Advocate Health’s Illinois Division Moves from Threshold to Target Engagement in One Year, with a 5.1-Point Gain in Psychological Safety

What Was the Opportunity?

Advocate Health’s Illinois division identified a performance gap through its anniversary survey results. The division’s engagement scores were sitting at what the organization classifies as “threshold” levels, meeting minimum acceptable standards but falling short of the “target” tier that indicates strong, sustained engagement. The executive team set a clear mandate: move from threshold to target engagement by the end of the year.

In a health system that had recently undergone a major merger, the Illinois division needed to demonstrate that its culture could not only absorb the organizational transition but actively strengthen through it. The anniversary survey, which captures teammate sentiment continuously across the employment lifecycle, provided the baseline data that made the gap visible and the improvement measurable.

What Was the Solution?

Rather than treating the survey results as a static report, the Illinois leadership team assembled a cross-functional working group of leaders, frontline managers, HR partners, and engaged contributors from across the division to analyze the findings in detail. Their review of comments and ratings surfaced a consistent pattern: the teams with the highest engagement scores had leaders who practiced specific, repeatable behaviors that built trust, clarity, and connection.

Identifying Bright Spots

The working group identified “bright spot” teams — those with high engagement scores and strong cultural indicators — and interviewed their leaders and employees to understand what differentiated them. The behaviors were not identical across teams but shared common themes: leaders who intentionally recognized wins (large and small), who created space in team meetings for questions and two-way communication, who helped employees understand the reasoning behind decisions, who held regular development conversations rather than annual-only reviews, and who invited feedback in both directions.

The Culture of Best Practices Program

From these interviews, the team curated the findings into the Culture of Best Practices Program, designed specifically for leaders in the Illinois division and built entirely from internal data and internal success stories. The program provided four core components:

Proven solutions: Real examples from high-performing Illinois teams, with specific detail on what actions improved engagement and why they worked.

Practical leader tips: Conversation starters, recognition techniques, agenda templates, communication approaches, and methods for strengthening psychological safety — all designed for immediate implementation.

Consistency tools: Checklists and rhythm builders to make engagement practices part of everyday operations rather than periodic events.

Stories from within: Spotlight features highlighting leaders and teams who demonstrated best-practice culture in action, creating social proof and peer motivation.

Each element was mapped to specific areas identified in the anniversary survey, creating a direct connection from employee voice to leader action.

What Was the Impact?

The Illinois division reached target engagement. By the end of 2025, the division moved from threshold to target engagement levels, achieving the executive mandate within the one-year timeframe. All six anniversary survey questions showed improvement, with the majority gaining 2 or more percentage points of favorability.

Psychological safety improved 5.1 points. The largest single-item gain was a 5.1-percentage-point increase in psychological safety, the survey dimension most directly connected to the Culture of Best Practices Program’s emphasis on two-way communication, respectful feedback, and leader openness.

Two items now exceed the 75th percentile. Two of the six anniversary survey items finished 2025 above the 75th percentile benchmark, indicating that the division moved beyond internal targets into externally competitive territory on those dimensions.

Sustained momentum throughout the year. Because the anniversary survey captures data continuously rather than at a single point in time, the Illinois division was able to track that improvement was sustained across the year rather than concentrated in a single period. This continuous signal validated that the Culture of Best Practices Program was producing durable behavior change, not a one-time spike.