Full transcript

Anika Rasheed: Welcome to the Strategy Catalyst Dispatch, a podcast from the Strategy Catalyst team at the Health Management Academy. I'm your host, Anika Rashid, senior analyst, and each episode we'll delve into the trends and insights shaping healthcare strategy today.

Let's dive in. Okay, so staffing gaps, widen margin shrink, and your system's workplace culture goals get deprioritized, But in U.S. hospitals, the average turnover rate for registered nurses is hovering around 16.4% in 2024. And the cost of replacing one staff nurse just climbed to over $61,000. So, what this means, culture isn't a nice to have. In today's environment, it can be the difference maker.

At Wellstar Health System, they've done something special. In this episode, Chief Strategy Officer Matt Terry tells us about how they've positioned culture as a strategic pillar complete with funding, metrics, and enterprise ownership directly tied to their other pillars. This episode is about turning something intangible into infrastructure.

My colleague, Tucker Doherty, associate director on Strategy Catalyst and author of our newsletter, The Strategist, sat down with Matt to unpack how Wellstar is making culture, measurable, fundable, and operational.

Tucker Doherty: Let's jump right in then. Matt, thank you for joining us.

Matt Terry: Of course, Tucker, happy to be here.

Tucker Doherty: So, culture is often described as a strategic priority, but it's also not where most systems say they're putting their dollars. How has Wellstar approached making that culture visible and fundable within your workforce strategy?

Matt Terry: Yeah, so Tucker, a couple of things to answer that question.

So, we've actually put culture as one of our five themes in our strategy. So, it's out in front. When we talk about strategy, culture is just as important as when we talk about our communities that we serve, the connections that we create, and the care models that we develop for our patients.

Like I said, it's not just a priority, it's a strategic investment, and we apply that same level of rigor to culture as we do to recruitment or physician alignment. That means really both scanning the internal and external environments, learning what's happening in the marketplace today, servicing ideas that move us toward our vision, and then evaluating them through the lens that our people are our greatest asset. And part of that is to make sure everybody has a chance to provide thoughts and ideas around how we can advance our cultural investments within WellStar today.

Tucker Doherty: So, you mentioned that culture is a strategic pillar in itself in your strategic plan. But culture also impacts every other part of the organization and has impacts on other parts of your strategic plan: the digital transition, the shift towards outpatient care. How do you view culture as interfacing with those other strategic priorities?

Matt Terry: Yeah, and that's a great question and we really built our strategic plan and our five themes to really support each other, right?

We have culture. We have connections, which is about identifying and building front doors and access to Wellstar. We talk about our consumers and really focusing on how do you develop the services and programs in a manner with which the patient wants that care, when they want that care, where they want that care and how they want that care delivered.

We have care model, which is really focused around the teams and how we develop our primary care and specialty offices to work cohesively. And then finally we have our communities, right? And we're the largest employer in many of our markets. And then how do we make sure we are fulfilling our commitment as a health organization and employer of choice to those communities?

And so, they all feed off each other and provide what I would call direction. So, the culture absolutely helps direct how we're going to do our community investment and growth. It's how we look for partners in the community that have a similar culture and mission and vision around treating patients.

The culture is inherently involved in how we develop those care model teams, right? They're going to be providing our, kind of our customer promise in ways that are consistent with Wellstar’s vision and experience factors. The culture is around how we develop our sites of care. And so, when we talk about the move to digital, more and more people want that care on a real-time basis.

So, the culture we're building is one around real-time response and ability to get you in as fast as possible and answering your questions as soon as we can. So, I see it Tucker that we're building our kind of the culture within Wellstar to start to develop and be much more outward facing and external facing.

That people, when they come to a Wellstar facility, or a physician or a nurse, or whomever, that first time they see that and they stay because they know they're going to get the answers they want, the care they need, and the quality that they deserve.

Tucker Doherty: So, when near-term needs like recruitment or physician alignment are competing for attention, how have you kept the long-term culture transformation on the agenda?

Matt Terry: Yeah, so we have a process in place today where we do what I would call a strategy refresh every year. And so, we have existing work teams that are focusing on our five themes on a constant basis. So, we've created the process in which, if there are short term needs and strategies to respond to, we have the people in place to respond to that and to secure funding.

