Bill Klaproth (Host): This is a special podcast produced on-site at SHSMD Connections 2026 in Baltimore as we talk with speakers and session leaders direct from the conference. I'm Bill Klaproth.

For health systems, brand reputation isn't just shaped by advertising. It's also shaped by employees, culture, leadership, patient experience, and what people in the community are saying about the organization. So, joining me to talk about how Adena Health used an inside-out brand strategy to rebuild pride, trust, and reputation are Laura Guido, Chief Strategy Officer at Adena Health, and Jennifer DeMatteis, Associate Vice President of Marketing Communications, also at Adena Health System. Laura and Jennifer, welcome.

Laura Guido: Hi, Bill. Thanks for having us.

Host: You betcha.

Laura Guido: Hi, Bill. Great to see you.

Host: Yeah. Thank you both for stopping by. I'm very interested to talk to you about this inside-out approach that you both took. Laura, let me start with you. So, take us back to the beginning. What was happening with Adena's reputation and employee pride that made you realize a traditional marketing approach wasn't going to be enough?

Laura Guido: Well, Adena has been around for more than 130 years. And I would say a few years ago was maybe one of the darkest days of the organization. We were facing a pretty big social media attack on some of our leaders, on the organization, on our employees—which we call all employees caregivers—on our caregivers, on the care, you name it. And we are a rural-based system, so you can imagine smaller communities like that, our community is our employees. So when we talk about inside-out, it is very much connected.

So at this point, over the course of several months, we were seeing a decline in most of our major metrics. From employee engagement, we do a twice-a-year survey with market share, with pride and reputation in the organization, as well as our net promoter scores both internally and externally. We really realized that what we had been dealing with was really impacting us across the organization.

And because of the nature of our communities, we realized we had to do something different. We can't advertise our way out of this. We can't do this alone. And we really partnered not only with leadership across the organization, but hand-in-hand with our human resources department and looking at how we can build pride across the organization, really through, transparent communication, giving platforms and opportunities for people to showcase their pride. But just importantly, really building accountability in our leadership and among each other and ensuring that we are moving forward on rowing in the same direction, if you will.

Host: Yeah. So when that net promoter score starts to take a dive, you know that people in the community kind of aren't digging your action kind of, right? That's kind of it?

Laura Guido: Well, even beyond that, we were seeing a, a reduction in market share as well. So it wasn't even just the reputation, which obviously as a marketer is really important. But when you see that impact the business, that's really when you know you have a problem.

Host: Yeah, absolutely. So Jennifer, once you decided to work from the inside out, what did that actually look like? How did you begin engaging employees and turning their experiences into part of the brand's story?

Jennifer DeMatteis: Yeah. So, that's a really great question, Bill. As Laura said, you know, when we had to look at several platforms in order to be able to accomplish this, historically, I think a lot of the pressure has fallen just on the marketing and communications team to really lead, manage, as well as execute. And so, being a role-based health system, we have about 4,000 caregivers and providers within the area.

And so, what we really dug into was how could we leverage them to tell our story? How could we start within our walls to really showcase how proud these individuals were to talk about what they do, how they take care of patients, and how much passion they have for the areas where they live and work.

And so, there's several things that we did in order to do that. The first thing that we did was really to tackle from the culture. As we looked at things from our employee engagement scores, we saw that those were dropping. We knew in working closely with HR that there was a significant need for pride, and that we needed to really overcome this.

And so, one of the programs that we adopted is known as the Adena Ambassador Program, and that gives the opportunity for anyone within the organization to become ambassadors. What that means is that they are representative of Adena, and they are sharing the good about Adena. And so with that, they have quarterly challenges.

We've been very strategic about it in regards to connecting it back to our strategic priorities to help them further understand the impact that they're having. And we've also been really strategic as a way to build that pride within teams, that it trickles down really to the entire organization. So, it's been incredibly successful. It's now in its second year. And we are almost at 35% of all caregivers within the organization being ambassadors, which is incredibly significant.

