The Challenge
The staff at St. Joseph’s Health Care London didn’t talk to each other. Yes, they exchanged words, but when problems were serious and emotions were involved, many side-stepped core issues. Not only was this behavior unproductive and disrespectful for employees, it was potentially dangerous for patients.

The organizational development staff identified a training course that might help, especially in the interests of their main concern, patient safety. They also knew they needed an executive champion who could persuade busy physicians and nurses to participate. So they approached Dr. Gillian Kernaghan, a veteran family practice physician who was then the hospital’s Chief Medical Officer. She agreed something needed to be done.

“Only 50 percent of meetings were productive,” remembers Kernaghan, who is now the hospital’s President and CEO. “We had a lot of ‘Groundhog Days,’ where we talked about the same thing and didn’t find common purpose or get to actions that were agreeable.”

Kernaghan describes an environment where people wouldn’t speak up and sabotaged decisions that were made in the real “meeting” that happened in the hallway after.

“People pushed through their agenda by using power words like ‘patient safety,’ ‘evidence-based,’ and ‘family-centered,'” she says. “The implication was, ‘If you disagree with me you’re obviously not patient centered.’ Essentially, others couldn’t speak up because they felt shutdown.”

She also observed the initiatives that grew out of those limited discussions were less effective, leading to “rework” and “I told you so” comments even though people hadn’t spoken up in the first place.

“We needed to not only teach people to be nice to each other, but we also needed to get results by teaching them how to follow up and follow through,” she says. “We knew that if we could transform the way we communicated, our staff would be happier and more productive, and ultimately, our patients would be safer.”

So when she was asked to champion physician training that purported to address those needs, she agreed, knowing that in order to be an effective voice, she had to be “integrally involved.” So she registered to become a certified trainer of Crucial Conversations.

The Results: Read our case study to learn how Dr. Gillian Kernaghan used Crucial Conversations and Crucial Accountability Training to earn accreditation with exemplary standing, improve employee satisfaction scores, and see a significant improvement in holding others accountable.

What St. Joseph’s employees have to say: Read this guest post to see other ways employees at St. Joseph’s Health Care London have used Crucial Conversations and Crucial Accountability Training to change their culture.