From a long-term perspective, right, we've backed that belief with real investment. We look at competitive compensation, market-leading retirement contributions, and differentiated wellness benefits.

So, programs like Spring Health, which is a mental health app that people utilize and have that for free over the course of the year. We have concierge services. We have our own internal wellness team as well to support the whole person. So it's not just about the dollars, Tucker, it's about making that culture tangible and sustainable for our colleagues.

Tucker Doherty: Makes sense. You're describing culture not as something aspirational, but as something funded and operationalized, just like any other part of strategy. You mentioned a few tangible investments that make it feel real for staff, from wellness programs to market leading benefits. What metrics or signals then do you find most credible for demonstrating that cultural change is actually taking hold in ways that matter to, say, executives and boards.

Matt Terry: Yep. So, Tucker, I mentioned our strategy. So, we have developed a dashboard that we actively use to measure progress against our five themes. And since culture is an existing theme that we utilize, we look at both retention and then we look at our Great Place to Work scores. And both of those are what we hang our hats on regarding culture. We've seen meaningful improvement in our retention thanks to our investments in compensation, development and wellness. And Great Place to Work gives us a real-time feedback from our team members.

Tucker Doherty: So, tell me about some of your most needle moving initiatives then for decreasing turnover. How are you tracking that return on investment, and what kinds of returns have you seen?

Matt Terry: When we look at turnover, we look at, you know, nursing and MAs. Basically all the kind of the main positions across our organization. And because we have that metric that we track on a quarterly basis, we're able to kind of see when there's moving across either one of our hospitals, maybe below par, or one of our practices. So, what we've done is, that data helps us then be able to respond in real time.

And so when we start to see some of that, we then kick up some of our outreach efforts, local college and universities, we maybe start to increase the promotion marketing around Wellstar as a system. That's a great place to work. So, we've got things in place that we can pull those levers, Tucker, when we need to, when the data tells us we may be lagging in a certain area.

Tucker Doherty: When we've spoken to other CSOs on this topic, sometimes we hear that culture can be a bit nebulous. Do you think these metrics really help you make it tangible or are there still parts of it that are hard to measure? Hard to nail down?

Matt Terry: Yeah. data's only good when you can measure it, right?

So, I would say, this is a good first step or even a second step. I mean, we've been using Great Place to Work for a while now. And it's really kind of informed us about some of the investments that we've made or need to make to maintain employees. It still is nebulous and we find is that you cannot over communicate.

So, when we talk about the focus on retention and the focus on our employees and colleagues, that is part of a weekly newsletter that we send out. It's part of every sort of meeting that we have around strategy. So, we try to make sure that that's ingrained in the culture and the philosophy of the organization from the top down to the workers on the floors.

Tucker Doherty: That makes a lot of sense. You're describing how measurement and communication reinforce each other. The point about it being impossible to over communicate is an important one.

Do you have any anecdotes from a time where you saw something happen and you either said, “Oh man, our culture investments really paid off. I'm glad we did that.” Or conversely, something that you see in the organization and you're like, “Wow, I really wish we had been investing in culture earlier in this area?”

Matt Terry: Yeah, I think there's two examples of that, Tucker.

So, we do an annual Leadership Wellstar Day, in the spring where we all the kind of directors and above come together and we look back at the successes of the year. But more importantly, looking forward to what we want to develop and continue to grow on our strategy.

And we also have an internal leadership academy where we nominate, both physicians and APPs on the clinical side as well as current kind of management folks in the director manager level, that helps them develop the skillset to grow and to develop and to mature into higher, levels of management within the organization.

And both of those are important. And we can see the culture is pervasive throughout those, because what you hear about in many of those events is the folks who have been here for a while and stay and then help promote and engender those efforts and the investments to their employees and their colleagues at Leadership Wellstar Day.

And then on the academy side, just seeing kind of breadth of talent that we've been able to acquire and attract has just continued to increase, again, in my limited time here at Wellstar. But I would say both of those are clear reflections of a culture we're building that's around sustaining and supporting the folks that we bring into Wellstar. And then inherently, how do they share that with the patients that we serve in the communities that we serve.

Tucker Doherty: Those are great examples that really make clear how those traditions reinforce the kind of continuity you've been describing.

