HSH CEO Alwin discusses his successes, obstacles and goals

Hot Springs Health’s (HSH) CEO Scott Alwin, along with several of his staff, sat down and explained how the hospital’s culture has been transforming into a new form.

Alwin started as CEO on July 1, 2022, just about one and a half years ago. Since that time, Alwin described some of his accomplishments. He said, “I think we’ve made a lot of great strides in many different areas. Number one, we’ve worked diligently to improve culture and reduce our turnover. We reduced our turnover rate from 25% in July 2022 to 15% as of current. Which says a lot about our entire organization in that individuals are not leaving for other occupations. They’re staying within the walls of Hot Springs Health or within the organization.”

Alwin added, “We’ve seen great change in our leadership structure. We’ve had a fairly new leadership team that has grown and developed quite a bit in both the board of directors and the executive team. Since I’ve been the CEO, we’ve had two new board members who are excelling in their roles as on the board of trustees. We have been able to fill very difficult positions for directors. And then additionally, we are seeing the number of travel staff reduce.”

The reduction of the travel staff is quite significant for HSH. Alwin explained there were several reasons for this. He said, “It’s significant because of many things, primarily is cost. It’s very costly to bring in travel staff. Number two, it creates a morale issue amongst the teams that are utilizing travelers. We’ve actually been pretty pleased with the fact that we have been able to recruit a fair number of travelers to our full-time staff. Which says a lot about who we are. It says a lot about our culture. When they can travel the country, make a lot of money. And yet they want to come here and they want to make this their home.”

When asked about who his influences were that helped develop Alwin’s leadership style and how it affected the culture at HSH, he said, “I had two big mentors. They were both CEOs at the hospitals that I worked for. One was from Burlington, Colorado, who actually planted the seed for my goal to become CEO. He pulled me aside. He encouraged me to add to my education in the area of hospital administration because he foresaw a potential in me to be able to be a part of his succession plan. The second mentor was from a hospital in Nebraska. He taught me a lot about what it means to be a good leader. I refer to quotes that he would share with me a lot.”

The most notable quote Alwin refers back to is when his mentor said, “Scott, you’re going to learn more from your mistakes than you are from the things that you’re doing right. Meaning those times you don’t do something correctly, learn from them and then be able to make progress.”

When it comes to navigating obstacles that hinder his goals, Alwin said, “I rely on the people around me, for example, our executive team at times. I rely on the directors who are in the organization. And then there are times where I’ll pull a group of even frontline staff members together to find out what’s blocking us from being able to get where we need to go.”

Regarding Alwin’s goals and focus, he said, “My main vision and focus is to be able to accomplish what I call an ‘Always Culture”. That being every patient who encounters an experience of Hot Springs Health has an exceptional experience. Every time. No questions asked. And that would extend over into our employees. So every employee would have an exceptional experience when they’re here at Hot Springs Health. That really is kind of a high-level mission. I think more of a short-term goal would be to help our organization fine-tune all what I call the 1% wins. Being able to fine-tune all the little things that help produce a wonderful experience for our patient.”

In learning more about the changing culture at HSH, Alwin invited Brian Bohleen from IT, John Dobbins of the Facilities Department, and Amanda Kretz from Reception to give their points of view.

Brian Bohleen described the cultural change in the past couple of years and said, “I’ve been going to the organization when the hospital purchased Red Rock Family Practice. I worked there for seven years prior to the purchase here and moved in here. I considered the clinic to be a very positive environment. People always said that we were a family and that it really was. All of those people are still some of my best friends. And then we came into this organization. It was tumultuous. We lost quite a few staff members and our cultures were not very compatible. And then, over the last probably four years, we have seen tremendous growth in terms of being able to communicate with each other. We are just generally nicer, which was not always a given, and we build better teams, both here in the hospital and across even the Thermopolis clinic, but also like our outlying offices as well. The attitude turnaround has been crazy. We communicate with each other better.”

John Dobbins added, “What I have seen for our culture when I got here was the tail end of the new hospital being built and then turning into the remodel. Then, of course, the pandemic. We’re all kind of blurred by that. The culture I see now is that we’re picking up on, like you mentioned, the 1% wins, some of the customer service training that we’re doing. We’re seeing a lot more of just the little everyday things we do is a very positive thing. We’re not bogged down in that remodel now or the pandemic of every single thing changing every single day. Things have stabilized.”

Bohleen also said, “I do feel it is a little bit of a settling in, especially once the remodel and that expansion was done. Like everyone’s mood kind of settled. It was a great high-stress environment at that time.”

