The health care industry’s transformational, irreversible changes make it clear that hospital-centric, disease-focused, acute episodes of care are not the future. This is creating confusion for caregivers on the front lines, who may no longer understand their roles or how to apply their knowledge. As board members, executives and physician leaders begin to rethink how and to whom care is delivered and how it is paid for, many are asking how to create high-performance organizations.

The answer is to design a delivery system that connects all of the people in it with a single purpose. “Purpose is not a strategy or a goal, although it is a powerful attractor for meaningful strategies and goals,” say Robert K. Cooper and Ayman Sawaf in Executive EQ, “it is the fundamental aim of your existence and your organization’s existence.”

Sustainable success demands clarity of purpose and a fully engaged workforce. When leaders create a culture that unleashes the potential of highly talented staff for the benefit of the individual and the mission, the organization achieves high performance.

In On Becoming a Leader, author Warren Bennis identifies three characteristics of leaders, each of which drives the process of connecting people to purpose: “The first basic ingredient of leadership is a guiding vision. The second basic ingredient of leadership is passion. The next basic ingredient is integrity.”

Northeast Georgia Health System, Baystate Health and Rush University Medical Center all have leaders who embody those characteristics and have created engaged, passionate cultures that deliver high performance.

Living the mission. Carol Burrell, president and CEO of NGHS Health System, Gainesville, embodies Bennis’ three characteristics. She believes that the Gainesville system’s continued success is anchored in the fact that “the NGHS mission and our core values are what we live every day, and are tied directly to our strategy and operational tactics.” She adds, “Leadership’s vigilance in living the mission and values is the reason staff are not just satisfied, but fully engaged — they understand their importance in our commitment to the community.” Interestingly, Burrell notes that the hardest lesson she has learned as a CEO is to “stay after the culture and to call out any variation in behavioral expectations. It takes constant discipline and focus.”

With a leader like Burrell, an organization develops a strong corporate culture. Corporate culture is the organization’s personality and is strong to the degree that all behaviors are driven by a core set of values. In Corporate Culture and Performance, authors John P. Kotter and James L. Heskett make a compelling economic argument for a strong corporate culture and high performance. Their research found that over an 11-year period, firms with strong corporate cultures increased revenue by 682 percent vs. 166 percent for firms with weak cultures, and improved their net incomes by 756 percent vs. 1 percent.

Strengthening culture. Andrew Artenstein, M.D., chair, and Jack Bailey, executive administrator, of Baystate Health’s department of medicine, led an interactive culture-strengthening change process at the Springfield, Mass., system that engaged all of the elements and staff within the department. This process resulted in the following six guiding principles:

1. Our No. 1 priority is to serve patients with clinical excellence.

2. We treat all patients, families and members of the health care team with respect and dignity at all times.

3. We make every effort to see patients when they need or want to be seen.

4. Our patients will know what to expect.

5. We work as partners in our patients’ care and exceed their expectations.

6. Every member of the health team — both clinical and administrative — is empowered to ensure that we consistently adhere to our guiding principles.

Designing a new vision. In 2013, Rush University Medical Center CEO Larry Goodman, M.D., and President and Chief Operating Officer Peter Butler initiated a seven-month comprehensive process to develop a new vision for the Chicago system, which resulted in a renewed mission, values and an inspirational new vision. The journey began with the board and senior leadership of all major clinical, academic and corporate departments engaged in strategic thinking exercises.

Throughout the process, board, executive, physician, nurse and other leaders presented a consistent message that the future will be built on Rush’s historically strong culture, and that everyone associated with the system will understand why the organization is moving in that direction and how each fits into this new future.

Positioned for High Performance

Theoretical and applied data about successful, sustainable high performance always comes down to these questions: Is everyone connected to the purpose or mission of the organization? Are our decisions and behaviors driven by our core values? Does everyone see him- or herself as an important part of achieving our vision? And perhaps most importantly, do all trustees, executives and staff see their work as a job or as a calling? 

View Rush University Medical Center’s vision process timeline and mission at

Thomas A. Atchison, Ed.D. (, is president and founder of Atchison Consulting LLC, Le Claire, Iowa, and a member of Health Forum’s Speakers Express.

Key Questions for Trustees

1 Does our organization have a strong, supportive culture?

2 Do we have clear, attainable goals directly tied to our mission, values and vision?

3 Are we led by a visionary CEO who is able to drive transformational change by communicating the bond between people and purpose?

4 Do our board meetings regularly discuss the metrics of our strength of culture and the success of the change process?

5 Do our internal and external communities see themselves as active and engaged partners in the change process?

6 Are the executive and clinical leaders of our organization able to quickly confront, educate or eliminate any individual who behaves contrary to our culture?

7 As trustees, are we committed to always achieving higher levels of performance and never allowing the compromise of our mission, values and vision? — T.A.A.