Shifting gears a bit, partnerships are a huge strategic lever for a lot of health systems. Which partnerships have been most valuable in shaping your talent pipelines or decreasing turnover or other elements of culture?

Matt Terry: Yeah, and we've got a few different areas of our buckets, I would say, of partnerships. Tucker, Internally, our business HR folks and our operational leaders have been incredible partners in building career care, which is really about helping people and the organization identify other opportunities within Wellstar, which they can hire, and apply for. And we provide some of the training educational experiences to get them helping to move vertically throughout their organization.

And we've streamlined rapid hiring for critical roles. Externally, we've done several things. We've built strong academic partnerships with Kennesaw State, we now have our partnership with Augusta University, as part of the Augusta University Health System that we've acquired over the past 18 months.

And we work with many technical colleges like West Georgia Tech and Chattahoochee Tech that helps us start to really program and develop our areas around MAs and other kind of, rad tech roles itself. We also work with Guild for prepaid tuition and Stride for CRNA pipeline. And then the community Tucker, we've collaborating with innovation academies and local high schools, and even into junior high schools to start to get the word out around, hey, healthcare is a great field, a great organization, a great industry for people to, to join and to work on, and what makes it fun for those students and kids.

And then through our WellStar Foundation, we've received generous support from organizations like Georgia Power Trust and Microsoft all helping us invest in skill building, in wage growth in underserved communities.

Tucker Doherty: As we wrap up our time together, my final question is this: If you had to boil down your advice for other CSOs and list the top three things health systems can do to strengthen their culture, what would they be?

Matt Terry: Three pieces of advice around culture, that I would offer to my colleagues…

I think first and foremost it's inclusion. So, what we've learned, as we've developed the strategy and focusing on the cultural piece, we try to bring as many folks as possible in terms of, different areas of the organization. So clinical, financial, HR, our medical group, because I think having the variety of different viewpoints is important.

So, the more we've done in terms of including people on decisions as well as generating ideas has been important. When we do a lot of training, we try to be consistent in our training approach. So, if that's through new employees when they join, we also do a yearly, what I would call update on what's happening at Wellstar.

We have consistent messaging that is resonating across the organization. So people, whether they're new, have been here for several years, have learned the language and learn how we communicate and learn the important parts. And they then help teach as well, right? You teach 'em how to fish, not just give them fish.

And then thirdly. I just think the importance that we've learned about having culture specifically called out as part of the strategy is important that does not get left behind. Because to your point earlier, Tucker, sometimes it gets lost in the other, the things that we're focusing on a real time basis or some of the longer-term financial goals or growth goals.

But we've called it out and I think having that called on as a specific focus area within strategy has been an important part to kinda keep that top of mind. And that way it then it becomes consistently involved in all of the conversations we have around growth and investment and quality and how do we do right by the patient.

So I think those are the three things, Tucker, I would say have worked well for Wellstar as we look at culture and how to continue to build our culture.

Tucker Doherty: Thank you so much for joining us today, Matt.

Matt Terry: Thanks again for the time.

Anika Rasheed: What stands out in this conversation is how deliberately Wellstar has positioned culture as the connective tissue running through everything else they do. Matt described culture as one of the five strategic pillars and that's a powerful statement about accountability.

The throughline in Matt's message is that culture needs the same rigor and visibility as other strategic investments. And data is important. They use data to catch early signs of strain, but it's more than staff surveys.

We also heard how they've put some real structure behind it. Programs to support internal mobility, partnerships with universities to build future pipelines, and wellness investments that make supporting the whole person something measurable.

I think there's this underlying connotation in healthcare that working in healthcare just is hard, that burnout, turnover, and disengagement are inevitable costs of the mission. But Wellstar is challenging that notion. Culture can live in systems, funding decisions, and the cadence of leadership conversations. And systems that make that culture measurable and fund it like infrastructure are the ones that are building resilience for whatever comes next.

That wraps up this episode of the Strategy Catalyst Dispatch. If you have thoughts or comments, we'd love to hear them. Please email us at StrategyCatalyst@hmacademy.com to share, and don't forget to check out other resources from The Health Management Academy on our website, hmacademy.com. That's it for this dispatch.

Thanks for listening.