How Transparent Communication Can Quiet Dissonance

The following article is a piece from Sarah Smith, Communications Consultant from IRI Consultants, taken from the 2021 Labor Activity in Health Care Report. Sarah has senior-level experience in public relations, corporate communications, change management, and internal communications.

When a large academic health system began to standardize pay practices across multiple facilities, leadership recognized that trust in change was essential—and the way to build trust was through transparent communication. This case study explores how a comprehensive engagement plan advanced a complex organization's evolution toward operating as one system.

More than 28,000 healthcare employees across 13 counties were accustomed to doing things their way, using their systems under their own policies. But when the member organizations where they worked became part of a larger, statewide healthcare system, employees would need to adjust to a new way of working under consistent standards. One of the first areas to standardize was among the most personal for employees—their paychecks and their time off.

The system's priority was to minimize any negative impact on employees as the standards were implemented. Leaders worked with each member organization to develop individual mitigation plans to ensure that if employees did see a loss, there was a plan to address it. 

While certainly not the first time that a larger organization had acquired smaller hospitals and medical centers, the key to a successful transition was all in the branding of change and in making sure employees were informed and enrolled in that brand as early as possible, through harmonized and transparent communication. The strategy was to position these changes as just one step in a journey toward a more cohesive organization and, along the way, highlight other initiatives that advanced the vision to tell the bigger picture. 

Set the Stage and Establish a Structure

Communicating a larger purpose and demonstrating a shared commitment across a disparate organization is essential before introducing policy changes. This transition began with the work of enrolling leaders of each member organization in the opportunities that would be created by standardizing pay practices. The system formed an executive-level steering committee with CEO co-sponsors that met monthly to discuss proposed standards, review data on how the standards would impact team members, and endorse final decisions as a unified group. It facilitated honest conversations where leaders could voice concerns, identify risks unique to their location, and begin to understand how the changes would impact their employees.

The composition of the committee was strategic. It brought together parts of the organization not previously so intentionally aligned in making broad, systemwide decisions. Representatives from human resources, nursing, payroll, operations, information technology, and communications were all at the table from the beginning, allowing decisions to be informed by all potential areas impacted. It formed smaller workgroups to tackle the more detailed components of the standardized pay practices, and their recommendations followed the workflow approval to the top.

This step cannot be overstated and should not be overlooked—buy-in and enrollment from the top-down proved critical in the many months ahead as the new standards were rolled out. The strategy relied on transparent communication and buy-in at every step along the way and every level of the organization.

The individual member organizations within the larger system each operated under separate policies, separate vacation programs, and separate timekeeping/scheduling software systems. In addition to the executive steering committee and smaller system-level workgroups, leaders of the initiative met in person with the senior leadership teams at each member organization several times from the planning to the implementation phase, ensuring that they understood the changes, had the opportunity to review communications, and could share feedback and concerns early in the process. The meetings were held on-site at the hospital, which signaled the inclusivity required for a successful rollout. 

Position the change as part of this purpose

The system created an umbrella name and branding for its overarching journey toward a more unified organization. All materials created for the pay practice initiative—from emails and fliers to presentations and webpages—carried this logo and branding. The branding became shorthand for employees to understand if a particular project or initiative was systemwide and connect the work to the larger vision and purpose of "system-ness." This strategic decision helped condition the work environment for change in the months leading up to the pay practices announcement.

All messaging emphasized the evolution toward a unified system that would be a complex journey phased in over many years and enrolling employees every step of the way. The details would not be dictated to them but rather designed with and for them. With the help of representatives from different regions, departments, and backgrounds, they aimed to create a more innovative and effective organization that leveraged technological advancements and industry-wide best practices.

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Establish a Hub

One of the most visible manifestations of the brand was a new website that would promote all systemwide projects, intended to be not only an information resource but a point of pride for employees demonstrating successes all across the system.

The website was an important transparent communication tool that would become central to its success – but it was critical that it launched before the announced pay practice changes. It launched three months before the pay practices were scheduled to be announced with a slate of stories that promoted the benefits of working together as a system. The system wanted it to have a larger purpose in showcasing positive ways that organizations across the system were working together to streamline processes and achieve greater healthcare outcomes representing all performance improvement areas from clinical to operations. 

Be Honest About Challenges for Transparent Communication

Just like any work environment, the system knew there were risks and challenges to overcome in planning for a successful transition to standard pay practices across multiple organizations. A series of meetings with managers at each member organization revealed some unique risks for each member organization but also several common threads where the system focused its change management efforts:

Support Managers

Across the system, leaders heard that managers were not particularly strong in delivering important messages, especially ones that may be difficult for team members to receive. Communications needed to prop up managers, provide them with additional support and enroll them in the changes. The transparent communications plan included messaging and training specific to managers that would help them deliver news with confidence. 

New Leadership

The system's leadership had recently changed, meaning that the new leader needed to be quickly enrolled in the project, featured prominently in announcements about it, and visibly endorse it systemwide. This set the tone that the initiative was supported at the very top level. 

Change Fatigue

Change is hard, and employees within the system had gone through a lot of it in the months leading up to the pay practice standardization. There was audible fatigue from employees responding to change and myriad new requirements and processes. The system prioritized simplicity and transparent communications to avoid further confusion or fatigue.

