CASE STUDY
Culture of Ownership Drives Remarkable Gains in Patient Experience
CASE STUDY
Culture of Ownership Drives Remarkable Gains in Patient Experience
Executive Summary
United Regional’s Commitment to Accountability and Engagement
United Regional Health Care System, a nonprofit hospital in rural Texas, has become a national model for how strategic service recovery, frontline empowerment, and real-time feedback can elevate the patient experience.
Located in Wichita Falls, Texas, United Regional serves a geographically vast and medically underserved population, often acting as the only accessible provider of trauma-level and specialty care.
In partnership with NRC Health, United Regional implemented a proactive, system-wide approach to service alerts that has transformed both patient outcomes and internal culture. By equipping nurse leaders with the tools—and the permission—to personally follow up with patients, the organization saw a dramatic improvement in experience metrics and team morale alike.
Key outcomes include:
Key outcomes include:
71% of patient detractors were converted into promoters after follow-up contact.
Net Promoter Score (NPS) rose from 15.1% to 71.5% among repeat patients who received a follow-up after a service alert.
A cultural shift toward ownership and transparency, with nurse managers now regularly accessing NRC Health’s platform to act on feedback and recognize staff.
What sets United Regional apart is its commitment to human connection, both with patients and among staff. The success of their service-alert strategy rests not just on metrics, but on a deeply embedded culture of trust, accountability, and compassion.
This case study explores how United Regional leveraged NRC Health’s tools to not only improve scores, but rebuild relationships, develop leaders, and ensure patients feel heard and valued—every single time.
Keep reading for additional insights on how you can employ these strategies in your organization.
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“Trust is everything. It’s the foundation of care. And we’ve built a system that helps us earn it back when it’s been broken.”
Ryan Graves, Director of Patient Experience, United Regional Health Care System
About United Regional
Nestled between Oklahoma City and Dallas, United Regional is a 296-bed nonprofit hospital serving over 225,000 residents across a broad primary and secondary service area. The system offers level 2 trauma emergency care and attracts staff and patients from across the region.
“We’re a hidden gem,” says Ryan Graves, Director of Patient Experience. “People are surprised by the world-class care we offer in Wichita Falls.”
United Regional sets the bar for healthcare in the region with exceptional care, advanced technology, and a dedicated team of professionals. Through outreach initiatives, health education, and partnerships that foster well-being, United Regional is committed to making a meaningful impact on people’s lives.
Challenge: Rebuilding Trust, One Patient at a Time
In health systems, access and continuity are core concerns—but so is trust. Leadership at United Regional recognized that trust wasn’t just a value; it was a measurable driver of loyalty and outcomes. Yet frontline teams struggled under traditional experience-measurement models, which relied on limited, delayed HCAHPS data.
“Our managers were frustrated,” Graves explains. “They were being held accountable for metrics that felt outside of their control.”
Enter NRC Health’s real-time service alerts, which transformed how feedback was accessed, addressed, and internalized by frontline leaders.
Strategy: Turning Alerts into Action
At the heart of United Regional’s patient experience strategy is a clear shift: from reacting to experience metrics after the fact, to acting in real time on patient feedback. This shift began with a powerful decision—to tie leader performance goals to service alert responsiveness, not static, retrospective metrics like year-end NPS percentages.
The team leveraged NRC Health’s feedback management dashboard within the patient experience platform, a real-time interface that centralizes patient feedback and service alerts. These alerts are triggered automatically by NRC Health’s natural language processing (NLP) engine, which scans open-ended survey comments for indicators of dissatisfaction, safety concerns, or unmet needs.
The result? A system that surfaces meaningful concerns—often before they escalate—and ensures they are seen, acknowledged, and addressed. This technology is what turned data into daily action.
Key elements of the strategy included:
Key elements of the strategy included:
Empowering nurse managers to directly follow up on alerts within 24 hours
Shifting focus from “fixing” to “listening,” creating space for empathy and connection
Training new leaders with a standardized mentorship and onboarding process
Transparent, unblinded reporting of alert response rates during monthly leadership meetings
By using the dashboard to monitor alerts and access specific patient comments, nurse managers stay connected to the real stories behind the scores. Rather than relying on centralized staff or waiting for monthly reports, unit leaders take the lead in service recovery—often following up with patients they personally met during rounds.
“It reinforces the fact that we really care,” Stringfellow explains. “We’re not strangers—we’re following up on a promise.”
“We gave them a goal they could control, and that made all the difference.”
—Kim Stringfellow, Vice President and Chief Nursing Officer, United Regional Health Care System
Results: Culture Shift with Measurable Impact
This deeply personal and highly responsive model has helped create a culture where feedback is acted on immediately, not abstracted or delayed. With NRC Health’s tools as the foundation, United Regional didn’t just improve scores, they transformed the way care teams connect with patients and each other.
The shift was cultural, operational, and measurable:
The shift was cultural, operational, and measurable:
71% of patient detractors became promoters following a follow-up call and subsequent visit, demonstrating the impact of personalized service recovery on patient loyalty.
Net Promoter Score (NPS) for repeat patients surged from 15.1% to 71.5%, a remarkable leap that reflects both improved experiences and restored trust.
Manager engagement with NRC tools increased dramatically, marking a departure from legacy platforms that left frontline leaders feeling disconnected and powerless.
