Talk with an expert to explore evidence-based strategies that align with your goals.

Talk with an expert to explore evidence-based programs that align with your goals.

Building Your Organization from the Middle

If you want to build a resilient, high-performing organization, start in the middle.

While senior leaders set strategy and frontline employees execute, mid-level leaders are the engine that drives organizational success. They translate vision into action, create team cohesion, and cultivate the culture that determines whether people stay, grow, and thrive.

Research from McKinsey & Company confirms what we at the Institute for Human Excellence (IHE) have long understood: organizations with top-performing operational managers see three to 21 times greater total shareholder returns over five years than those without.

These managers are the architects of engagement, the amplifiers of leadership, and the foundation of sustainable growth. When you invest in them, you unlock the full potential of your organization.

The Mid-Level Multiplier Effect

Organizations don’t succeed because of policies or processes—they succeed because of people. And if you really consider it, the people who have the greatest influence over daily performance, team culture, and long-term retention are your middle managers.

When middle managers are empowered with the right skills, mindset, and structure, they create workplaces where:
A. People are engaged, motivated, and connected to purpose

B. Teams work with clarity, trust, and psychological safety

C. Innovation and collaboration thrive

D. Burnout and turnover decrease, while performance soars

At IHE, our most successful clients don’t just manage their operational leaders, they build them into a competitive advantage.

How to Build a Thriving Organization From the Middle

1. Give Managers the Space to Lead

Often, the tendency is to overload middle managers with administrative tasks that keep them from actually leading people and driving performance.

To enable managers to lead effectively, organizations should instead prioritize:

  • Reducing unnecessary bureaucracy and streamline decision-making
  • Leveraging technology and AI to automate repetitive tasks
  • Ensuring managers have enough time to develop their teams and drive strategy

By freeing managers from excessive administrative burdens, you activate their ability to coach, connect, and inspire.

2. Invest in Leadership Development at the Middle Level

The strongest, most resilient organizations don’t wait until their people reach executive levels to develop leadership skills. They invest in talent development early and often.

As a result, their people across all levels master:

  • Communication that creates clarity and alignment
  • Coaching that strengthens engagement and growth
  • Trust-building that fosters high-performing teams

At IHE, we help organizations implement Connected Leadership—a framework that turns key people into culture builders, talent developers, and strategic leaders.

3. Make Connection a Leadership Priority

The best teams don’t just work together—they are deeply connected. Trust, open communication, and shared purpose fuel engagement, retention, and innovation.

People who foster connection do so by:

  • Actively listening and responding to emotional cues
  • Encouraging collaboration and diverse perspectives
  • Creating psychologically safe spaces where people feel valued

This isn’t just a leadership philosophy—it’s a proven driver of high performance and well-being.

4. Support Middle Managers to Reduce Burnout and Turnover

Middle managers are one of the most overlooked and overextended groups in organizations. When they burn out, they take top talent with them.

The best organizations don’t just expect resilience—they equip managers with the skills to cultivate it. This includes:

  • Listening Reflectively: Developing deep listening skills to understand underlying concerns, validate emotions, and build trust within teams.
  • Connecting Through Presence: Cultivating mindfulness and intentionality in interactions to create meaningful relationships and foster a supportive culture.
  • Asking Powerful Questions: Encouraging curiosity and critical thinking by using thoughtful questions that unlock insights, perspectives, and solutions.

A leadership team with these skills creates stability, engagement, and an environment where people want to stay and grow.

Some of Your Greatest Growth Opportunity Is in the Middle

For too long, organizations have treated middle management as an afterthought. But the data is clear: companies that thrive are those that empower, develop, and invest in their middle leaders.

Building your organization from the middle is the most effective way to create sustainable success—where people are engaged, teams are high-performing, and cultures are built for long-term growth.

The question isn’t whether middle managers are essential. The question is whether you’re giving them what they need to help your organization thrive.

Jennifer Krippner

Chief Experience Officer

“So often we ask our physicians and caregivers to perform at expected levels—seldom giving them the tools to meet those expectations. It is essential to our success that we give them a common framework and language to help them make connections that can improve the experience of patients and families.”

