Healthcare’s Opportunity: Breakthrough Performance May Be Hiding in Plain Sight
In multi-location industries, sites that share the same brand, strategy, and technology often perform very differently. The RBL Group’s work shows that the difference usually comes down to leadership, talent, and culture. In one global hotel portfolio, top-performing hotels delivered three times the financial results and customer satisfaction of mid-performers. Healthcare systems show the same pattern. Before investing in expansion, leaders should find out why their best hospitals, clinics, surgical centers, and assisted living communities outperform and spread those practices across the network. The authors recommend five steps: compare locations fairly by adjusting for patient needs and local conditions, look for patterns that hold up over time, investigate what drives the difference, transfer practices rather than targets, and align leader selection, development, and accountability to reinforce what works.
Healthcare’s Opportunity: Breakthrough Performance May Be Hiding in Plain Sight
Before building or acquiring the next hospital, surgical center, dialysis center, or assisted living community, healthcare leaders should ask a simpler question: How much untapped value already exists in the locations they operate?
The question comes from what we have seen in other multi-location industries. In hotels, quick-service restaurants, banks, and retail chains, the same pattern shows up again and again. Walmart has discovered that employee satisfaction impacts customer basket size and has leveraged that relationship to increase store revenue.
Locations that share a brand, a playbook, and a technology platform still perform very differently, and the difference usually comes down to leadership, talent, and culture.
That changes where the biggest gains are found. For many organizations, the larger opportunity is not beating competitors but narrowing the gap between their own best locations and the rest. In one project with a global hotel company, the top-performing hotels delivered three times the financial performance and customer satisfaction of mid-performing hotels in the same portfolio.
How the gap gets closed
In that work, we compared the leadership behaviors, talent practices, and culture of hotels in the top quintile with those in the middle and lower quintiles. The differences pointed to specific actions. Once those actions took hold, the process was repeated, creating a cycle of improvement with three parts:
Why healthcare is next
Healthcare systems look a lot like those businesses. Their locations often share a brand, strategy, technology platform, and operating standards. Yet some consistently deliver better patient and resident experiences, more stable workforces, better health outcomes, and stronger financial results.
Knowing which locations outperform is useful. Knowing why, and spreading that performance across the network, is far more valuable.
Look beyond the scorecard
Financial and clinical scorecards show results. They do not explain how those results were produced. That requires connecting outcomes to the leadership, talent, culture, and operating practices behind them. The questions differ by setting:
- Hospitals: What distinguishes locations that coordinate care effectively, manage patient transitions, and sustain employee commitment?
- Surgical centers: What distinguishes centers with better patient outcomes and stronger nurse and staff engagement?
- Clinics: What distinguishes clinics that support treatment adherence, maintain staffing continuity, and build trusted patient relationships?
- Assisted living: What distinguishes communities that retain caregivers, respond to changing resident needs, and earn family confidence?
In each case, the answer rarely rests on one standout leader. It lies in organizational capability: how people work together, day after day, to deliver reliable care.
Compare fairly and learn systematically
Healthcare adds a complication that hotels do not face: patients vary widely. A hospital serving a medically complex population should not be judged as if it serves the same patients, with the same resources, as every other hospital. Clinic networks and assisted living communities also operate under different local conditions. The goal is not another league table. A sound approach has five steps:
- Establish level comparisons. Account for differences in patient or resident needs, service mix, market conditions, staffing constraints, and facility characteristics.
- Identify meaningful performance patterns. Look for sustained strength across quality, safety, experience, workforce, and financial outcomes, not a single favorable metric.
- Investigate what explains the difference. Examine leadership behaviors, staffing and deployment, teamwork, accountability, and daily management routines. Test explanations rather than assuming correlation proves causation.
- Transfer practices, not just targets. Turn promising practices into observable behaviors and repeatable routines, then test whether they improve results in other locations.
- Align the people systems. Reinforce what works through leader selection, development, succession, recognition, and accountability.
Scale capability, not just capacity
Expansion adds beds, treatment stations, and locations. It does not automatically add the leadership and organizational capability needed to run them well. Before approving the next acquisition or expansion, leaders should be able to answer four questions:
- Do we understand why our best locations outperform?
- Which practices transfer, and which depend on local circumstances?
- Can our leadership pipeline reproduce those capabilities?
- What would closing even part of the performance gap mean for patients, residents, employees, and financial sustainability?
Few healthcare organizations can answer all four with confidence. Those that can treat their best locations as more than benchmarks. They see them as evidence of what works and a blueprint for building leadership, talent, and culture across the enterprise. That is the work we have been doing with multi-location organizations at The RBL Group, and healthcare is where we see it mattering most right now.
The next breakthrough in healthcare may not require a new location. It may require understanding, and scaling, what is already working in the locations you have.
What sets your best locations apart? We’d welcome your perspective in the comments.