When the MRI staff in Memorial Hermann hospital system in Texas kept running into an awkward problem, they turned to a hula-hoop for the solution. 

Standard MRI machines have a diameter of just under two feet. Cramped at best, claustrophobic at worst, these machines put patients through a tight squeeze to extract remarkable, life-saving insights. But for some, recounts Memorial Hermann COO Erin Asprec, a tight squeeze isn’t an option. These patients showed up after a long waiting period only to discover they couldn’t fit.

Amid high demand for healthcare, scarce resources, and so much outside of our control, how can we tap into the creativity and capability of our employees and leaders?

They often felt embarrassed. Their appointment had to be rescheduled, meaning the expensive, in-demand MRI machine might go unused during that slot. And the problem persisted until one employee thought of a highly-effective, low-cost solution.

“This clever individual took a hula hoop and changed it to the size of the MRI bore,” explains Asprec. “The patient would see if they fit into a hula hoop. And if you didn’t, we scheduled them in a larger, open-bore machine.”

The hula hoop was part of a broader program at Memorial Hermann, called iGenerate, that encouraged employees to submit ideas to improve quality, service, and efficiency. Altogether, the program has already saved at least $15.4 million and boosted employee engagement. This kind of innovation points to the core question healthcare organizations must solve for today: 

Amid high demand for healthcare, scarce resources, and so much outside of our control, how can we tap into the creativity and capability of our employees and leaders? 

Zooming Out and Table Setting 

At the Hudson Institute of Coaching, we’ve spent decades thinking about and researching how to create cultures of growth for individuals, teams, and companies. Employees are capable of extraordinary things. They have creative ideas bubbling beneath the surface — like using a hula hoop as an MRI pre-diagnostic. And at its heart, coaching is about unleashing this potential.

Nowhere is this mission more urgent than in healthcare. Health expenditures in the U.S. were nearly $5 trillion in 2023. An aging American population is requiring more care, pushing already strained resources to the brink, as Cedars-Sinai Chief Human Resources Officer Andy Ortiz told me. Providers are burned out, especially after the pandemic. Senior leaders are departing, making succession planning urgent. Consolidation means employees must navigate shifting company cultures, even as these companies navigate a shifting regulatory landscape. At the same time, medical innovation is happening faster than ever and exciting, if daunting, transformations are just around the corner as some in the sector are forging a path to value-based care.

In response to all these challenges, all healthcare organizations need to do is simultaneously optimize for low-cost, broad-access, and high-quality care, keeping their employees, their patients, and regulators happy at the same time. Easy, right? 

Not quite. But after spending the past few months interviewing four top leaders in healthcare, I’ve come away inspired by the innovation taking place at different healthcare organizations across the country – and convinced that development and coaching, which are already playing an instrumental role, can make an even bigger difference in the years to come. 

These conversations surfaced so many wonderful takeaways that I’ll share in greater detail below. But if I had to sum it all up, it would be:

• With so many things outside of organizations’ control, everyday development is an immediate path to boost engagement, bolster innovation, and buoy performance.

• In an era when healthcare is driven by increasingly advanced technologies, it’s increasingly important to focus on human skills. 

• To succeed, organizations must move beyond coaching as a series of one-off engagements and instead adopt it as a day-to-day practice.

The good news for healthcare organizations is that coaching builds on a practice providers already use in the exam room: asking smart, empathetic questions to understand what’s going on. And the good news for everyone is that if coaching can work in healthcare, where the urgency of life-saving care mingles with complex bureaucratic systems, then it can work anywhere.

What is Everyday Development?

Growth and Development in Times of Transformation

In his decades conducting hundreds of searches for healthcare executives, Jack Schlosser has picked up a thing or two about the industry and successful leadership. A lot has changed. Consolidation is playing an increasingly important role, as physicians transition from private practice to employment by larger medical groups. Employees are more likely to switch jobs than they once were. But through it all, Schlosser observes, the best leaders have been the kind who balance empathy with operational rigor, and who are capable of “dealing with ambiguity.”

