When healthcare executives talk about their organizations' strategy, they will often repeat the mantra: We put patients first. John Couris, president and CEO of Florida Health Sciences Center/Tampa (Fla.) General Hospital, disagrees.
"I don't believe the patient comes first. I believe the team member comes first and the patient comes second," Mr. Couris said. "I believe that if you give your team members what they need, where and when they need it, and if you show up for them as your best self, they will then be able to do their best work — work that focuses on and elevates the care of the patient. And so while technically the patient is not the main focus, at the end of the day, the ultimate beneficiary is the patient, but you are serving them by serving your team members."
Mr. Couris said people often argue with his thesis. They tell him putting his team before patients is not the right approach.
"I say, 'Is it?' Let's look at the macro indicators. For 25 years, this industry has talked about patient satisfaction as being one of the most important things to focus on. But when you look at customer service and quality in the industry, it's average at best," Mr. Couris said. "When you look at the cost of healthcare, it bounces between 17-20% of GDP, so if it were all about the patient, don't you think quality would be better and costs would be more competitive? If they were, we would be able to pass that value on to the consumer. Don't get me wrong, there are plenty of great health systems doing incredible work across the country, but we haven't reached critical mass — or enough of it to really benefit the consumers on the whole."
The traditional model of focusing on the patient to deliver a better experience has not worked, Mr. Couris said, and he is ready to try a new strategy. That is why he developed four core leadership principles within the system — principles that put the team first:
1. Lead with authenticity. "We show up as who we are — as our genuine selves — and that creates a connection to our team that is very organic," Mr. Couris said. "Authenticity and being genuine is incredibly important because it improves relatability and deepens the bond that you have with the team members you lead."
2. Transparency. "We share everything with the team," Mr. Couris said. Twice per year, Couris holds forums where he meets with team members and providers, providing updates on the organization's strategic trajectory (as outlined in TGH's five-year, board-adopted strategic plan), sharing successes of team-led initiatives or implementation of team-inspired ideas, explaining the why behind the organization's decisions and soliciting feedback along the way. He then shares the feedback and ideas with his leadership team, and they collectively work to incorporate it into the organizational action plan and strategies.
"Transparency is transformational because it builds trust and because you're honestly sharing with people exactly what is going on," he said.
3. Lead with kindness. "Kindness is critically important. I, and all leaders, lead with kindness and love," Mr. Couris said. "People deserve to be treated with kindness, love, respect and empathy. Treating every person this way is the right and decent thing to do. Kindness is critically important."
4. Lead with vulnerability. "You have to admit when you make mistakes, and you have to admit when you don't know the answer. You also must be comfortable asking for help or suggestions around really difficult situations and problems," Mr. Couris said. "You can only do that if you are willing to be vulnerable. Vulnerability is inherent to who we are and by peeling back the layers and showing folks that you are human — and all that entails — creates alignment with the team and culture that you're trying to build.”
After Tampa General began to actively engage with this leadership model of authenticity, transparency, kindness and vulnerability, and focus on putting team members first, Mr. Couris said team member engagement improved significantly. When he started the culture shift, TGH's Press Ganey team member engagement score (as tabulated through an organizationwide, independent team member engagement survey) was in the 40th percentile; today, the health system's engagement is measured in the 87th percentile with a 90% team member survey response.
"The team continues to let us know that they feel very connected to the organization and leadership team," Mr. Couris said. "I think making them feel and recognize that they are number one in the organization's eyes really drives that connection. I think another key component to their alignment, deep caring and engagement with and in the organization is because we make them feel safe. We have developed a culture where they feel safe to express their opinions, make mistakes, fail, but also share those and learn from them. They believe that they won't be judged and criticized unnecessarily and inappropriately when they're trying new things, innovating or and challenging the status quo."