Columbia County Health System, also known as Dayton General Hospital, is a Public Hospital District located in the sparsely populated Columbia County, WA. Our public hospitals are safety net organizations that provide health care services to rural communities, and we are very often the only emergency services provider for miles. In addition to delivering these essential services to our communities and the people who visit or travel through our rural highways, we are also often the largest employers in our counties.

Our mission is critical as we provide life saving and life supporting services in addition to being economic powerhouses that sustain our small communities, but the mission is daunting and the challenges pervasive. According to the Cecil G. Sheps Center for Health Services Research, there have been 180 Rural Hospital Closures from January of 2005 with 136 of those occurring since 2010. When a rural hospital closes, it has devastating consequences to the people and towns once served, but it also means depreciated health outcomes, increased deaths from a lack of emergency services, and increased health disparities between rural and urban environments.

The strategy most often found in rural health systems is simply to survive, but this approach leads to a reactionary culture or culture by crisis. Our health system was not immune to this, in 2016 we created our first five-year strategic plan and implemented it in 2017. While proud of that effort, we found ourselves challenged to meet our objectives and the added operational pressure of 2020’s pandemic exposed our structural and institutional weaknesses. Our successes came from the grit, endurance, and commitment of our employees. The personal cost, however, was high as the prolonged physical and emotional response persisted throughout the year.

The executive team found themselves looking for new solutions having exhausted all internal resources and witnessing daily the stress on the faces of our managers and staff. Morale was low, the organization was fatigued, and the enemy was an invisible virus with an ever changing set of State and National expectations for addressing. Worst of all, the pressure of daily operations was tearing at our inherent operational weaknesses and staff were taking the frustrations out on one another.

This is where Team Concepts found us when we initially contacted them. At first it seemed counterintuitive to start a large culture and leadership objective at a time when everybody was feeling exhausted and overwhelmed, and we thought about postponing in favor of some ambiguously defined “better timing”. Looking back over the last four months, moving forward with Team Concepts was the single best decision we could have made for our organization and community, and we broke through that cycle of hoping and waiting for better circumstances. Now was the time.

The executive team was the first to experience Misipati Bird (Semi) with his energetic, charismatic, and academic approach to leadership education. The executive team was transformed on that first day. We walked into that first session as a group of drained, concerned, apprehensive, and skeptical people. By the end of the first day, we found renewed energy seeing the potential of what was possible, and we were excited to start the second day with most of us showing up early sharing thoughts and strategies catalyzed from the previous day’s engagement. This was no longer just about making the organization better, this was going to be an investment in ourselves; a journey of self-discovery that challenged our perceptions of self and each other that was driven by proven scientific tools, techniques, and an engaging mentor. We also unilaterally understood that every one of our managers needed the same experience.

I was given the privilege of kicking off the classes and I made a point to follow up with team members after their first or second day of training. The transformation was obvious and consistent across each cohort: Team members walked in carrying the burdens of the previous year, skeptics wondering how they would be able to take this additional task on, and they each left reinvigorated with a head full of ideas and new tools. What Team Concepts has done is refuel the organization through our people.

This is not a brief intervention or short cycle motivational exercise that provides a small bump in morale, it is not a quick read book, and it is not simply conceptual, it is transformational and an investment. This program is built to put points on the board early and build a system of communication and accountability. The most satisfying effect happens when staff realize that this is an investment in them as people; the tools being provided to them shape all their interactions and perceptions, not just their work interactions.

High performing organizations are made up of high performing people. A high performing culture is never created by accident, and we must be pragmatic about building and maintaining it. We have partnered with Team Concepts to be with us through 2021 and they are coaching us through organizational structure, reporting, R2A2 (Roles, Responsibilities, Authorities, and Accountabilities,) strategic planning, board education, and quality improvement initiatives. We are actively removing victim behaviors that have persisted for years and we are replacing them with accountable behaviors that drive solutions for complex and deeply embedded problems inherent to all business but that can have crippling consequences when allowed to exist in health care settings. This journey has just started for us, but we are no longer feeling helpless and hopeless waiting for circumstances to change, we have embraced our future, we are finding solutions, and we are going to make it happen.

~ Shane McGuire CEO at Columbia County Health System