Case Studies Creating a Common Language: CHRISTUS Health Improves Employee Engagement and Retention

CHRISTUS executives felt that the organization had fallen into a trap that many organizations face; they had developed a culture of being "nice." Determined to make a change, the executive team enlisted Fierce, Inc. to partner in a leadership training program that would assist in improving the company culture.

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CHRISTUS Health is an international Catholic, faith-based, not-for-profit health system comprised of almost 350 services and facilities. Operating in six states within the United States, six states in Mexico, Chile, and Colombia, CHRISTUS Health has more than 60 hospitals and long-term care facilities, 175 clinics and outpatient centers and dozens of other health ministries and ventures.

Employing roughly 45,000 Associates, CHRISTUS Health has grown to a health care system including more than $6 billion in assets under management that acts as a leader, partner, and advocate in the creation of innovative and effective health solutions that improve the lives and well-being of individuals and communities.


CHRISTUS executives felt that the organization had fallen into a trap that many organizations face; they had developed a culture of being “nice.” Associates of all levels were mistaking CHRISTUS’ value of compassion with avoiding difficult conversations and constructive feedback.

After undergoing analysis from a third party consultant, CHRISTUS learned just how deeply this avoidance had bled into the organization. According to this analysis, many leaders “avoided having conversations that involved feedback about their team’s work” and front line Associates were confused as to why they were not receiving critique from managers. With a lack of feedback from leaders throughout the organization, some Associates became disengaged from their work and the organization.

Another problem that persisted within the organization was the lack of opinions shared by some Associates of all generations and different position levels.

Through some leaders’ unwillingness to have conversations, CHRISTUS was concerned that some Associates felt the culture failed to encourage and empower Associates who were not yet in a managerial role to share opinions or ideas. CHRISTUS leaders knew that without the participation of the entire staff, they were missing out on a wealth of opportunities, ideas, and talent, ultimately costing the organization.

To add to the cultural challenges previously mentioned, CHRISTUS had consolidated its corporate offices from three geographically dispersed locations to one, losing approximately 60 percent of its corporate staff in the process. Knowing they needed to rebuild the relationships with their Associates, CHRISTUS leaders sought a partner that could help them address the recent changes with their staff and enhance the current company culture.


Determined to make a change, the executive team enlisted Fierce, Inc. to partner in a leadership training program that would assist in improving the company culture. CHRISTUS turned to Fierce because the company’s core philosophies and approach to conversation mirrored CHRISTUS’ values, particularly that of integrity and the importance of relationships.

“I have never worked with a company that has values and goals that align so well with CHRISTUS,” said Lisa Reynolds, Vice President of Talent Management at CHRISTUS Health. “Our Associates are treated with dignity and respect, a critical tenet of Catholic social teaching. Fierce has the spirit of Catholic health care.”

CHRISTUS defines integrity as maintaining honesty, justice, and consistency in all relationships. Avoiding difficult conversations had made it difficult to fulfill this value. Fierce stands by the belief that the conversation is the relationship and those relationships live and die by the effectiveness of conversations. Through this lens, CHRISTUS wanted to reinvigorate interactions between colleagues through honest, meaningful conversation.

Working with the Talent Management team at CHRISTUS, Fierce developed a leadership training program that concentrated on four specific skills: delegation, team conversations, confrontation, and coaching. Current leaders, including managers and executives, and Associates who lead CHRISTUS’ patient experience work, were the first to undergo the new programming.

Conversation and confrontation were critical in addressing the issues with avoiding difficult conversations. Coaching was an area of value because the CHRISTUS team felt that if their leaders could understand and adopt the Fierce practices effectively, they could then teach those who reported to them this new skill set and eventually lead to an overall shift in culture.

“The number one improvement since partnering with Fierce is the creation of a common language where people can understand principles and apply them,” said Scott Hopkins, Director of Leadership Development at CHRISTUS Health. “Fierce concepts and language have allowed us to build other system-wide training programs and integrate aspects of Fierce into them, reinforcing the key concepts into our everyday lives.”

Seeing how the Fierce outlook on conversation and the language used in the training had become engrained in the company culture, CHRISTUS decided to invest in training all new managerial hires. CHRISTUS provides them with programming that takes place over the first year after hire, and concentrates on having meaningful and direct conversations. The program also focuses on how leaders could empower Associates to share opinions, regardless of their position or age.


One of the major changes CHRISTUS Health created was viewing investment in leadership as a proactive measure for the organization. “Too often organizations use coaches to correct performance issues,” said Marty Margetts, Executive Vice President Corporate Services and Chief Human Resources Officer. “Our approach is to get upstream of any potential issues and leverage the strengths a new leader brings to drive organizational change.”

Since beginning work with Fierce in 2013, CHRISTUS has seen a number of improvements across the organization, including a 50 percent reduction in executive turnover. Another notable improvement is that 100 percent of the top executives, 184 in total, went through an executive leadership feedback and individual development planning (IDP) that totaled 1,200 hours of coaching.

While there have been dramatic improvements from a numbers standpoint, it’s hard to measure the improved value of Associates feeling equipped to have meaningful and effective conversation. “People leave class excited and having enjoyed the session. But that’s not the only place Fierce lives and breathes; it is integrated into all other training,” said Hopkins. “I think Fierce concepts have positively influenced the people who live out our culture for the rest of their lives.”

Further proof that the Fierce mentality has become an embedded aspect of CHRISTUS, they have started offering refresher courses from members of the team that were certified by Fierce to teach the curriculum. These courses are designed to remind Associates of the foundation of their training while refreshing the skills they’ve developed.

Another program that benefited from this strategy is the Leadership and Ethics Academy, aimed at training high potential mid-level leaders who are strong candidates for promotion more extensively. Each year, 25 candidates partake in the program and receive roughly 500 hours of coaching. Since its launch, the program has produced 100 new leaders and among graduates, CHRISTUS has seen a 36 percent promotion rate, 81 percent retention rate, and a 73 percent improvement in targeted competencies that arose from IDP feedback.

Overall, the leadership programming has proved to be so successful that in 2014, CHRISTUS was awarded The International Coach Federation (ICF) North Texas Prism Award. This award is presented yearly by the ICF to honor an organization that has demonstrated that professional coaching used as a leadership strategy can pay off greatly. Previous winners of the award include IBM, ORACLE, Deloitte and Touche, and Xerox Business Systems. Margetts stated that CHRISTUS views their “intentional use of coaching to assimilate new leaders as an investment in the future of [their] organization.”

After implementing Fierce’s practices, CHRISTUS Health has seen improved Associate engagement, dedication to constant personal improvement from all levels of Associates, and an increased commitment to the organization and its mission, values, and goals.


Fierce remains a close partner to CHRISTUS Health, assisting in the advancement and teaching of their training programs. But the development isn’t scheduled to stop. The emphasis started on the leaders of the organization, but now the focus is shifting to younger Associates with the intention of empowering them to be leaders from the beginning.

By implementing Fierce’s approach to communication, CHRISTUS created an environment that appreciates feedback and encourages conversations that solve problems and foster creativity. The partnership with Fierce has made CHRISTUS Health better positioned to not only function more effectively through its relationships and culture, but to thrive as an organization. “With Fierce, Leaders feel as though CHRISTUS is investing in them by providing learning that helps not only with their job function, but in all areas of their lives,” said Reynolds.