Trinity Health is the fourth-largest Catholic health system in the United States by operating revenue. The organization had $6.7 billion in unrestricted revenue in fiscal 2009 and employs 47,000 full-time-equivalent employees across nine states in more than 450 facilities, from hospitals to outpatient facilities to home health care and hospice programs.
The overarching challenge facing Swedish is building a uniform brand and image of Trinity Health across the organization’s entire footprint and promoting consistent execution around that brand image. In other words, Swedish has had to get thousands of managers and physicians to think, at least in some part, like businesspeople.
It can be difficult to get executives in the health care field to think like businesspeople. In the world of business, change is constant, calculated risk-taking is generally viewed as a noble pursuit and mission statements are often boiled down to a couple of quick-hitting sentences that can easily fit on a plaque in the lobby.
In health care, it’s not quite the same.
“One of our main challenges in this industry is that historically, at least as far as what I believe, it has been a risk-averse industry,” Swedish says. “There are a lot of reasons for that, and many good reasons. In health care, you can’t latch onto the deal of the day. Change is based on evidence, and sometimes that can get in the way of taking risk. So developing an identity as risk-takers was very important to our standing in the industry.”
Changing the mindset of the organization meant changing how Swedish and his leadership team communicated with employees throughout the organization and how they created alignment with people at all levels and locations.
“I had to develop a plan of attack to overcome this,” Swedish says. “In my career, I’ve specialized in complex, multihospital environments, and over that time, I’ve come to realize that there is probably no more powerful word regarding the management scale than ‘unity.’”
His efforts over the past six years have helped a unified brand take root at Trinity Health and have helped the health system become a growing organization and top performer in its industry.
“We have a clear direction flowing from our strategic plan,” Swedish says. “We have a strategic construct that is well understood throughout the organization. I believe that after six years, we have created remarkable success (and) also a recognition that a never-ending pursuit of excellence keeps us on a path that is straight and narrow as is possible, notwithstanding the economic turbulence that surrounds us.”
Here are the principles that helped Swedish create a more unified culture.
Start at the top
If you want to bring a new brand to life, you need to define what your brand will stand for. In order to do that, you need to set the example from the top. Your managers and employees will breathe life into your new image, but they won’t be able to take a first step without a detailed and workable plan of action from upper management.
When Swedish first took over as president and CEO of Trinity Health nearly six years ago, he quickly identified the people who needed to hear his vision first: the people on the top level of the organization along with him. Those are the managers he could hold directly accountable for accepting and promoting his future vision for the health system.
“Early in my career, our key executive leaders totaled probably 40,” Swedish says. “I first had to communicate my beliefs and my definitions of leadership, my standards of excellence as a new CEO, and then I put the questions to them. Given what they now know of what they represent and knowing my expectations of what success looks like, how do you establish this culture imperative that leadership first strives to understand, and then strives to achieve?”
He wanted to take ownership of the transformation of the company.
“Obviously, I had a lot of influence behind the design and the thinking of it,” he says. “I wanted to provide them with the guidance that would get all of us to a common understanding of our destiny as an organization.”
The ultimate product of Swedish’s collaboration with his direct reports was a brand definition known as “unified enterprise ministry,” known commonly throughout the organization as UEM.
“Unity is a standard that we strive for, to help overcome this natural disconnectedness of a large-scale organization,” he says. “The word ‘enterprise’ was carefully chosen — that tells you it is all about complex organizations taking risk, which has historically not been a goal that health care organizations have strived for. Ministry, by definition, means to serve. As a faith-based organization, that is a very critical statement of fact and commitment. So when you put that all together, the unified enterprise ministry is our brand, and it represents our culture as risk takers with a desire to overcome the natural fragmentation that occurs in large organizations.”
Strive for clarity
When you’re taking your organization in a new direction, Swedish says you should expect three questions from your employees.
“I tell my leadership team that they should always be prepared to answer these questions: ‘What about me?’ and, ‘What about me?’ and, ‘What about me?’” he says. “When it comes to communication, you need to start with the belief that it is all about how you treat people. The expectations that you communicate spread throughout the entire organization.”