“When there’s change or when there’s something that’s different, that can create anxiety. And I think there’s a lot of that right now,” he says. 

At Cedars-Sinai, AI is being used to automate note-taking and ease the cumbersome process of inputting electronic medical records manually, which providers often do late at night even after they’ve already gone home. New tools and technology will boost efficiency. They will also change the way employees engage with one another and with their patients, creating uncertainty. 

“As AI takes away all the technical pieces of the job, what’s going to be left is all the human factors,” suggests clinician-turned-executive Marguerite Samms, arguing that human skills will be increasingly valuable. 

It’s not just AI: many healthcare systems right now are transitioning to value-based care, which rewards healthcare organizations for the quality of outcomes they produce rather than the number of procedures they perform. In the past, explains Samms, a hospital was the “revenue engine that supported all of the nonprofit areas of healthcare” whereas value-based care means that “now, the tables have switched” and “the hospital is the cost center.”

“They’re all feeling it,” says Samms, suggesting that employees are facing “psychosocial adjustment issues” with the transition to a new way of operating. 

The best coaching directs inquiry within the bounds of an organization’s mission, finding the critical overlap between an employee’s motivation and the company’s interests.

One thing I heard repeatedly in my interviews is how the mission of healthcare can serve as an anchor and shared reference point for employees and leaders, even as the landscape around them changes. Ortiz suggests that, while competitive pay remains essential, so too is helping employees feel like they can care for others without running themselves into the ground.

Schlosser agrees, noting that, “people that are drawn into healthcare are often there because they want to do some good.” 

At Memorial Hermann, for example, the painstaking but essential process of standardizing care pathways as part of a larger transition to value-based care was successful largely because the system tapped into physicians’ motivation to improve patient care. Yes, it reduced costs too. But a budget isn’t as powerful a motivator for employees who entered the field because they want to make people healthy. 

The best coaching directs inquiry within the bounds of an organization’s mission, finding the critical overlap between an employee’s motivation and the company’s interests. 

Retaining Talent 

At Intermountain Health, a network of dozens of hospitals and hundreds of clinics in Utah, Colorado, Idaho, Montana, and Nevada, a single coaching conversation saved at least $100,000, recalls Marguerite Samms, who is the system’s Chief Learning Officer. 

Samms began her career as an ICU nurse, citing her passion for “being with people in vulnerable situations,” before transitioning to administrative roles focused on learning. She joined Intermountain in 2014 and began scaling an ambitious development program. Over the past decade, Intermountain has trained over 6,000 leaders in how to have empowering conversations. 

“Our journey has taken us from ad-hoc coaching to systematic programs to coaching with patients,” explains Marguerite Samms, lauding how coaching has helped leaders “manufacture time because they stop being the problem solver.” She admits, however, that the impact of coaching can feel fuzzy to outsiders. Because “seeing is believing” when it comes to coaching, Samms started tracking outcomes. She shared one with me that stood out:

A new physician came on board at Intermountain, and after just six months, decided the demands of the job were too great with two small kids at home. This was part of a pattern of losses for the organization. This time would be different, because the administrator overseeing the employee came to Samms. 

As a good coach does, Samms switched into learning mode and asked some questions that flipped the problem around. “What do you want to see happen?” she asked the administrator, who was clear that they wanted the physician to stay.

The administrator worked with a separate medical leader the physician reported to for their growth and development and coached them on how to talk to the physician. This medical leader then engaged the physician, asking “What would make it possible for you to stay?”

Intermountain re-negotiated the physician’s contract. She stayed. And the organization saved at least $100,000 because they didn’t have to replace her. 

Over the past decade, Intermountain has trained over 6,000 leaders in how to have empowering conversations.

More broadly, coaching at Intermountain “has led to statistically significant improvements in engagement, inclusion, and well-being.”

