Douglas McNeill coaches culture at Atrium Medical Center Featured

8:00pm EDT May 26, 2009

Douglas W. McNeill knows better than to think that one day he’ll hear a magical click as his corporate culture snaps into place.

More likely, he’ll spend his entire leadership lifetime making tiny adjustments to keep the 1,913 employees at Atrium Medical Center on track. The president and CEO even has a name for those little nudges, and identifying those “coachable moments” is a key component to how he develops his employees every day.

Sure, caring for patients is inherent in the health industry. But McNeill — who served as the president and CEO at Middletown Regional Hospital for 14 years before it moved and donned the name Atrium in December 2007 — realizes that you have to care for employees, too. By staying on the lookout for learning opportunities and encouraging his employees to adopt the same awareness, he can keep them equipped with the tools they need.

“Culture is not like making a cake, [where] at the end of adding all these ingredients, you have a final product and you’re done,” he says. “Culture is really a lifelong exercise because circumstances, the environment, the organization and different generations of people are changing all the time. And therefore, organizations have to keep adapting.”

McNeill — who led Atrium to 2008 revenue of $233 million, up from $184 million in 2007 — keeps communicating the expectations that shape the changing organization.

But it’s not just lip service. After all, he’s not the kind of coach that orders his team to run laps while he loafs on the sidelines.

“The most effective way you teach people after you set the expectations is walking the talk,” he says. “They’ve got to see you do it. And then you have to take a genuine interest in helping others along the way.”

Find employees who fit

Atrium’s culture begins with employees who embrace the values of service, respect and compassion. McNeill calls for help to find them, drawing several people from his staff into group interviews.

“It’s helpful to involve people where a candidate may end up working and to involve, also, people at the highest level,” McNeill says.

For example, registered nurses who apply at Atrium may interview with their potential manager, other nurses they’ll be working with and even the vice president of nursing. The variety and amount of interviewers will paint a more complete picture of the candidate than one or two isolated conversations.

Besides the traditional questions about aspirations and expectations, McNeill and his team look for a cultural fit during those interviews.

“The key is really making sure that they embrace our values,” McNeill says. “We talk to them in terms of, not so much, ‘Is this a value that you can identify with?’ but really talking to them about their experience and how they can express those values and how they have expressed those values in prior work experiences.”

So rather than asking general questions like how they work with other people, ask for specific examples, such as how they reacted to a conflict with a previous co-worker. Current employees can pull other questions from their recent experiences.

“Several nurses might take a recent example of how we were dealing with a patient and a really concerned group of family members,” McNeill says. “[The nurses ask] how they would deal with those kinds of situations, how they’ve dealt with them in the past. It’s almost like a conversation.”

You should inform the candidate about your company, your culture and your values, as well. The interview is your first opportunity to begin setting expectations and requirements for new employees. But it shouldn’t just be a forum for you to preach about how you do things at your company.

“Really, what we try to do in these interviews is allow the candidates to do most of the talking,” McNeill says. “We’re really trying to learn from them how they’ve applied their life experience as they’ve dealt with opportunities that have been successful and those that haven’t, and what they’ve learned from it, what they’ve applied from those experiences, how they think that those experiences might apply this time.”

While new hires must adhere to the same set of values, McNeill treasures the diversity in how they apply them. In the same way, you must corral a group of individuals under the common ground of company standards.

“People come in many different packages. That’s OK. It’s not the package that separates one from success,” McNeill says. “Every package has the potential of embracing the right attributes. You’ve got to have a passion for helping other people.”

Coach employees to coach each other

McNeill’s passion for helping other people isn’t like a surgeon performing brain surgery. Instead, he’s more like an ever-accessible first-aid kit, mending his employees’ daily bumps and bruises.

“We’re all about helping people, and part of that definition is coaching and mentoring folks, helping people grow and learn,” he says. “And people grow and learn probably more from making mistakes than from success. So what we’re trying to do is find these little teachable moments.”

While annual evaluations can check employees’ general progress, more meaningful lessons are spurred by everyday behavior. McNeill watches employees interact with each other and with customers to find opportunities for adjustments.

“It is more often outside of the formal evaluation process, where we have opportunities to take a manager and say, ‘I was in that meeting that you led the other day; how did you feel the meeting went? What went right? What didn’t go so well? Here’s what I saw.’ Every day there are lots of opportunities.”

