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Case study

Implementing a leadership system to drive change in a community-based healthcare organisation

John B. Chessare, Carolyn L. Candiello and Lisa Groff-Reuschling
Management in Healthcare: A Peer-Reviewed Journal, 9 (4), 328-337 (2025)
https://doi.org/10.69554/APFG5353

Abstract

Healthcare organisations are people-intensive, complex systems. Traditionally, effective leadership required the leader to possess and develop skills and competencies; however, these alone are insufficient to generate aligned and sustained change. A standardised and systematic leadership approach, aligned with strategy, can help leaders move from reactive daily problem-solving to a culture of learning, improvement and innovation. Utilising the Baldrige Framework for Excellence, GBMC HealthCare developed and implemented a formalised Leadership System that is grounded in the organisation’s mission, vision and values. It considers stakeholder requirements and provides a stepwise standard approach for setting direction, building commitment, action planning, achieving results and developing people. Each step of the Leadership System has associated competencies that are used to foster development and growth. This approach was deployed across the GBMC HealthCare System, a community-based continuum of care organisation that includes an acute care hospital, a large hospice and elder care company and an ambulatory and specialty care provider group. Through case study, this paper details the framework and steps taken to develop and deploy a Leadership System that has led to sustained clinical and operational improvement. GBMC achieved the Baldrige Award in 2020, the nation’s highest presidential honour for performance excellence. In 2019, the Leadership System was recognised by Baldrige as a national best practice. Organisations can easily adopt this low-cost, high-impact method to create a standardised approach to help leaders achieve excellence both in their day-to-day activities and in guiding long-term strategic results. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/

Keywords: leadership system; Baldrige Framework for Excellence; change management; strategic integration; innovative leadership; mission-focused leadership

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Author's Biography

John B. Chessare , MD, MPH, is President and CEO of GBMC HealthCare, Baltimore, Maryland. A graduate of Boston College, the University of Rome School of Medicine and the University of Michigan School of Public Health, he completed his Pediatrics residency at the University of Massachusetts and his Academic General Pediatrics fellowship at Boston Children’s Hospital. Chessare is recognised for improving patient flow and for designing safer medication delivery systems in both academic medical centres and community hospitals. He is currently transforming his organisation to deliver better health, better care and lower cost with more joy for those providing the care.

Carolyn L. Candiello , MA is the Senior Vice President of Quality and Patient Safety at GBMC HealthCare in Baltimore, Maryland. She has dedicated her career to healthcare performance improvement, patient safety and quality and helped guide GBMC to achieve the 2020 Malcolm Baldrige National Award. She has served as both a state and national Baldrige examiner. Candiello presents nationally and internationally as both a keynote speaker and workshop leader on leadership, strategy, patient safety and performance excellence. In addition to her work at GBMC, she is actively involved in the Institute for Healthcare Improvement, serving as faculty and as an active member of the Leadership Alliance. She served on the IHI’s National Workgroup on the 2024 Update of the National Action Plan to Advance Patient Safety. She is a member of the American College of Healthcare Executives and holds a master’s degree in leadership/management from Notre Dame of Maryland University and a bachelor’s degree in business administration from Fitchburg State University.

Lisa Groff-Reuschling DNP, RN serves as Senior Nursing Director and Service Line Administrator for Women and Children’s Services at GBMC HealthCare. She completed her BSN at the University of Maryland School of Nursing, her MSN at Hood College, and received her Doctor of Nursing Practice from Johns Hopkins School of Nursing. Lisa has over 35 years of experience supporting clinicians through innovative approaches, developing the workforce for the future of nursing and health care. She has served as a regional examiner for the Partners in Performance Excellence programme and as a national Baldrige examiner. She helped guide GBMC to achieve the 2020 National Baldrige Award for Excellence. Her expertise focuses on enhancing interdisciplinary collaboration, developing professional practice environments and refining systems to support high performance.

Citation

Chessare, John B., Candiello, Carolyn L. and Groff-Reuschling, Lisa (2025, June 1). Implementing a leadership system to drive change in a community-based healthcare organisation. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 9, Issue 4. https://doi.org/10.69554/APFG5353.

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cover image, Management in Healthcare: A Peer-Reviewed Journal
Management in Healthcare: A Peer-Reviewed Journal
Volume 9 / Issue 4
© Henry Stewart
Publications LLP

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