Case Studies

Culture Transformation Case Study: CommWell Health System

Over the last 25 years, Corporate Transcendence founder Pamela Tripp has developed a comprehensive, proprietary cultural transformation training curriculum for healthcare organizations. The Corporate Transcendence program was fully tested and applied within a healthcare organization that was on life-support.


The Starting Point

In 2009, CommWell Health a large non-profit multi-county community health system in Dunn, North Carolina, which offers medical, dental, behavioral and specialty services was failing in all areas of culture, quality, finance, and regulatory governance; it was described by a Joint Commission surveyor as being “burnt to the ground.”  CommWell had massive debt and was being operated by a struggling group of disengaged, disenfranchised, hopeless colleagues. Faced with a recommendation of bankruptcy, Ms. Tripp and the Board of Directors made a decision to try to save the organization and implement the Corporate Transcendence program they named the Eagle Excellence Academy.

Ms. Tripp realized that this extremely challenged environment was the perfect arena to provide a proof of concept for the Corporate Transcendence program.


CommWell Health Organizational Facts in 2009 before Corporate Transcendence and the Eagle Excellence Academy

  • Over $8.4 million in debt with $15 million budget, negative cash flow.
  • Lost 80 employees through voluntary termination and layoffs within two months.
  • Voluntary deferment of some compensation for 1.5 months to make payroll. Did not make payroll one time,  $275,000 out of $425,000 payroll was divided among remaining staff. Some doctors were paid less than $90 with deductions.
  • Joint Commission 2010 surveyor remarked, “You were burnt to the ground.”
  • Entire executive leadership had abandoned ship.
  • Infrastructure was non-existent. Forced to close two office practices.
  • Every state and federal grant was in jeopardy.
  • Accounts receivables were $3 million, with no hope of successful collection. The billing department was completely dysfunctional.
  • Accounts Payables were consistently overdue with past due invoices up to over 6 months.
  • Employee morale extremely low and staff turnover very high.
  • Poor scoring on Joint Commission accreditation; HRSA funding in jeopardy.

Corporate Transcendence – Eagle Excellence Academy Implementation

After the CommWell Board of Directors made a committed decision to implement a complete cultural change using the Eagle Excellence Academy program they created the Eagle Excellence Council that established training for all stakeholders in the organization including leadership, management, colleagues and professionals.  Using the design that Ms. Tripp had created, the Council took the following steps over a period of two years to completely change the culture, behavior and success of the organization.


  • Executive Leadership and Board of Directors approve Culture Transformation Journey.
  • Organizational Assessment of Mission, Vision, Corporate Values, Strategic Plan.
  • Orientation and Onboarding of employees to Corporate Transcendence.
  • Eagle Excellence Council formed made up of Soaring Eagles, Senior Leadership.
  • Corporate Transcendence named Eagle Excellence by Colleagues.
  • Train the Trainer (Soaring Eagles) for Front line Eagle Colleagues.
  • Soaring Eagle Colleagues teach peers mastermind/workshops quarterly.
  • Multidisciplinary Mastermind Group sessions taught by CT Coaches: Senior Leadership, Middle Management.
  • Multidisciplinary Mastermind Group sessions taught by CT Coaches: Medical, Dental, Behavioral Health, Specialty Providers.
  • Flight School for Personal Professional development of Eaglets (to continue program leadership development).
  • Best practices focus under Four Trees of Transcendence: Culture, Quality, Finance, and Governance in Departmental Operation Eagle meetings and in Department Quality Eagle meetings.
  • Alignment of culture to Code of Behavior, Core Values, Mission, Vision, Strategic Goals.
  • Colleagues have been through 2-year terms for each level of CT/Eagle Excellence by volunteering to be a participant in the following successive levels of Eagle Excellence: Flight School, Soaring Eagles, Eagle Mentors, Silver Eagle Ambassador.
  • Reward and Recognition living a culture of excellence and for internal success for key performance measures and external accolades for organizational success at state and national level.
  • Annual external audit on Eagle Excellence initiative.
  • 100% of colleague participation in Eagle Excellence and in 2017 60% of colleagues have been actively engaged in teaching at some level.


What Happened after implementing the Corporate Transcendence Training Program?

Today, CommWell Health is thriving financially and 70% of the workforce expresses a desire to work with CommWell Health for 10 years or more! Patient satisfaction and clinical outcome scores and best practices have soared, and financial outcomes for the organization have risen above most industry benchmarks. In just a few years the organization went from a life support to a high quality organization, being awarded the North Carolina Governor's  Malcolm Baldrige Quest for Excellence Milestone One award in February 2016, and has received over 50 service excellence and best practice awards over a 6 year period.  In 2017 CommWell Health was awarded 3 national recognitions by the National Rural Health Association:  Most Outstanding Community Health Organization, Most Outstanding Community Outreach Program, Most Outstanding Educator.  Also in 2017 CommWell Health received the North Carolina Community Health Center Association “Dr. Evelyn D. Schmidt Outstanding Service Award.” Ms. Tripp has also received the coveted Blue Cross Blue Shield “Robert J. Gretyzn Jr. Award for Healthcare Leadership Excellence” with an accompanying $25,000 donation.


Key Performance Indicators (KPI); 3-5 Years after Culture Transformation Training:

Culture (People)

  • Employer of Choice 93% employee engagement - Press Ganey.
  • Internal Promotions (25-30% / 5 years).
  • Turnover Rate (12%).
  • Colleague Degrees obtained or in process (23% of staff) without tuition support.
  • Two-thirds of front line colleagues taught service excellence workshops to staff.
  • Internal Governing “Cultural” Council for Excellence Provider and Colleague Satisfaction Scores (Loyalty - 50% greater than 10 years.
  • Patient Experience: 16 locations score 89-95% patient satisfaction.
  • Provider of Choice: Patient Volumes growth annually.


Quality (Systems)

  • Track over 190 clinical values in real time.
  • Three Joint Commission accreditation: 1- Medical/Dental, 2-Behavioral Health, 3-Patient Centered Health Home.
  • NCQA Level 3 (15 locationa)
  • Work Flow System.
  • Innovation of Performance Improvement Model operates at all levels of organization.
  • HRSA Quality Measures.


Finance (Sustainability)

  • Doubled size of organization- practices/locations.
  • Budget over $22 million.
  • 90% in Debt Reduction.
  • Over 30 newly funded Grants.
  • $5 million in reserve.


Governance (Accountability)

  • Meets all state, national, regulatory requirements.
  • Member of Medicare Savings Program/ACO receiving value based reimbursements.
  • Received Milestone 1 – Malcolm Baldrige Quest for Excellence Governors Award.
  • Awards and Recognition, State and National.
  • Best Practices receive State and National Recognition HIV/AIDS.
  • Most Outstanding Healthcare Organization, Most Outstanding Community Outreach program.

Employee Most Outstanding Clinical Educator from National Rural Health Association 2017.



The CommWell Case Study is a real example of Corporate Transcendence from failure to success. The processes created with the Eagle Excellence Academy can be duplicated in any health care organization and will result in dramatic improvement with the organization’s Culture, Quality of Service, Financial Performance and Corporate Governance.


“It's time to put the oxygen mask on our healthcare system.”

― Pamela Tripp, Founder & President, of Corporate Transcendence