Culture Transformation
Reviving Union Collaboration to Drive Patient Satisfaction Outcomes Delivering $20M in Revenue
Healthcare
Transformed labor-management friction into frontline ownership—driving measurable gains in patient care, cost performance, and trust through co-led 90-day improvement sprints across the hospital system.
The challenge
A large, multi-hospital, faith-based health system in New York faced a dual crisis: strained management-labor relations and stagnant patient experience metrics. Years of financial pressure, burnout, and transactional labor interactions had eroded frontline trust. Leadership had grown frustrated with the limits of morale-boosting initiatives that delivered short-term optics but failed to shift outcomes.
They needed a new model—one that would rebuild collaboration from the ground up and translate it into measurable improvements in patient care and profitability.
Our approach
Rather than deliver “off-the-shelf-program,” we launched a coordinated system of 90-day performance sprints across each hospital, designed to drive immediate improvements while transforming how labor and management solved problems together.
These cross-functional sprints were co-led by operational and union representatives, focused on high-impact, locally relevant issues:
Reducing patient length of stay and avoidable readmissions
Improving nurse response times to patient calls and ED wait times
Elevating patient satisfaction scores (e.g., Press Ganey)
Enhancing profitability across underperforming service lines
Each sprint balanced local ownership with a shared enterprise standard for rigor, accountability, and results. Rather than working around labor, leaders worked with them—proving that better outcomes and better relationships could be achieved together.
The results
50% reduction in average call bell response time
20% decrease in patient length of stay
$20M in cost reduction and revenue enhancement
Strengthened management-labor trust and system-wide improvement in patient satisfaction
Why it worked
The engagement broke through long-standing resistance by embedding performance into partnership. Instead of asking teams to engage in abstract culture work, the system equipped them to drive outcomes they cared about—and could prove.
By using tightly scoped, time-bound sprints, teams focused energy and built quick wins, which reinforced belief and momentum. Union leaders became co-owners of performance, not just participants in process. What started as a turnaround initiative evolved into a new model of frontline collaboration—with measurable ROI and lasting relational shifts.
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Mining
Rescuing iron ore profits, retaining $450 million in revenue, and boosting throughput, quality, and safety
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