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Van Diest Medical Center (VDMC) had strong leadership, a six-woman administrative team that was visible and genuinely connected to the community, and a culture that actually reflected the care staff wanted to deliver. By most measures, they were doing well. But doing well has a ceiling, and the center in Webster City, Iowa, had been bumping against it: patient experience scores plateaued and turnover lingered.
The team effort was there, but the infrastructure to convert that effort into sustained, measurable results wasn’t.
In 2022, VDMC partnered with Custom Learning Systems (CLS) to break through that lid.
Hardwiring empowerment
VDMC launched Ignite the Patient Experience through CLS and got to work, not by adding another program to the pile, but by activating ownership at every level:
Underneath all of it ran a structured accountability framework: Who will do What, by When, and How. Cultural expectations became specific commitments.
By year two, inspiration had become infrastructure. A service recovery process ensured concerns were handled consistently. And a simple practice took hold: every employee or provider named positively in a patient survey received a handwritten note from leadership — a small gesture that kept reinforcing the same message. Every role matters, patients notice, and leadership is paying attention.
VDMC’s CMS rating tells the clearest version of the story. 3 Star in 2022, 4 Star by year two, 5 Star by year three. When that final rating came through, the administrative team didn’t send a company-wide email. They personally visited every department to share the news, which was itself a reflection of the culture they had spent three years building.
The retention numbers fill in the rest of the picture, showing a 68% reduction in turnovers.
| Measure | 2022 | 2024 |
|---|---|---|
| Clinical turnover | 21.2% | 6.8% |
| CMS Star rating | 3 Star | 5 Star |
In rural Iowa, where staffing shortages are a daily operational reality and not an abstract HR concern, these changes are transformational. Staff stayed because they felt valued, visible, and part of something worth staying for.
The world started to notice these improvements. VDMC was named a CHARTIS Top 100 Critical Access Hospital for 2026 and a 2024 Top Workplace, and was recognized as one of only two critical access hospitals in Iowa to receive a prestigious state designation that year.
The organization also earned CHIME Digital Health recognition and multiple revenue cycle and community awards. The reputation had caught up to what was already happening inside the building.
CEO, Van Diest Medical Center, Iowa
“If you have a chance to implement Service Excellence, definitely get started. It has been highly effective for our hospital, and we have been able to sustain the positive impact since we started. We are on the journey as a high functioning hospital that provides excellent patient care. Custom Learning Systems has seen wonderful for us in achieving and sustaining our 5 Star designation.”
By year three, recognition at VDMC wasn’t something leadership administered. It was something the culture had absorbed and made its own — and that’s the shift CLS works toward with every partner. Moving an organization from programs that require constant maintenance to a culture that generates its own momentum.
For VDMC, that meant 5 Star ratings, national recognition, and a workforce stable enough to actually deliver on the promise of rural community healthcare. Good became exceptional. And it continues to hold for VDMC today.
With Custom Learning Systems to learn how you can transform your culture.
Insights for Healthcare Leaders
