Background
TriHealth, Inc. is an 1,100–bed Cincinnati-based healthcare system comprised of two major tertiary-care hospitals, more than 9,000 employees, 2,000 physicians, and 1,600 volunteers, all dedicated to delivering personalized, compassionate care at more than 50 locations, including two hospitals, two inpatient Hospice locations, physician offices, plus fitness, rehabilitation, occupational health, and outpatient centers.

Founded in 1995 as a joint operating agreement between two hospital systems that included three leading acute-care hospitals, the organization spent its early years undergoing a significant financial turnaround, which included closing one of the hospitals.

By 2003, TriHealth experienced positive operating margins and was being recognized for its success, repeatedly being named a Solucient Top 100 hospital, one of Cincinnati’s “Best Places to Work,” a top employer nationally by Working Mothers magazine, one of the top 100 “Most Wired, ” as well as one of the top 25 “Most Wireless” hospitals.

The Burning Platform that Drove the Change
Despite these achievements, TriHealth executives saw an opportunity to accelerate their success by transforming the organization into a true “health system.” Part of this transformation included growth. TriHealth completed a $150 million expansion at one of its hospitals, which increased inpatient capacity by 45% and took it from what was once a small community hospital to a 400-bed tertiary-care facility and the area’s second busiest adult trauma center. Simultaneously, the other hospital underwent a $122 million modernization and expansion that included a new 10-story tower and a new national training site for robotic-assisted surgery. In addition, a new $31 million state-of-the-art ambulatory center opened in the rapidly expanding northern region.

But to complete the transformation into a premier health system, TriHealth needed to do more than just get bigger. It needed to develop a more performance-based, strategy-driven, quality-focused culture.

This was no small feat to achieve within the complex operations of a large, multi-facility, and rapidly growing healthcare organization. The system’s business units are very inter-dependent, yet often lacked good ways to coordinate efforts. The larger the system, the more complex these problems can become.

Aligning the business units with TriHealth’s strategy required that executives first clarify the strategic objectives and then deploy them in such a way that the complex workforce would understand the objectives. To reach this end, employees would need to clearly see how their individual efforts aligned to the system goals and the goals of inter-dependent departments. They would also need to feel “bought in” to the way they would be measured and ultimately feel personally accountable for their portion of the organization’s success.