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Ruben Acosta, MD

Faculty

Dr. Ruben Acosta has always had a strong desire to care for others in their time of need. Dealing with a new medical diagnosis can be scary, and he is driven to help patients navigate that difficult journey. Dr. Acosta is dedicated to making interactions between providers and patients more effective. His view is that patients will only share critical information with their providers if they trust them. His goal is to earn that trust and ensure their priorities are met. Board certified in internal medicine and gastroenterology, Dr. Acosta is a fellowship-trained gastroenterologist with advanced training in endoscopy. Dr. Acosta earned his undergraduate degree from the United States Naval Academy before completing his medical degree at the University of Connecticut in Farmington, CT. He underwent internship and residency training at the National Naval Medical Center in Bethesda, MD, before pursuing a fellowship in gastroenterology at the National Capital Consortium. As part of his fellowship training, he engaged in nine months of advanced endoscopy training at the University of Maryland in Baltimore, MD. “I focus on the patient-centered model of healthcare. I consider myself the expert on the medical knowledge side, and the patient is the expert on themselves. By creating a safe space for patients to share information regarding themselves, I can provide more effective and accurate care,” Dr. Acosta said. Before joining Capital Digestive Care, Dr. Acosta served as a Captain in the Medical Corps of the United States Navy, most recently serving as a staff gastroenterologist and director of endoscopy at Walter Reed National Military Medical Center. He was also an Associate Professor of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, MD. He served on the ASGE Standards of Practice Committee for three years, authoring many papers on the safe, quality focused performance of all endoscopic procedures. Outside the office, Dr. Acosta spends his free time with his wife, their three children, and their dog. He likes to travel and enjoys many outdoor activities including bicycling, hiking, and swimming.

Michelle Liu, MD, MPH

Faculty

Dr. Michelle Liu is board-certified by the The American Board of Otolaryngology – Head and Neck Surgery. She is also a fellow of the American Academy of Otolaryngic Allergy, specializing in the comprehensive management of allergy and inflammatory disease in the ears, nose and throat. She currently is the Clinical Director for ENT Allergy in a private practice Otolaryngology group in Fairfax, Virginia. Michelle is an alumna of the Warren Alpert Medical School of Brown University and earned a Masters in Public Health from the Harvard TH Chan School of Public Health. She completed Otolaryngology residency training at the Naval Medical Center in Portsmouth, VA and served as a physician in the United States Navy for 21 years. Michelle’s passion for teaching and mentoring has focused on coaching healthcare providers in patient-centered communication and leadership for the past ten years. Before her military retirement, she was a hospital command suite leader, serving as President of the Medical Staff and on various hospital committees with a focus on high reliability, quality improvement, and patient safety. In her spare time, Dr. Liu enjoys spending time with her husband and three children, engaging with church family, volunteering as a USA Swimming Official, traveling, and outdoor gardening.

Terri Veneziale, MBA

Faculty

Terri Veneziale transitioned into healthcare 25 years ago, bringing with her a wealth of skills acquired over 20 years as a leader and change agent in the hospitality industry. These skills, along with close collaborations with clinical leaders have led to the development of groundbreaking patient experience and healthcare communication systems serving as Patient Experience Manager at Mayo Clinic in Florida and Co-Director of the initial Communication in Healthcare program at Mayo Clinic. She currently serves as Director of Patient Experience at Cleveland Clinic, Vero Beach, Florida. She also provides ongoing patient experience to Aveanna Healthcare, the nation’s largest pediatric home healthcare provider.

