The senior management team at Holy Cross Hospital, a nonprofit hospital based in Florida, wanted to build a culture at the hospital which was different from the traditional authoritarian and hierarchical hospital cultures at other for-profit and nonprofit hospitals across the United States. John Johnson, CEO of Holy Cross Hospital, believed that there was another way to run a successful hospital, a way more in keeping with the needs of both hospital employees and patients. He developed a new cultural strategy based on Jeffrey Pfeffer's book, The Human Equation: Building Profits By Putting People First. By 2000, Johnson was pleased with his progress, but he was also frustrated with the occasionally slow pace of change and wondered what he should do to move things forward more quickly. Johnson also felt that the cultural transformation was beginning to lose some steam and he needed to revive employee enthusiasm.
