health care."

Van Gorder also encourages his employees and physicians to speak with him directly if they believe they're not getting the support necessary for them to do their work, or even if they just want to chat. And he also makes a point to respond to every email he receives within the same day.

"One of our values is respect," he said. "If I'm not responsive to them, I'm not being very respectful." (Bean, Becker's Hospital Review, 5/31).

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