Regions Hospital

Regions Hospital serves the Twin Cities area and western Wisconsin with more than 26,000 admissions and nearly 90,000 emergency visits annually. As the largest private employer in St. Paul and a teaching hospital partnering with the University of Minnesota Medical School, Regions had the infrastructure, expertise, and commitment to provide exceptional care.

Yet despite these strengths, the hospital faced operational challenges that prevented them from reaching their goal: ranking in the top 10% nationally for patient experience.

Staff Operating in Silos, Not as a Team

The hospital ecosystem is complex and interconnected. Security, custodial teams, administrative functions, nutrition services, and clinical staff all influence patient experience. But these departments operated in silos, each focused on their own tasks and priorities.

"We kind of talk about working with your blinders on and just worrying about yourself," one staff member explained. "You're going through your day almost robotically, checking the box and not connecting with people."

Director of Nursing Sarah Cassell observed: "It's easy to go inward, because there are so many tasks to accomplish. I have to do X, Y, Z, I don't have time."

Poor Communication Between Staff and Patients

The HCAHPS (Hospital Consumer Assessment of Healthcare Providers & Systems) survey measures patient satisfaction across key areas including communication between healthcare staff and patients, responsiveness of hospital staff, and overall care experience. Since 2012, the federal government has used HCAHPS scores to help determine hospital eligibility for quality-care incentive payments.

Regions' scores showed troubling gaps. Patients didn't consistently feel that nurses explained things clearly, listened carefully, or took their preferences into account. The high-pressure environment exacerbated the problem.

"At every second of every day, you're very worried about a patient that you don't understand their diagnosis, or a person's life is in your hands," explained Brett, a staff member. "You look at patients and other people as obstacles. You're in my way of getting to what I need to do."

The result? Patients perceived staff as too busy to care about them. "It shows to every patient, they see you that you're busy, they see that you're stressed. They don't see you caring about them," one nurse acknowledged.

Low Employee Engagement and Retention

Internal surveys revealed concerning patterns. Staff didn't feel management understood or responded helpfully to their needs. Employees across departments didn't understand each other's goals and objectives. Leaders weren't explaining the reasoning behind their decisions.

These engagement issues contributed to retention challenges—a critical problem in an industry already facing workforce shortages. Tyler Schmidtz, Executive Director of Ancillary Services, recognized that improving patient experience required first addressing how staff worked together and felt about their work.

Anabel De Juan-Gomez, Leader of Organizational Development & Learning, articulated the core problem: "The pressure of knowing that there are patients who are waiting for us and needing our services, the stress increases. Then we're not able to provide the best care and the best experience that we promise, and that we want to live up to."

Regions needed to reach top 10% performance in patient experience. Achieving this would require new levels of staff responsiveness and cross-department collaboration that traditional training approaches hadn't delivered. 

Regions partnered with Arbinger to conduct pilot programs testing various training configurations for front-line staff. Rather than focusing solely on external behaviors described in HCAHPS surveys, the training would address the underlying mindset driving those behaviors.

Flexible Training for a High-Pressure Environment

Given the urgent, fluctuating nature of hospital work, Regions needed training that accommodated inevitable interruptions during shifts. Arbinger created video training segments that could be used adaptively alongside traditional workshop methods. Some care management teams also received leader development sessions and one-on-one coaching.

The programs factored in staff availability, frequency of development meetings, and the percentage of staff able to attend initial workshops. Different units tested different implementation strategies to identify what worked best.

Shifting from Tasks to People

All training focused on building employee self-awareness about the mindset underlying their efforts. Participants realized that how they viewed patients, coworkers, and supervisors could either amplify or undermine the effect of their behaviors.

Staff came to acknowledge greater responsibility than merely conducting work obligations with professional competency. They saw the need and benefits of fully encountering the personhood of others—both patients and coworkers.

"The first thing out of their mouth was, this isn't just another flavor of the month or another fad," Sarah M. recalled. "They really felt like Outward Mindset was something they could latch onto and start using immediately. It's almost like the foundation of how we approach the work."

Breaking Down Silos Through Shared Focus

The training helped employees appreciate how coworkers with different roles contributed to patient wellbeing. When everyone focused on the patient rather than their individual task lists, collaboration became natural rather than forced.

"Things tend to be more efficient because you're not thinking about yourself. You're thinking about your team now," Steven explained. "They're not a medical record number anymore. They're not a vehicle you need to get past to get to the next thing, but they become a person, they become human."

Staff began seeing patients differently: "When we talk about our culture at Regions, having a head and heart together, that's really what we mean. We have to do all the head things the right way, but we have to use our heart at the same time." 

Each pilot program showed dramatic improvements across multiple metrics, demonstrating that addressing mindset created measurable operational outcomes.

Patient Satisfaction Improvements

Three different HCAHPS measurements showed notable improvement. In one wing, the number of patients who felt nurses explained things in an understandable way increased by 8%—exceeding the hospital's improvement goal. The same intervention resulted in a 5% improvement in patients who felt nurses listened carefully.

In another wing, implementation of Arbinger's tools resulted in a 5% increase in patients who felt their preferences were taken into account. These percentage increases represent hard-won progress considering the emotional and financial strain patients experience during hospital stays.

"Scores on would you recommend the hospital have gone up dramatically, because we are different. The patients are the same. We changed how we approach them, so that they are feeling like we care," Linda explained.

Employee Engagement Transformation

Before training began, Regions surveyed employees about how well management understood and responded to their needs. The pilot programs enabled improvements of 43% in one program and 26% in another. Understanding of each other's goals and objectives increased by an average of 23%.

One pilot group showed a striking 68% increase in employees who felt leaders explained the reasoning behind decisions. That group reported improvement in all seven categories measured by the employee engagement survey—an important indicator of satisfaction and retention.

Tyler Schmidtz, Executive Director of Ancillary Services, called the engagement score changes "frankly remarkable."

Cultural Shift Creates Sustainable Change

Beyond the metrics, participants reported seeing improvement in how teams worked together to solve problems. The training helped cultivate lasting relationships with coworkers across departments.

Staff reconnected with their purpose: "It reminded me of why I do what I do and how to do it a lot better. I love what I do, and this helped me remember why," Jessie reflected.

The improved collaboration and communication positioned Regions for continued progress toward their goal of top 10% national performance in patient experience—while also addressing the critical challenge of employee retention in healthcare. 

Regions Hospital demonstrated that patient satisfaction scores and employee engagement can't be improved through task-focused behavior changes alone. When staff across all departments—from custodial to clinical—shifted from "What do I need to get done?" to "How can I help patients and coworkers?", silos broke down, communication improved, and both HCAHPS scores and employee engagement increased significantly. The measurable improvements in patient experience and staff satisfaction prove that addressing the mindset underlying behaviors creates sustainable operational results, even in high-pressure healthcare environments.