Shortly after Chris Van Gorder began his tenure as the president and CEO of Scripps Health, he attended a marketing meeting at one of the system’s hospitals.
“I was listening to their marketing plan,” Van Gorder says. “Their marketing plan was to take as many patients away from Scripps La Jolla as they possibly could.”
Five different health care campuses in the San Diego area share the Scripps name. They’re all under the same corporate umbrella. But each location was wrapped in its own silo and, in some cases, competing directly for business with another Scripps location.
“We’re all one company, so that makes no sense whatsoever,” Van Gorder says. “But people were thinking and operating in their own silos. Hospitals can become very big silos, and it then becomes very easy for an employee to say, ‘I work for Scripps, but I really work for Scripps Mercy Hospital. It’s a mindset that pays no attention to the fact that you might be in direct competition with other areas of the organization.”
The silos had developed over time throughout the 12,700-employee organization, ironically because the power at Scripps had become too centralized. The system’s corporate leadership had dictated policies from headquarters, and in many cases, the administrators, doctors and staff on the hospital level didn’t agree with the policies or they felt that the hospitals weren’t given enough say in creating the rules.
As a result, the hospitals had become strategically and philosophically detached from corporate leadership and from each other.
“It was the biggest challenge I had when I first got here: how to overcome a vote of ‘no confidence’ from our managers and employees on the organization and its strategic direction,” Van Gorder says. “They simply did not agree with our direction or strategic plan.”
To re-engage the team members working at the hospital level, Van Gorder had to put decision-making power back in their hands. He had to give the hospitals an ability to impact the strategy and direction of the organization. He had to decentralize the entire system by starting from the center and working his way out.