What’s remarkable about this story isn’t just the bottom-line outcome, but the process. At least three separate coaching conversations needed to take place to make this happen — illustrating the collaborative problem solving coaching enables when it’s part of a shared culture across an organization. In other words, coaching has notable network effects: benefits above-and-beyond those that arise from individual interactions. These only accrue when a critical mass of people have the tools to coach. 

“Potential is that tiny little intersection between someone’s capabilities and our future needs,” reflected Samms. In this case, burnout was at first making it tough for a promising female physician to continue with a job she was excited about. Understanding the obstacle, and then working together to remove it, enabled her to stay. 

Once an employee is convinced that they’re staying, how can organizations unlock their leadership potential and creativity?

Burnout is a common retention issue in healthcare that organizations can begin to address by normalizing seeking mental health support, offering wellness initiatives, improving work-life balance through revised schedules, and more. In other cases, however, retention challenges stem from unmet employee growth expectations. Jack Schlosser, an expert in executive searches, emphasized the need to generate alignment between organizational and employee goals. 

Recruiting and retaining top talent are just the start of a healthcare organization’s development challenges. Once an employee is convinced that they’re staying, how can organizations unlock their leadership potential and creativity?

Transitioning to Leadership Roles

Healthcare organizations face a version of a problem we’ve long seen among companies: employees are promoted to management roles based on the strength of their individual contributions, even though leadership requires different skills. Marguerite Samms notes that providers are often frustrated when they transition from being the expert medical leader of a care team to a novice administrative leader in the system. Jack Schlosser agrees that “physician leaders often skip a grade, missing management training essential for team leadership.” 

Andy Ortiz, the CHRO at Cedars-Sinai, explains that in the past, healthcare organizations have taken the “deep end” approach to leadership development: A skilled radiology tech, for example, who has done terrific work for 15 years might apply and secure a promotion to be a manager.

“And now you have 25 people that report to you and we throw you in the deep end with no life jacket,” explains Ortiz, warning that this kind of approach can have adverse impacts on the new manager and patients alike. “This whole notion that you have to go through the school of hard knocks is really antiquated.”

Instead, Ortiz advocates slowing things down and teaching someone about “what is the role of the supervisor or manager.” He sees this learning as going beyond important but insufficient programs that instruct managers on legal technicalities like what they can’t ask in an interview. At Cedars-Sinai, new managers are paired with mentors and offered access to coaching circles. As Samms points out, “coaching prepares leaders for the discomfort of transitioning from expert to novice.” 

This brings me to a bigger idea that’s core to our philosophy at Hudson: For development to work, it can’t be treated like a one-off vaccine: an intervention that provides lifetime protection. Nor can it be a seasonal vaccine like the ones we receive for the flu. Effective coaching is more akin to a healthy lifestyle: a choice we can and should make every single day. 

“This whole notion that you have to go through the school of hard knocks is really antiquated.”

Opportunities like the coaching circles Ortiz describes, group coaching, and other efforts that bolster community can help employees feel less isolated and more likely to seek out help. They are a form of communal health, so to speak. For example, Ortiz acknowledges that providers who are “always willing to help others… don’t always ask for help” themselves — and that Cedars-Sinai has been most successful in offering resources when they’ve created pathways for people to openly share their struggles.

Why It’s So Important for Leaders to Show They Care

Research shows that doctors who are compassionate and kind have patients who heal faster. A similar principle applies at an organizational level: leaders who are empathetic and show they care have employees who perform better and feel happier. These outcomes arise from leaders signaling that they value employees, even if they don’t have immediate solutions to offer.

“All people want is to be heard and seen. And if that happens, even if the problems don’t get fixed, it’s okay,” reflects Andy Ortiz. Jack Schlosser agrees: “The healthcare system is under pressure, but recognition and acknowledgment can energize teams.” 

Research shows that doctors who are compassionate and kind have patients who heal faster. A similar principle applies at an organizational level.

Erin Asprec, the COO of Memorial Hermann, suggests that ideas such as using a hula-hoop in the MRI process or the many others that improved quality, service and efficiency, were only possible in a culture where employees felt like they were likely to be heard. Grassroots innovation depends on an environment of trust, which can only be created when leaders listen to their employees and follow through. 