Host: Was that volunteer? Did people just sign up to become brand ambassadors?

Jennifer DeMatteis: Very much so. So, it's definitely been a journey, and I would say it's a great example with seeing my team within the marketing and communications world as far as how we've learned and grown and evolved. But it is. Our philosophy is once an ambassador, always an ambassador. But it is essentially they participate in challenges.

One of the most recent ones that they've done, as I said earlier, connects back to our strategy, and it talks about the impact that they have. It goes into really digging into how their roles in somehow, some way are contributing to our strategic goals, and that everyone within the organization is needed to help our organization succeed.

I will also add there are some benefits to becoming an ambassador. Anyone that is an ambassador within our organization has a portion of their badge that reflects that. And then on top of it, there are opportunities to get Adena-branded merchandise as well, which is very popular. And it's another great way for us to get our name out in the community to support that brand awareness.

Host: So, it sounds like you would start with your most engaged employees. And then, once they start becoming brand ambassadors, other people might say, "Oh, I want to do that too." So, it kind of starts spreading through the organization that way. Would that be right?

Jennifer DeMatteis: Very much so. I would say it's very much a domino effect. And momentum continues just to go in the direction of, you know, positive success.

Host: Yeah.

Laura Guido: I agree with everything Jen said as well. But really, I think, in so many ways, the stars aligned at this point for us. While we were looking for opportunities to really give a platform for everyone to showcase their pride, our partners in HR were really digging in around leader accountability. And putting those two together, really, I believe is the secret sauce for this success.

And the only other thing I would add, when we were being attacked on social media, we had a lot of our caregivers who wanted to, like, push back. And you know what they say about a bully, right? You're probably not going to beat a bully. So, we wanted to give them a platform to talk about their pride in a really positive way that didn't make it a little difficult for them on their own personal social channel. So, I really think it was that combination of having that all come together that really allowed us to be successful.

Host: Yeah. And then, Laura, I know you describe brand stewardship as an enterprise-wide responsibility, so we've kind of talked about the employees a little bit. How did you get leadership and other parts of the organization to understand that brand isn't something that marketing can own alone?

Laura Guido: A lot of conversations. I would say we're also very lucky to have a really engaged executive team with open minds around what can be, and understanding that sometimes you need to do things differently to really impact change. The other thing that really was at our benefit is we do an annual scorecard around metrics for the organization. It's based on four quadrants. Human experience, so that's employee and patient experience. we have a quality and safety quadrant, a stewardship quadrant, and then growth. And we incorporated ambassador goals as part of our growth quadrant that allowed us to really look at system-wide metrics, and those goals cascaded across the organization. So, it really became everybody's responsibility for success.

Host: So, I guess, marketing can't repair the brand if operational problems, bad leadership behavior, those kind of things, or poor employee experiences continue. So, you really got to work from the inside out to take care of these things. Is that right?

Laura Guido: Absolutely. And we take a lot of pride in our communities saying that friends and family and neighbors take care of friends, family, and neighbors. And it's really important to us in connecting with the community that that philosophy really is part of our every single day. And so, the more that we talk about that, the more we align around strategic objectives and strategic targets that go across marketing and brand and reputation and our patient experience and our employee experience, which then obviously quality care is paramount to that, which also then helps stewardship. It really is everybody's responsibility. And if one is missing, I don't know that you hit on any of them.

Jennifer DeMatteis: Yeah. And I will add to that, Laura. I think that's fantastic, but I think the other thing that we really learned is, because of our reputation challenges, how do we consistently look for channels where we can be pushing out positive content? And the more positive content that you're pushing out, the more that is actually going to push down the negative content. And so, that is a very, very intentional strategy. We learned, because it's rural, I always refer to it, it's like the set of Cheers for anyone that remembers that show, but everyone knows one another in that community.

And when they see people that they know, they're easily able to form the, a great emotional connection, and it just helps to reinforce the pride and the commitment, that these caregivers have. But also, you know, the stories that we've been able to tell externally about our patients and those that have also benefited from care within our health system.