During his rounds one morning, for example, McNeill noticed a nurse struggling to communicate with a patient’s family. So he pulled her aside and asked her to switch roles, imagining herself as the family and considering how she would like to hear the news.

“Part of our job as leaders is daily helping find those coachable moments and act on them,” he says. “And frankly, the sooner you can act on those moments, the more meaningful they are.”

But you can’t spot every opportunity for improvement, nor do you have time to tend to every employee. So encourage managers to step in and coach each other and have them do the same with their employees.

Pay attention to which employees tend to socialize together in order to pair up employees who are already comfortable with each other. Then encourage stronger employees to offer insight to their struggling colleagues.

“If you can have someone that you trust and who is not threatening help you along or at least ask the right questions, make you think about it and weigh one approach over the other, those are the best moments,” McNeill says.

He guides employees through the conversation in three steps. First, ask how your co-worker feels about the decision he or she made and whether he or she would have done it differently.

“We’re always asking the question, ‘Now if we had that one over to do again, how would we have done it better?’” McNeill says. “And I think that that kind of nonthreatening discussion leads to a lot of growth.”

Second, pull examples from your own experience to illustrate a different scale for measuring the options. Explain not just what you did, but why you decided to do it.

“Say, ‘Hey, you know, here’s how I kind of sized it up. Here’s what you might have said instead,’” he says.

Finally, ask for feedback to make it less like a confrontation and more like a conversation.

“Say, ‘Well, what do you think? What are the pros and cons of that approach?’” McNeill says. “And so, in a way, it’s more intellectual and didactic than confrontational.”

These conversations aren’t necessarily about correcting behavior with the right answer. They’re more about opening employees up to other perspectives.

“Having robust discussions about the different approaches we took in certain situations leads to a lot of enlightened thinking,” he says. “A lot of it, too, is just developing the experience and judgment that you can apply. What we’re trying to do is just elevate our fund of common sense and judgment, and we do that by spending a lot of time talking to each other about stuff that’s happened.”

Because other employees could be struggling with similar issues out of your sight, don’t let teachable moments become isolated incidents. McNeill takes examples back to his executive meetings for them to share with their teams, as well.

Ask for feedback

When you make learning a continuous process, you need to balance it by constantly asking for feedback to make sure your lessons are getting through.

This is an obvious step if employees are clearly not meeting your expectations. Asking for their input may help you distinguish between an employee who doesn’t fit the role and one who just doesn’t understand the expectations.

“More often, you will find that it’s either a situation of clarity — they didn’t know what they were supposed to be doing — or they thought they were supposed to be doing something and it turned out to be different,” McNeill says.

“Perceptions have to be aligned with your intentions. And the only way you’re really going to know is to continuously solicit feedback.”

After meetings, for example, McNeill asks for reactions when he runs into people, asking what was clearly articulated and where the ambiguities lie.

“It can be as direct as, ‘What’d you think of the meeting?’ or, ‘What’d you think of the message?’” he says. “And then you say, ‘Well, why? Why did you think that?’ Another key to developing people is always asking open-ended questions.”

But the communication loop still isn’t complete. If you ask for employees’ feedback, you need to use it. For example, they may fire back ideas about how to improve your message or your delivery of it. And those suggestions can’t be ignored.

“Your critics can offer you a very valuable service if you take it constructively and not make it personal,” McNeill says. “Think about what they’re saying and why. Put yourself in the shoes of the critic; why would [he or she] see it that way? Try to understand it from a different perspective.”

And even if employees’ ideas won’t work, you need to let them know why so they don’t think they’re going unheard.

“Usually, the biggest problem you have is someone will say, ‘Well, this is what I think.’ And then if you don’t do it, the common reaction is, ‘Well, they really didn’t listen to me,’” McNeill says. “So … get back to people and say, ‘Thanks for your idea. We tossed it around. This is where we came out. Here’s why.’”

This final step can be done formally. At Atrium, for example, submissions to the suggestion box are printed in the newsletter with answers. But informal personal responses can be even more effective — whether you discuss it at a departmental meeting, send the employee a follow-up note or just stop the person in the hall.

“Look, leadership is a team sport,” McNeill says. “And yeah, there’s only one CEO, but the CEO’s prime responsibility — in addition to serving customers — is to develop a strong team. So you’ve got to learn how to be a good team member. Part of being a good team member is developing this trust so that you can talk candidly about what went right and what didn’t and how you fix it.”

How to reach: Atrium Medical Center, (800) 338-4057 or