How One Hospital Is Creating a Culture of Change in Healthcare

Posted by Cathy Swenson, RN, BSN, MA on February 5, 2018
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The compliment would be a crowning achievement for any healthcare facility: “We have a hospital closer to us, but we heard how good they are at Morgan Memorial, so we decided to go there instead. I am so glad we did!” – A patient at Morgan Memorial Hospital (MMH).

Such a statement from a patient is especially important for Morgan Memorial Hospital. Not so long ago, patients might have driven in the opposite direction instead of going out of their way to reach the Madison, Georgia facility.


But hard work and sweeping culture change have patients choosing to use MMH and have the staff earning important validation for their efforts and gaining knowledge that can be shared to help others embrace change.

MMH is good now, and the Georgia Hospital Association (GHA) recognized that quality with the 2015-2016 Quality and Patient Safety Award in the category of, “Nursing Cultural Triad: Trust, Commitment & Clinical Experience.”

“What we’ve done recently is extraordinary. What people should be talking about is how amazing this hospital is – specifically, the clinical experience that is applied here on a daily basis and the customer satisfaction,” said Ralph Castillo, Morgan Memorial Hospital CEO.

Setting the Scene

In 2012, things were far from excellent. MMH experienced everything from cellphone usage in front of customers, unfair staffing practices, to minimal communication between staff members as well as patient safety concerns.

The issues decreased morale, productivity and efficiency. Employee satisfaction and support of the hospital’s mission and values were at an all-time low. Morgan Memorial was in dire need of a positive culture change.

Changes amongst leadership were made, and the realization of how badly progress was needed pushed Susan Jackson, MMH’s Nurse Manager, to start making modifications.

Creating and Visualizing Change

Patient safety and staff satisfaction were two main goals of the culture change. Nurse-to-patient ratios were decreased and CNA-to-patient ratios were increased. There were continuous assessments and revisions made to the staffing matrix to improve the culture of safety.

MMH worked to engage existing staff by making staff meetings more flexible and discussing more interesting content. Staff meetings went from having 5-10% attendance in 2012 to 90-100% attendance in 2015.

Additionally, MMH encouraged a new education initiative among hospital employees. Staff participated in GHA-sponsored webinars, safety summits and leadership conferences, as well has actively engaged with the Hospital Engagement Network (HEN).

The next step focused on how MMH expanded on its existing team. A major alteration was made to the interview process. The hiring staff revised interview questions to give insight into each candidate’s attitude, personality, critical thinking and customer service skills.

Morgan Memorial hiring staff concentrated on being transparent with candidates about the culture: They shared the current state and the vision for the future. By being open about MMH’s goals, hiring staff could make sure they were getting the right people to achieve the overall vision.

Once hired, new employees were required to review and sign a commitment letter. The letter outlines goals for accountability and partnership. MMH followed with an orientation and training program for new employees, which helped ease the transition.

Today, I feel like we are working as a team, not against each other, and we are more of a family than we were when I first came here.” – Nurse Angela Justice, a Morgan Memorial Hospital nurse of 15 years.

Looking Forward

Sustaining changes of this magnitude can be difficult for any organization. To combat any potential regression, Morgan Memorial made multiple commitments to continue to improve its culture. MMH commits to:

  1. Evaluating patient satisfaction and the culture of patient safety on a regular basis as a way to access progress and further needs for improvement.
  2. Enabling frontline staff to attend GHA-sponsored seminars and other educational opportunities to stay abreast of best practices and initiatives.
  3. Reorganizing the orientation program to include preceptors who will drive progress improvement.
  4. Harboring a just culture, accountability, equity, partnership and ownership to support colleagues in these areas.

To continue this dedication to improvement, Morgan Memorial Hospital is implementing Amplion Alert. The tools in Amplion Alert are built around communication and teamwork. This care assurance platform is a great fit for where MMH is in its process.

“I’m most excited about Amplion’s ability to help us improve the patient experience within our hospital,” said Beth O’Neil, Chief Nursing Officer for Morgan Memorial. “This platform will greatly improve our ability to meet our HCAHPS objectives.”


When Amplion asked Susan Jackson what she would say to other hospitals undergoing a culture change, she had three key points.

First, Susan advised, “You have to be persistent. Everybody has to be on the same page.” She led the changes at Morgan Memorial. At the start of the process, she said, she was not liked very much. However, she worked hard to get everyone on the same page and to collectively support the mission. Ultimately, Morgan Memorial reaped the benefits of working together as a team.

Next, Susan advised other hospitals to acknowledge that staff members are human. Throughout the change, it was important to recognize that staff needed to vent. Instead of doing so in open hallways, nurses were provided private, appropriate spaces to discuss their thoughts. This was beneficial in assuring that everyone’s voices were heard – but not in a way that disturbed patients and families.

And Susan reiterated the importance of altering the interview process to be transparent. “You don’t want people to come in and be surprised,” she said. “You have to give them the full picture and show that you are making progress once they get there.”

This method was validated, Susan said, when a nurse said, “I almost worked somewhere else, but they don’t do it the way we do it at Morgan Memorial.”

What ways are you creating positive change at your hospital? Tweet your ideas to @amplionalert.

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