Host: I love what you're saying here. I've been writing down a couple of notes here. So in a rural health system, the lines kind of between employee, patient, neighbor, friend, community member, they all kind of blur together, right? So, the nurse who works at the hospital may also be your neighbor, could be your kid's soccer coach, or somebody you see at the grocery store. So, all of this ties into that. Would that be right?

Jennifer DeMatteis: Absolutely. And it's been very eye-opening. One of the other campaigns that we have launched, and this has been an external focus, is known as Faces of Adena. And with that, the goal was very much what I just said. How do we look for opportunities to push out the good news, and leveraging those in our community to really tell those authentic stories?

And so, being able to talk about our caregivers, whether it is our nurses or we did a great story on someone within environmental services, down to the patients that are treated at Adena Health, and hearing their stories, has really helped to reinforce the impact that we have.

It's also helped to reinforce that they can receive care close to home, which is another big I would say sometimes a misconception within a rural health setting, is that you have to travel far for your services. And so, part of our strategic initiative, Bill, was to be able to identify key services where we wanted to have essentially awareness or on the specialties that they're doing and or awareness on those providers. And s,o having the patients come in and tell those authentic stories has gone so far and has been incredibly beneficial.

Laura Guido: The one thing that I would add to that too is in addition to the patients and the caregivers and providers that we've featured, we also have featured community partners. And that is absolutely essential to our success, our ability to treat our communities, is those partnerships.

So, whether it is local superintendents where we provide athletic training services or school-based health services. We featured executive director from the YMCA where we do a lot of programming together, and I can name dozens of those partners. But not only does that showcase the extension of our services beyond the walls of the hospital, also provides a little bit of that third-party validation, which I think is really key when you're looking at net promoter scores. And that's really what that's all about.

Host: Yeah. This is really good. Getting back to the employee sentiment, I guess all of what you're talking about can really spread quickly and help to change that community perception, right? And then, Jennifer, you're talking about the authentic storytelling. That was a big part of the strategy as well.

Quick follow-up for you. For somebody listening, can you give me an example of that, of storytelling that you put together to reach the community, using one of your employees?

Jennifer DeMatteis: Yeah. We have about 70 of them. And it's still going strong. And so, I would say for anyone, first off, looking to learn more, I definitely encourage you to go to adena.org/faces.

We had a patient who had a stroke, right? And so, lots of things came from that, right? He not only received care at one of our critical access hospitals, but then he went into our inpatient rehabilitation. This individual was very well-known in the Greenfield, Ohio area, and really was able to talk about how his quality of life has improved because of the inpatient rehabilitation care that he was able to receive right here at home.

And so, it is very empowering to hear these stories, not only from, you know, what I'm hearing from the marketing and the communications lens, but also being in the shoes of a caregiver myself to really hear how it's impacting our patients, how it's impacting even the caregivers as well, as Laura said, with the community members as well.

Host: Yeah. Thank you for that example. I love that. And Laura, you said that you have seen measurable results because of this. I think that's one of the most interesting parts of this story. What did you see in areas like employee engagement? We were talking about net promoter scores, patient experience, or even community perception.

Laura Guido: Well, we've fortunately seen improvements across the board. We measure net promoter score both among our caregivers as well as our customers, so internally and externally. From an external perspective, over the course of two years, we saw a 35-point increase in net promoter score, which is pretty impressive, if I do say so ourselves. We saw a 10-point increase internally among our caregivers, which is also very notable. But we're seeing increases in market share. We saw an increase with our recruitment efforts from a bottom decile to top decile, which is really hard to wrap your head around. And recruiting in rural communities isn't always the easiest thing to do. But we've also seen improvements in retention across the board, leader index scores. So, we're really proud of being able to have truly measurable targets that we've exceeded.

But in addition to that, I would say, and, you know, Jen I'm sure, will agree with me on this, we've seen a lot of increases around our engagement with our content as well. So, we're seeing it really organically as well as, you know, some of our very structured measurements.

