Physician, Heal Thyself: How a Hospital in California Became a Model of Change Management

In his latest column for Forbes online, Drucker Institute Executive Director Rick Wartzman examines Citrus Valley Health Partners, a nonprofit community hospital system based in Covina, California—and, as Wartzman describes it, “easily one of the most impressive turnarounds I know of.”

How has Citrus Valley dramatically improved clinical quality, patient satisfaction and financial results over the past few years? Wartzman says it boils down to two words: courage and communication.

In the piece, Wartzman details how Citrus Valley CEO Robert Curry and the health system’s chief medical officer, Paveljit Bindra, have implemented new protocols and measures of accountability—even in the face of “a tremendous amount of pressure” from “recalcitrant physicians” and others.

“Constant, clear, consistent communication has to occur to change a culture,” Curry asserted.

At Citrus Valley, Wartzman says, “this manifests itself in various forms—from the Monday Morning Memo that Curry sends out weekly to let everyone in the organization know what’s on his mind; to the Leadership Academy that was launched last year to teach employees the standards that Citrus Valley now expects; to the new physician-coaching initiative through which the docs who “get it” are guiding their more change-resistant peers.

“Open communication has also altered behavior in other respects,” Wartzman writes. “For instance, Bindra was able to get doctors to stop utilizing so much unnecessary blood (and losing millions of dollars in the process) by making public who used what amounts for different procedures and comparing that with recommended levels.”

This wouldn’t have surprised Peter Drucker, who considered a well-run hospital “the perfect paradigm of the knowledge-based organization,” as Wartzman puts it.

“The real strength of feedback information—and the major reinforce—is clearly that the information is the tool of the worker for measuring and directing himself,” Drucker wrote in his 1973 classic Management: Tasks: Responsibilities, Practices. “The worker does not need praise or reproach to know how he is doing. He knows.”