Jamie Oberman, MD, FACS, CAPT, MC, USN

Faculty

Dr. Oberman has been at the forefront of improving communication in military healthcare settings for the past decade, becoming part of the Northeast Florida Community Collaborative Improving Communication in Healthcare Initiative, and serving as Co-Clinical Champion and Course Director for the Patient Centered Caring Communication in Healthcare Initiative, both within the National Capital Region. His service included—U.S. Naval Operational Tours, Submarine Squadrons SIX and EIGHT, Norfolk, Virginia, and Senior Diving Medical Officer for Explosive Ordnance Disposal Group TWO, Little Creek, Virginia. He also served as Chief Quality Officer at Walter Reed National Military Medical Center. After retiring from the Navy, Dr. Oberman joined Becker ENT/Princeton HealthCare System, serving as its Medical Director for Patient Experience. He is currently an ENT surgeon at Princeton Health System at the University of Pennsylvania. Medical Degree, Tufts University School of Medicine, Boston, Massachusetts Residency Pediatrics/General Surgery/Otolaryngology, Naval Medical Center, Portsmith, Virginia Board Certified, American Board of Otolaryngology Fellow, American College of Surgeons

Faith Zwirchitz, BSN, MAN, RN, PHN

Faculty

Faith Zwirchitz is Director of Women’s and Children’s Services at the largest birth center in Minnesota. Her career began as a medical surgical nurse and quickly transitioned to the care of critically ill patients and their families. For many years, her passion for ongoing growth and development in herself and others has driven her professional path. Her expertise lies in working with teams on change management and the strategic growth of people and programs. Bachelor of Science, Nursing, Bethel University, Saint Paul, Minnesota Master of Arts, Nursing Education & Healthcare Leadership, Bethel University, Saint Paul, Minnesota

Elizabeth (Bitsy) Recupero, DO, MPH, MEd

Faculty

Dr. Recupero is currently a primary care provider for the New Orleans VA, as well as a Clinical Champion and Educational Champion with the VA’s Office of Patient Centered Care and Cultural Transformation. Her career has included opening a Recuperative Center—a solo primary care practice focused on Holistic Healthcare. She practiced with the VA in Boston, Massachusetts distinguishing herself as an expert in Whole Health during the organization’s Whole Health pilot study. She is considered one of the leading subject matter experts in Whole Health Clinical Care and trains providers throughout the VA System in Whole Health and patient-centered care. Medical School, Kansas City College of Osteopathic Medicine, Kansas City, Missouri Residency, Internal Medicine and Pediatrics, Newark Beth Israel, Newark, New Jersey Fellowship, Integrative Medicine, University of Arizona, Tucson, Arizona

Jacie Volkman, MPH, CIC, FAPIC

Faculty

Jacie Volkman has worked in Healthcare Quality and Patient Safety for 17 years. She is currently the Executive Director of Infection Prevention and Epidemiology for Prisma Health System, Greenville, South Carolina, faculty for the Institute for Healthcare Excellence and owner of the consulting company Safe Patient Surveys. She has a background in public health epidemiology and over the years has partnered with caregivers and healthcare leaders to help ensure safety from infections across the continuum of care. She is certified in infection prevention and control, holds a bachelor of Science in Biomedical Science from Texas A&M University and a Master of Public Health in Epidemiology and Biostatistics from Texas A&M School of Rural Public Health. Jacie is the President of the Western North Carolina AIDs Project Board of Directors, and has spent many years volunteering on other boards, such as the Association for Professionals in Infection Prevention and the Certification Board for Infection Control and Epidemiology.

Patrick Kneeland, MD

Senior Physician Advisor

Dr. Kneeland is Vice President of Medical Affairs at DispatchHealth where he leads Advanced Care—a service line dedicated to bringing hospital level care to patients’ homes. He is Associated Clinic Professor of Medicine at the University of Colorado where he is a founding faculty member of the Institute for Healthcare Quality, Safety, and Efficiency. Dr. Kneeland previously served as the Executive Medical Director for Patient and Provider Experience at UCHealth in Colorado. Residency, Internal Medicine, University of California—San Francisco, California Fellowships, Academic Hospital Medicine and the Institute for Physician Leadership, Center for Health Professions, San Francisco, California Certified Patient Safety Officer, with advanced training from Stanford’s d.school in user-centered design