“Before NRC Health, I dreaded being asked for data,” says Graves. “Now, I can walk into a unit and show exactly what’s working and what’s not. It’s empowering.”
This empowerment has created a flywheel of continuous improvement. Nurse managers, who were once passive recipients of delayed survey data, are now active agents of service recovery. They engage with patient feedback in real time, close the loop on concerns, and turn moments of dissatisfaction into opportunities for connection and coaching.
The result is a culture where feedback is not feared but embraced. Real-time alerts aren’t just a tool for mitigating risk—they’re a catalyst for recognition, learning, and system-wide accountability.
“Calling a patient back isn’t just a task,” says Stringfellow. “It’s a message: We heard you. We care. And we’re doing something about it.”
Sustaining the Gains: Trust, Transparency, and Staff Support
At United Regional, trust extends beyond the bedside to shape how leaders engage with staff, how teams support one another, and how the system reinforces its commitment to both service excellence and employee well-being.
“Trust is everything,” says Graves. “If we broke it, we need to rebuild it—and not just with patients, but with our team.”
United Regional’s culture of transparency is powered by tangible practices. Daily interdisciplinary huddles and unit-based rounding are standard—giving frontline staff opportunities to raise concerns, identify barriers, and recognize wins in real time. These moments help identify issues early, so they can be addressed proactively rather than reactively.
To ensure that staff voices don’t just get heard but also influence strategy, the organization leans heavily on frontline governance councils. These cross-unit forums empower employees to co-create solutions, propose quality-improvement initiatives, and bring department-level insights into broader system discussions.
Communication training further reinforces this culture of respect and responsiveness. All clinical staff are trained in the “heart-head-heart” model of service recovery—a framework that begins with empathy, addresses the issue, and ends with compassion. The approach equips team members to engage with patients thoughtfully and confidently, even in high-stress situations.
But perhaps the most powerful signal of trust is the organization’s stance on staff safety and respect.
“We tell our team: you’re not here to be abused for a good survey score,” Graves emphasizes. “We support our staff the way we expect them to support our patients.”
That support is backed by policy and culture. Staff have the autonomy to step out of unsafe interactions. Peer collaboration is encouraged, and nurses often switch assignments or floors to diffuse tense dynamics, without blame or stigma. This flexibility has created an environment where employees feel respected, heard, and protected.
The results are undeniable:
The results are undeniable:
Negligible agency staffing needs, signaling strong retention and morale
High levels of employee engagement, reflected in feedback and performance
A renewed sense of ownership, where everyone—from leadership to bedside staff—understands their role in shaping the patient experience
“Make it easy for staff to do the right thing,” says Stringfellow. “That’s how you build a culture that lasts.”
By embedding trust into every layer of its operations, United Regional isn’t just maintaining performance, it’s sustaining a workforce that’s equipped, motivated, and proud to deliver exceptional care.
The NRC Advantage
For United Regional, the relationship with NRC Health goes far beyond data collection; it’s a true strategic partnership that has redefined how the organization approaches patient experience.
Prior to adopting NRC Health, United Regional leaders often felt frustrated and reactive. Access to meaningful insights was limited, turnaround times were slow, and the data that did come through lacked the specificity needed to drive targeted improvements. Managers were left guessing—or worse, implementing broad, unfocused changes based on assumptions.
A partnership with NRC Health changed all of that.
Key advantages of the partnership include:
Key advantages of the partnership include:
A four-fold increase in survey response rates, providing a richer, more representative view of the patient experience across all units
Granular, department-level insights that allow leaders to zero in on issues unique to their areas—no more one-size-fits-all strategies
Real-time access to patient comments, enabling timely service recovery, immediate coaching opportunities, and near-instantaneous staff recognition
“We don’t make blanket changes anymore,” says Graves. “We make smart, strategic changes, because we have the data to guide us.”
Perhaps most importantly, NRC Health’s tools have made data accessible to the people who need it most. Nurse managers, who once relied on monthly reports pulled by someone else, now log into the platform themselves, engage with feedback in real time, and use that information to improve daily operations on the ground.
Beyond the technology, United Regional credits NRC Health’s team with providing critical guidance and support. Whether it’s discussing strategy with a dedicated partner or getting a near-instant response to a data request, the collaboration is consistent, responsive, and deeply aligned with United Regional’s goals.
This level of partnership has empowered United Regional to not only elevate patient-experience metrics, but to do so in a way that strengthens culture, engages staff, and builds trust at every level.
Service Recovery as a Competitive Advantage
United Regional has proven that service alerts, when embedded in a culture of listening, accountability, and care, are more than a tactical tool. They’re a strategy for healing relationships, improving retention, and strengthening community trust.
As Graves puts it, “When we broke trust, the best way to rebuild it was to call—just call them. And that’s what we did.”
Key elements of the strategy included:
Key elements of the strategy included:
Start with culture.
“If you don’t want to serve, you’re going to hate it here,” Graves jokes. “But culture isn’t fancy—it’s consistent.”
Make it manageable.
Set conservative goals early on. “Ease into high performance,” says Stringfellow.
Empower your leaders.
Give them the tools, data, and insights and make it easy to do the right thing.
Alignment
“It has to be a priority at the highest levels,” says Graves.
Related resources
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Learn more about NRC Health’s platform here or call 800.388.4264.
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©NRC Health. Select images featured in this case study have been provided by United Regional Health Care System and are used with their permission.