Host: Would it be fair to say more engaged employees too? A happier workforce?

Laura Guido: Without a doubt. So, engagement scores have increased. We look at pride and reputation. We look at engagement overall, and definitely have seen increases. And the leader index, I think, is really notable, and there was a structured program that our leaders had to go through based on the outcomes of their engagement surveys. And it wasn't to put people on notice or make it punitive at all. It was giving them resources to be better leaders.

And so much of this, I believe, is really rooted in transparency and accountability. And we've taken a very transparent approach to how we talk to our organization. If there are issues, if we can talk about it, we're going to talk about it. Obviously, we have to be mindful of HIPAA and all of that. But we really have taken that approach and really encouraged our leaders to understand that it is their responsibility as well to talk to their teams and to do so in a transparent, direct kind way. And that really is reaping the rewards for the organization.

Jennifer DeMatteis: Yeah. And one more thing to add, Laura, the other thing that's been really interesting with the data is how it's trickling down to our patient experience scores, right? And so, there's been a significant impact in regards to quality of care, patient experience, and overall satisfaction that we've been able to see.

So, I think when we look at this from the total package and all of the data, it's also fantastic validation to show that it's working. And from the marketing, from the communications lens, it can be very hard to track measurable ROI and hard to track what that data is. However, these have all been fantastic indicators to show that what we're doing is working, and it's only continued to increase momentum. And now, we're just looking at how do we continue to grow and expand.

Host: I love it. This has been great, ladies. Thank you so much for stopping by our podcast booth at SHSMD Connections 2026.

Last question to each of you. Quick wrap-up. Laura, let me start with you. For a rural or community health system that may be dealing with similar reputation or employee engagement challenges, what's the first step you recommend they take?

Laura Guido: I think having really honest conversations among their leadership team and not being afraid to have those tough conversations. It is really hard when you see yourself or your colleagues being blasted on social media for things that are pretty untrue and really unkind. You don't want to talk about it. You have to talk about it. And I think that being transparent and direct and a little vulnerable with each other is really step one, and then coordinating efforts across the system and really recognizing that we all have to work together.

Host: So, honest conversations and allow yourself to be vulnerable to really move the organization forward.

Laura Guido: Absolutely.

Host: Yeah. Jennifer, how about you?

Jennifer DeMatteis: I completely agree. I think that transparency is essential, but I also think it's asking the questions, peeling back the layers. One of the things that I've really pushed my team to do to help get to the root of how do we approach this and what are the areas that we focus on, is forming those relationships with our service lines, with our providers, with executive leadership to really understand and really kind of understand what it's like to be in their shoes.

Because I think sometimes when you are in the marketing communications role, it can really be hard to really understand the day-to-day as far as what's happening on the clinical side. And so, this has encouraged us in a very good way to really dig deeper and to really look at how do we form relationships where we can get those authentic stories and those pieces of information that are really valuable to share both internally and externally.

Host: I love that. So, building those relationships internally as well is really important.

Jennifer DeMatteis: Absolutely.

Host: Yeah. This has really been interesting. So listen, you can't always market your way out of a bad reputation, right? And you found that out, and instead you worked to improve the organization from within; hence, the inside out, then used employees and community voices to tell that story outward. Wow, this is awesome. Laura and Jennifer, thank you so much.

Laura Guido: Thank you so much for having us. This has been great.

Jennifer DeMatteis: Yeah. Thank you, Bill.

Host: Yeah, absolutely. And once again, that is Laura Guido and Jennifer DeMatteis. And a recording of their session will be available to members during the SHSMD Connections Virtual Conference. And if you found this podcast helpful, please share it on your social channels and subscribe so you don't miss future episodes featuring healthcare strategists, marketers, leaders, topics, and solutions. And to access the full SHSMD podcast library, visit shsmd.org/podcast. I'm Bill Klaproth. This has been a production of Doctor Podcasting. Thanks for listening.