A Whole Organization Culture Change

The CEO of a mid-size hospital saw the impending health care funding crises and recognized that by improving communication throughout the organzation they would solve several additional problems. How to make this happen in short time to get impactful results?

He enlisted then Chief of Psychiatry, Dr. Greg Sawyer, to act as an organizational psychiatrist.  They then set out to find ways to make the improvements they wanted.  Their path led to Dr. Sawyer attending a workshop that included using personality models for improving communication.  Then began a partnership between Temperament Research Institute (TRI), a Linda Berens company, and the hospital to help them realize their vision.  We worked first with the Executive team at a retreat. Rick Linneweh, CEO, said the experience at that retreat established his trust in us to take good care of the people in the organization.  Our method was to look at what was going on, how the hospital was already organized, and to give the executive team information that shifted their behaviors.  We presented them with the analogy of being like a family business where one aspect is about the operational and financial functioning of the organization and the other was about growth, development, and health.  That analogy made so much sense to them that they united around being “healthy” in all those aspects at the same time.

We introduced the individual differences information first to the executive team and then, to all of the managers. The question then became how to get at least some of that information infused throughout the organization so that the managers could use it for healthy conversations with those they were managing. Looking at how this particular hospital worked and what facilities they had available, we designed what is known as a critical mass event.  We introduced the four temperament patterns to every single staff member in half-day workshops.  We conducted 17 trainings over the course of 4 months.  The group size ranged from 24 to 90.  We also trained a group of ‘facilitators’ who became ‘tour guides’ to take small groups of 10 around to different ‘learning stations’ so they could have more individualized attention.  Each training was the same and involved a self-discovery process where the individual owned the information.  We didn’t use any assessment tools or personality “tests” because we wanted it to be safe and to build self-awareness. The goal was to introduce the temperament framework as a language rather than a label for people. We started our work with Memorial in late 1997.  The program is still alive and well and enthusiastically received.

One key to the success of the program was the support of the CEO and his willingness to give equal treatment to all of the employees.  It helped that we had a big “wow” from the early participants.  Employees were in groups with people they hadn’t met before and a general feeling of community and caring emerged.  Some said they had never worked for an organization that cared so much about them.  The word spread and people couldn’t wait to sign up for the “communications workshop.” Another key to the success of the program was setting up in-house expertise.  First Dr. Sawyer, then Jennifer Tate, the Organizational Health and Wellness manager, became the in-house experts.  Together, they kept the information and use of the model alive by 10-minute tidbits at every management team meeting, inserts into the newsletters, and monthly meetings with the facilitators.  We have been back to train more facilitators and to introduce new material to keep them on the cutting edge in their field.  Both Dr. Sawyer and Ms. Tate are called upon to work with specific teams.  Some managers have facilitators come to staff meetings to facilitate discussions that lead to more interpersonal understanding and better communication.

And we left them with the tools we used so they could do the same workshop in their new employee orientation, so everyone speaks the language.  There were also collateral pieces developed.  Every manager has a poster in his or her office that depicts the four temperaments along with the 4-A Problem Solving Process.  Each employee has a wallet size problem-solving card and a booklet.

In many ways, we worked ourselves out of a job!  Our role was to help set up something that was sustainable.  There was a considerable up-front investment, but now it is pretty self-sustaining.  They are considering rolling out the next level of information and increasing the skill level of the facilitators.  We will help in the design of the program, but they will do the implementation, probably not in a large group format, but in a concentrated period of time so everyone has the information relatively quickly. We helped Yakima Valley Memorial Hospital achieve in 3 years what they had thought would take 10 years. They are considering applications to patient safety and patient satisfaction, as well as continuing the program that contributes to employee satisfaction.  All of these would have significant bottom line impacts; however the value perceived is in more of the intangible and not-easily-measured improved communication, increased staff morale, and sense of community.  It was certainly a project we were delighted to be a part of.

Critical Issues Considered to Ensure Impactful Results

  • Organizational readiness
  • Executive buy-in
  • Grass roots or bottom-up driven
  • Levels of expertise inside the organization to keep the information alive
  • Safety to allay fears of getting fired etc.
  • Bias and stereotyping
  • Sustainability measures
  • Bottom line outcomes
  • Varied learning styles
  • Mixed educational levels
  • External constraining forces such as the current economic climate


  • Immediate results—After the first session, the phone started ringing with employees making sure they were signed up.  Enthusiasm was very high.  Sense of community and well-being increased.
  • “Side effects”—Since the CEO had the wisdom to give all employees the same quality of presentation, they felt as if they were given a gift that would help them in many personal ways, not just on the job.  One groundskeeper had tears in his eyes as he told one of the facilitators he’d never worked for a company that cared so much about him.
  • More “side effects”—Work done with the managers taught them facilitation skills. Improved communication documented through stories like the doctor who was having trouble with the spouse of a patient and the nurse used her understanding of differences to coach the doctor on how to approach the spouse.
  • A few hard-to-replace employees decided to stay after they used this information to better understand their supervisors.
  • After the very first downsizing ever for the hospital, there was no decline in morale as reported on the annual employee survey.
  • Eighteen years later, it is woven into the fabric of the organization and contributes to the overall sense of ‘this is a great place to work.’ It forms the foundation for facilitating strategic planning sessions, team development, and coaching for improving engagement, and conflict resolution and increases the effectiveness of these programs.

Yakima Valley Memorial Hosptial

Here is what the CEO of a hospital we worked with said about our communication intervention. The engagement began in 1997 under the name of Temperament Research Institute (TRI), a Linda Berens company. Today, that intervention is thriving and contributed to the hospital being selected as one of Fortune Magazine’s Top 100 Best Companies To Work For in the US. [jwplayer mediaid="5966" player="1"]

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