“One of our employees told me, you know, ‘I used to work somewhere and I used to give ideas all the time, but they would never come to fruition.’ And because we do that loop closure and we ask them to champion the idea, and senior leadership makes sure they get the resources to implement it, they get super excited,” says Asprec.

One way that Asprec personally engages beyond her immediate direct reports is through “rounding,” a practice that typically refers to healthcare providers making the “rounds” to check on patients. Asprec “rounds” to interface with staff throughout the Memorial-Hermann system, and recalls one time when a woman wasn’t able to print things and was running around in search of a printer. With one call to IT, Asprec resolved the problem.

“You thought I’d given her a million dollars,” she recalls, pointing to how small gestures from leaders help employees feel seen and appreciated. 

Ortiz, too, has adopted the process of rounding, in his case with patients: “The rounding process for me as a leader is super helpful. It enables me to go talk to our patients and find out what their experience is — because we might be able to learn something about the way we’re delivering the care. The inquiry is powerful and important and keeps you connected to where the action is at.”

At Intermountain, an emphasis on clear, kind, and direct communication has been key to fostering trust and helping employees feel empowered.

Coaching asks us to shift from a fix-and-tell mindset to one of inquiry. Inquiry connects leaders to the action, including to employees and the problems an organization is facing. What I love about rounding is that it blends the confidence and humility crucial to great management: the kind that believes you can help other people but keeps an open mind as to how exactly that help can be offered. Or as Jack Schlosser put it: “Listening and understanding the needs of your people can make the biggest difference.” 

Lessons for Healthcare Organizations

All leaders, no matter what industry they work in, can adopt this process of “rounding” throughout their organization. The best leaders know what’s going on beyond their immediate office. They show themselves as accessible and interested. And there’s so many ways to do that, from asking a team member “What’s on your plate today?” to just showing up and observing.

The more you walk around, the more you’ll discover, and the more employees will believe you’re there because you want to listen and help them grow.

Conclusion 

We know that environment shapes gene expression; though in many cases, the pathways of how this unfolds remain scientifically murky. The good news is that when it comes to human behavior, we have a much stronger sense of the practices and protocols that optimize employee creativity and engagement as well as organizational growth and success. 

Cedars-Sinai continues to work to create an environment in which employees can thrive and do their best work, including through wellness initiatives and experimenting with AI. 

Lessons for All Organizations

Intermountain is implementing the latest phase of its learning blueprint, aiming for widespread adoption of coaching and increased investment in learning initiatives. Marguerite Samms notes that “we’ve gone from coaching being corrective to coaching being a badge of honor.” 

Part of that shift has involved emphasizing to people that coaching doesn’t mean fixing every problem; rather, it’s seeing the organization as a whole as resourceful, capable, and creative. And it doesn’t hurt that Intermountain has documented incremental changes in a Culture Journal, making progress visible and reinforcing the value of coaching in real time. 

After weathering financial crises and COVID, Memorial Hermann is engaged in a new transformation focusing on improving community health, including experimenting with initiatives like mobile obstetrics vans to reach underserved areas. 

“If you invest in people and allow them to be their very best, the metrics will fall in line,” proclaims Asprec.

Still, the system continues to grapple with talent shortages and burnout. One of the most successful ways Memorial Hermann has bolstered its leadership ranks is through a program Asprec created named “Women Leaders of Memorial Hermann.” It has already graduated 1,600 mentees and boosted the representation of women at the EVP level from 13% to 43%. 

“If you invest in people and allow them to be their very best, the metrics will fall in line,” proclaims Asprec. Leaders should measure results, but not let a lack of immediate hard numbers prevent them from putting more resources into employee growth and development.  

Some of the most important challenges that healthcare organizations face aren’t within their direct control. Government regulations. Reimbursement schemes. Global health crises. But investing in coaching and employee development is an immediate, actionable path to helping healthcare organizations address existing challenges, and prepare themselves for future ones.