Make it Personal

The team helped the organization's leadership articulate the true "why" of the changes and why employees should care. The team needed to understand why this was a good thing for the workforce and what was in it for employees, then weave these messages into all our transparent communications:

  • Remove ambiguity about what to expect from one facility to another and establish a greater sense of consistency for employees.
  • Make it easier for employees to seek career advancement within the system.
  • Draw upon the strengths of being part of a larger system while recognizing the value of each affiliate's local culture and history.
  • Improve the overall employee experience and increase the ability to retain top talent – fundamental to the organization's mission.
transparent communication strategy

Consider the Audiences

Pay and time off are personal. When changes are made to an employee's compensation and benefits, it hits at the core of their workplace experience. The system knew it would need a variety of change management resources to ensure that all managers and employees understood them. The core communications components of the rollout included:

  • Manager Toolkit: This 90-page document was the master change management tool for managers to learn about and understand the new pay practices and policies. It included an introduction from the CEO, a fact sheet on each new pay practice, and an abundance of anticipated FAQs. It also included tools specific for managers, such as message points for the overall "why" the system was making these changes, talking points for conversations with their employees, and a tip sheet for helping them lead their teams through change. It was available as a printable download or digitally on the website. 
  • Dedicated website: On the website created for systemwide initiatives, the team developed a comprehensive information source for facts, FAQs, and example scenarios on all the changes. The manager section of the site was in addition to information accessible to all team members on the main page. It included a password-protected Manager Resources page with manager message points, detailed information on the more difficult topics to communicate, like PTO and changes in shift differential, a glossary of terms, and more. 
  • HR Quick Guide: This guide was developed specifically to reinforce the decisions made about practices and policies for the human resources business partners responsible for implementing and communicating them. It highlighted the new rules and policies in language that HR professionals would understand and included easy-to-skim reminders about specific aspects of how the policies would be put in place. This was an important piece because of the visible role HR business partners played in helping managers at each member organization fully understand how the new practices would affect them. 
  • Presentation Templates: Presentation templates that each member organization could customize allowed the system to maintain message integrity while allowing local leaders to integrate nuances in content that their local managers and employees would respond to. Each organization held open forums for managers in the weeks leading up to the changes being implemented, during which the new practices were discussed, and managers could freely ask questions of leaders. Featured FAQs were developed and shared on the website following these sessions as question trends surfaced. 
  • Printed and Digital Signage: For some organizations, a printed flyer posted at a timeclock or digital graphic rotating on a flatscreen were the most effective communications tools. While much of the transparent communications strategy focused on consistency, being responsive to what employees at one facility would pay attention to was central to a successful transition for all facilities. These materials reflected the same look and feel as the toolkit, website, and presentations so that employees would quickly see the 'umbrella brand' as a signal for positive change on the horizon.
  • Video: Knowing that people have different learning styles, the team prioritized the most complicated changes and those with potentially the most negative impact and created animated videos to help explain them. The videos were posted online and shared with managers via email as another means to convey the importance of learning about the changes before they took effect.
  • Employee Feedback Loop: After the initial announcement of the changes, months before they would go live, the team opened a question form online where employees could submit their questions about the new practices. The team was intentional in the messaging to not promise individual responses. Instead, the team used the information submitted to identify trends and messaging hotspots where it needed to focus on talking points, FAQs, or other transparent communications.

Be Ready to Flip the Script

Years of careful planning and a strategic cascade of information for the pay practice standardization were turned on its head. Just three months before the system was set to announce the pay practice changes, the COVID-19 pandemic hit, requiring all leaders' attention and focus and delaying the pay practice announcement. The pandemic also required a swift reimagining of some of the most important tactics outlined in the transparent communications strategy because of policies in place to protect the health and safety of employees. Once a new go-live date was approved, the system went from a several months-long runway that included in-person training of leaders to a three-week runway that relied solely on virtual pushes.

Manager Training

The original change management plan included four weeks of in-person training for managers focused on understanding change and how to be a leader in helping their employees adapt to it. When in-person experiences were prohibited because of COVID-19, the team converted the training curriculum to enhanced materials in the manager toolkit and added related content to the webpage and presentation templates. 

Open Forums

In-person opportunities to talk with leaders in small groups at each member organization turned into highly personal virtual open forums with the HR teams. The dates and times were published on the website, and the communications lead participated to hear concerns and potential hotspots that may need supplemental materials. 

Announcement Timing

Instead of preparing managers for change and then announcing the change, the team instead announced the change and then offered support resources. The new timing of the announcement leveraged employees' increased level of trust in system communications resulting from the pandemic. Because of the necessary systemwide response to the pandemic, the environment was more ready to accept other systemwide policies.

communications strategy

How do you know if it worked?

Measuring the success of such a comprehensive and complex rollout is always complicated. The team evaluated the go-live in two ways: employee feedback and statistics from the support center. Further evaluation may be needed as the system continues its journey toward consistency across all of its organizations.


The first wave of the go-live included more than 20,000 employees. 

  • On day one, only 10% of the cases opened in the HR support center related to the new pay practices.
  • On the weekend of the first paycheck under the new standards, the system's support center received only 11 calls. 
  • Only 49 employees required an adjustment on their first paycheck following the new standards.  

Employee Feedback

While the system hasn't conducted a formal survey, it did capture informal feedback shared by employees in the days following the implementation of the new standards. 

  • "We're finally getting this right."
  • "This is a breath of fresh air."
  •  "Such a positive change for the organization."
  • "There are a lot of positive changes happening, COVID19 is a terrible thing, but at least we've made it into a positive for our organization."

Transparent Communication Takes Practice

The transparent communication strategy developed for these critical policy changes set the standard for future workforce announcements. Leadership within the system understood that clearly written communications designed within a unified brand elevate the credibility and integrity of the message. As a result, employees' trust in the system increased, and their ability to adapt to change improved.

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