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Change Management


Recovery room



How Patricia Maryland enables her employees to help her steer St. John Health System through a down economy

By Erik Cassano


Smart Business Detroit | September 2009

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From the start, Patricia Maryland knew it was going to take a team effort.

In early 2008, several months into her tenure as president and CEO of St. John Health System, Maryland and her leadership team had crunched the numbers, taken a long look at the downward trend of the Michigan economy and arrived at a hard-to-swallow conclusion.

“I had to launch a transformational effort almost immediately,” Maryland says. “Specifically, I had to trim about $85 million in operating expenses in order to move the organization to a reasonable operating margin.”

It was a problem without a simple solution. Expenses needed to be reduced, which would require the elimination of some jobs, but Maryland and her management team also needed to develop creative ways to increase revenue.

At the center was Maryland, who was charged with uniting the entire St. John organization and keeping its nearly 17,000 employees focused on the health system’s core mission of patient care — and do it all as the system underwent a metamorphosis, becoming leaner and more able to weather the oncoming economic storm.

“Believe it or not, out of the challenge came major opportunities,” she says. “I was able to bring together the leadership team and management at all levels of the organization and look at some things we could do differently to address our needs. We put together teams of individuals that we felt had the talent to think outside the box a little bit and who weren’t uncomfortable with looking at their own operation from a different viewpoint.”

Maryland needed to form a new mindset, she needed people throughout the organization to embrace that mindset, and she needed new ideas on how to improve the system’s budget.

Maryland wasn’t just facing a budgetary issue. She knew that to truly make the health system run more efficiently and effectively, she needed to perform a cultural shift.

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