With that in mind, you need to focus on delivering clear messages and doing so repeatedly through all of the channels available to you. If your communication loses steam over time, the message will fail to take root, and you could jeopardize your new strategy entirely.
“Once you’ve established the importance of treating people well, the second essential point is to remember that no amount of communication is ever enough,” Swedish says. “Effective communication will get you to a point where you maybe have achieved meeting your plan and expectations, where you’ve met those initial goals that you had established. But it’s remarkable to me how quickly success devolves into failure because you don’t maintain the level of intensity that you had when you first started communicating. That’s why no amount of communication is ever enough. You can’t stop.”
After you’ve established a sense of clarity and a method for driving home your core messages on an ongoing basis, you need to find new ways to reach your work force. Putting your shoes on the ground and visiting all of your offices is the ideal way that most leaders would like to communicate, particularly on matters that affect the whole company. But it’s not always realistic. You can’t be everywhere at once, and you can’t be the lone conduit through which managers and employees at different locations can share ideas and best practices.
That is where technology comes into play. With the growing popularity of social networking tools such as blogs, Facebook and Twitter, modern business leaders can reach employees with essential messages in many different ways. Over the past six years, Swedish has taken advantage of the entire spectrum of social networking opportunities that are available.
“Technology has evolved to the point that we are now working with multiple media outlets,” he says. “That’s the third point. In our organization, we are now challenged with the implementation of our best practices around social networks and how that can help create better relationships with both our associates and our external customers — be they patients, families, physicians or vendors. It has always been about effective use of technology. Earlier, it was printed-word mediums like newsletters. Now, it is about technologies and Internet-based approaches that support social networking.”
Be a strong leader
Leaders all need to have a common set of traits — including passion for the work and integrity — in any initiative. But especially if you are promoting change, your passion for your new initiative must show through to be successful. It’s something that Swedish had reinforced to him as he advanced Trinity Health’s new branding foundation.
“As CEO of an organization, you’re not just selling a product,” he says “You’re building a sustainable culture. I think our lesson learned as leaders is that successful organizations have a culture that is clearly identifiable and nurtured.
“I think a lot of organizations limit their ability to create a sustainable culture because they’re only focused on the technical and process aspects of cultures, and therefore, they create limitations on the ability of communication to sustain and advance the culture. It goes beyond the technical and process aspects to strategy and structure, and supporting the culture with well-defined strategies and structures.”
Sustaining and advancing any new initiative comes back to authenticity, which is another key to being a strong leader. Your managers and employees need to know that your desire to keep them informed and involved in building the company’s new direction is something real, not a front you’re putting up to placate them.
Especially as the economic challenges of the past two years have, in some cases, placed additional strain on the relationship between management and employees, you need to realize that the people in your organization will be extremely sensitive when it comes to information disclosure from management. If employees and lower-level managers get the sense that you aren’t telling all there is to tell, their willingness to follow you down a new path will erode, and you’ll find your credibility damaged.
“The engagement of the CEO and all of senior leadership leverages off of — and this is critical — being authentic,” Swedish says. “Putting yourself out on the point requires an authentic executive able to present clarity of purpose and strategy and an understanding of tactics.
“On top of that, associates today have their antennae up with regard to validating that their leaders are authentic. The converse is that you’re disingenuous and people will stop listening to what you say. So that authenticity really drives a sustainable culture.”
But where the great leaders separate from the merely adequate leaders is at what Swedish calls the “uncommon traits.” The ability to project ambition, to aspire to something larger than simply turning a profit, and to provoke a sense of urgency throughout an organization, all of these traits help drive a brand, a culture and a work force beyond the commonly understood must-have traits for business leaders.
“And, on top of that, being a risk-taker,” Swedish says. “Being unafraid to fail. The leaders that I have observed and respected throughout my career are not afraid to fail and, therefore, are innovators and creative minds, which plays into the final uncommon trait, which is the absolute necessity to execute. When it comes to new initiatives, 95 percent of the effort seems to be in the planning. Where most businesses fail is in the final 5 percent, which is execution.”
How to reach: Trinity Health, (248) 489-6000 or www.trinity-health.org