Jennifer Clark, MD

Faculty

Dr. Clark is a Healthcare Delivery Scientist providing a range of consulting services in the healthcare sector and educating as faculty at the University of Tulsa Institute for Health Care Delivery Sciences. She has practiced Internal Medicine, Pediatrics and Palliative Medicine. She is certified in Ayurveda, an ancient medical tradition in India, and is a former Chief Medical Officer of a large healthcare system. She has presented regionally in the fields of executive medicine and palliative care, as well as on the topics of well-being, purpose, and resilience. She has completed the Harvard Medical School Palliative Care Education & Practice program and the Chopra Center Perfect Health Teacher’s training. Medical School, University of Kansas School of Medicine, Kansas City, Kansas Internship and Residency, Medical University of South Carolina, Charleston, South Carolina

Timothy Poulton, MD

Faculty

Dr. Poulton is a family medicine physician in Asheville, North Carolina and Regional Medical Director for Aledade, Inc., which is dedicated to building and supporting a new model of primary care. He is a member of the faculty for Communication in Healthcare and Relationship-Centered Leadership courses for Mission Health System. He is a member of the American Academy of Family Physicians and the Western North Carolina Medical Society. He has served as a physician advisor to the Clinical Documentation Integrity Team and on the Western Carolina Medical Society’s Healthy Healer Committee. He has published on topics including improving physician-patient relationships, patient-centered care, and evaluating online physical activity tools. Medical School, University of Michigan Medical School, Ann Arbor, Michigan Residency, Mountain Area Health Education Center, Asheville, North Carolina

Joseph (West) Paul, MD, PhD

Faculty

Dr. Paul is Chief Clinic Officer and Senior Vice President at Novant New Hanover Regional Medical Center where he serves as a member of the Operational Leadership Team and spearheads all system quality and safety initiatives. He also serves as a member of the Board of North Carolina Quality Association. Prior to his current position, Dr. Paul served as Chief Quality and Medical Staff Officer at WakeMed Health and Hospitals. He was founding Chair of the Division of Consultative and Diagnostic Medicine at Mayo Clinic, Florida. He served as Associate Director of Internal Medicine Residency at Mayo School of Graduate Medical Education and as Medical Director of the Pharmacy and Perioperative Clinic. He chaired the Clinical Practice Quality Oversight Committee and was Vice Chair of the Department of Internal Medicine Mayo Clinic, Florida. Dr. Paul has many professional memberships. He currently holds two patents, has published in peer-reviewed journals, has been a visiting professor and lecturer throughout the United State, Europe and the Bahamas. Medical School, East Carolina University School of Medicine, Greenville, North Carolina Residency, Department of Internal Medicine, Mayo Clinic, Florida

Carrie Grant, RN, BSN, MBA

Faculty

Carrie Grant, RN, has worked in healthcare for over 25 years. In addition to serving as faculty member at the Institute for Healthcare Excellence, she is a Chief Nurse Executive and Executive Vice President for a multisite children’s health system. Prior to her current position, she served in a variety of roles for academic medical centers, health systems and community hospitals. Carrie has published on the subject of physician-administrator relationships and simulation. She has served on the board of the Utah Organization of Nurse Leaders and partnered with academic nursing leaders on improving nurse training programs. Currently she serves on the Ronald McDonald Charities Central Florida board. Associate Degree Nursing, Florida State College, Jacksonville Bachelor’s Degree, University of North Florida Master’s Degree, Brigham Young University, Provo, Utah

Diane Colgan, MD

Faculty

Dr. Colgan is a plastic surgeon based in the Washington, D.C. metro area. She is the Medical Director of the Suburban Outpatient Surgery Center and Chair, Medical Staff Leadership Council at Suburban Hospital in Bethesda, Maryland, part of Johns Hopkins Medicine. She is the former Chief of Staff at Suburban Hospital and was named Physician of the Year at Suburban Hospital in 2016. She trained as a surgeon with the U.S. Navy. Her Navy career included an appointment as Chief of Plastic Surgery at the National Naval Medical Center. She served on active duty and as a reservist, retiring as Captain in the Medical Corps and was awarded the Legion of Merit. Dr. Colgan has been a lecturer on topics ranging from advances in plastic surgery and skin cancer, as well as patient and family centered care.