Amanda Kretz, who has been at HSH for the past couple of years, said, “When I came in there was like an aura of something in the air for sure. Just maybe a lack of communication, that kind of thing. However, I will say that several things have definitely made it an employer of choice in my opinion. One, I came in at an entry-level position, which I hadn’t been in for a long time, and they allowed us the cost-of-living increase that let people like me who are happy in their position to be in that position and to stay in that position. So that was huge for those of us that were just starting out. They probably would have gotten off or somewhere else. Now I could say I’m not even looking in that interest. And that kind of calmed, I think, a lot of entry-level or, you know, low, lower-paying positions because it wasn’t pretty when I applied for the position I took on.”

Kretz added, “I would say that communication since I started has tremendously changed. I feel like we work as a team overall. I see that teamwork. I see that people generally want the community and those who come in to be treated at 100%. We’re bringing in people. There’s passion, there’s compassion, there’s empathy, there’s sympathy. I see it all across the board. I could touch base on a few things that could be adjusted. But overall, I think our culture is great.”

When it comes to the reasons why the changes in HSH’s culture turned around, Bohleen said, “We started our Service Excellence Initiative, which we just finished our first year. And I think that was where a lot of the big breakthroughs came through. It basically really forced people to work together in a way, even if it was just for a little bit. And I think a lot of communication breakthroughs happened because of that.”

Kretz also added that the Service Excellence Initiative was a significant part of the change in the culture, but she also said, “I feel like from Scott Alwin down, that level of expectation for our communication, if that makes sense. I don’t feel like anybody is going to be allowed not to improve in their department or not to improve in their position. I feel like we’re supported, but at the same time that’s an expectation.”

Alwin described the Service Excellence Initiative as “a guaranteed method of being able to improve your organization’s culture and improve your employee retention. It is owned by Custom Learning Systems, a Canadian-based organization that works with hospitals in multiple countries. They provide all the materials and resources necessary to have a successful implementation.”

Kretz also spoke of the change in accessibility to communicate with different staff members. She said, “I heard a lot of, ‘Well, you can’t talk to that person or you can’t go to that director. You can’t talk to that tech’ Since I started, and maybe it’s just me and how I am, but I feel like we don’t have anyone we can’t approach if that makes sense. There is no one at a level that you can’t walk in and talk to.”

Regarding the staff and their various departments working together and solving problems, Bohleen, Dobbins, and Kretz described their members working together, and that everyone has input. CEO Alwin added to their comments and said, “I think something that we have accomplished over the last year and a half is we have really raised the bar on accountability. That’s been an expectation that’s come from not only myself but the entire executive team that we have, that everybody in the organization is equal and we’re expected to be able to make sure we accomplish the tasks at hand and that we ensure that the job gets done and that we treat each other appropriately. And I think that has improved a lot around the organization.”

Alwin also emphasized one key administrative strategy in how he leads HSH and said, “A couple of other things that have really helped is we have specifically trained frontline staff members to function as service excellence advisors, and they have had the ability to step into a role that they never would have had before and helped lead the initiative. And that’s been a very eye-opening experience for a lot of them. When we talk about communication, I have what we call a Service Excellence Advisor or a SEA synergy meeting every month. They get to sit down with me once a month and there’s nine to 12 members. I’ve got a few standard questions that I ask them, but they basically have a free forum to come directly to the CEO and share what’s happening at the front line. What’s going well? What’s not going well? Why is this happening? Hey, we’ve got a question about this new policy that came out. Scott, can you fill us in on why that’s there, how it works? And the beauty of that activity is it has very much developed a sense of trust. They all have the ability to come directly to me and share their thoughts, their concerns. But then they turn around and they go share that with their friends and neighbors in their own departments…I take copious notes and I go to my executive team sometimes to the board, and I share with them what the frontline staff is enduring. And that’s been in my mind a very healthy dialogue to improve culture, to improve communication, to improve trust and the relationship between all of us.”

Alwin concluded his thoughts and said, “We’ve finished our first year of the Service Excellence initiative. That’s going to continue on. It’s at a minimum a three-year initiative, which is about the average time it takes to start to see a culture shift. It doesn’t happen quickly, it does take time. I think the beauty of that is we’re showing our organization and our community that we are invested in making a change to ensure that our patients and our community have an amazing experience while we’re here. And not only that, but that we become the employer of choice where people want to come here, they want to come here to work.”