Laura Bennett, MSN, ARNP, CNM

Faculty

Laura Bennett has 22 years of healthcare experience as a nurse, nurse practitioner, educator, administrator, and leader. During her naval training and service, she was one of the first four women to serve on an aircraft carrier. She was a healthcare provider at Guantanamo Bay. She ran a portion of the military response to the Tohoku earthquake, tsunami, and nuclear disaster in Japan. She serves as Directory of Midwifery, Department Head of Obstetrics & Gynecology, and multidisciplinary committee chairperson roles. Additionally, she developed evidence-based training programs to alleviate burnout in healthcare staff and improve performance and resilience in soldiers, sailors, and Marines. Now retired from the Navy, Laura serves as an educator, coach, consultant and speaker focused on optimizing potential, success, and reliance for people in high-impact, high-performance, and high-burnout roles. She is active as a community-builder, is a member of Leadership Jacksonville and is a Strategic Partner for Teach for America.

Read Pierce, MD

Faculty

An experienced clinician, healthcare leader, coach, and facilitator, Dr. Pierce is a specialist at fostering the transformation of organization culture and complex clinic systems. He has directed major initiatives to increase joy in practice, reduce physician and advanced-practice provider burnout and increase measures of psychological safety. Dr. Pierce founded both the Institute for Healthcare Quality, Safety and Efficiency based at the University of Colorado and the Hospital Medical Section at the San Francisco VA Medical Center. He is currently Chief of the Division of Hospital Medicine at Dell Medical School (DMS) and also serves as Associate Chair for Faculty Development and Well-Being in the Department of Medicine at DMS. Medical School, University of California, San Francisco Internship, Brigham and Women’s Hospital, Boston Residency and Chief Residency, Internal Medicine, University of California, San Francisco

Sandra Argenio, MD

Faculty

A family physician and educator, Dr. Argenio served as Consultant in the Department of Family Medicine at Mayo Clinic Florida and Assistant Professor of Family Medicine at Mayo Medical School, where she continues as an Emeritus member of the Family Medicine Department. Prior to her work with the Institute for Health Excellence, she served as the inaugural program director of the Family Medicine Residency at Mayo Clinic Florida. She has had a leading role in establishing communication training at Mayo Clinic, was Chair of the Mayo Clinic Florida Communication Faculty, and developed coursework for faculty and trainees at Mayo Clinic. Dr. Argenio has also served on many committees in the family practice physicians area and earned numerous awards including Outstanding Florida Family Medicine Educator and Mayo Distinguished Educator. She was also named one of Jacksonville’s Best Doctors. Medical School, Hahnemann Medical University, Philadelphia, Pennsylvania Residency, Family Medicine, Geisinger Medical Center, Danville, Pennsylvania

Robert Eric Dinenberg, MD, MPH

Faculty

Dr. Dinenberg is dedicated to coaching healthy lifestyle change for well-being, with a passion for teaching mindfulness for stress management and peak performance. He has served patients in private practice on the campus of Scripps Memorial Hospital, La Jolla, California and as Chief Medical Officer and Whole Health Physician for a population health company in Saint Louis, Virginia. He currently serves as Physician, Health Nucleus in La Jolla, California. Dr. Dinenberg has published numerous articles and book chapters in the field of health protection and health promotion. He is the author of Mindfulness and Peak Performance: Touch the Ground, Touch the Sky. Medical School, Medical College of Pennsylvania and Hahnemann University School of Medicine, Philadelphia, Pennsylvania Residency, Occupational and Environmental Medicine, University of California, San Francisco Master of Public Health, University of California, Berkeley, California.

Linda Scaz, RN, PhD, FCN

Faculty

Dr. Linda Scaz served as Senior Director of Clinical Care and Operations at Haven Hospice of Northeast Florida and as Director of Community Engagement. She has worked extensively to educate professionals and caregivers around end of life care issues at the local, state and national levels. She has served in leadership capacities on numerous nurse advisory councils, health coalitions and boards. She has traveled to Haiti on medical mission trips and published her experiences in Perspective on Nurse Executives: Lessons Learned in Haiti. She has also co-authored several articles for the Journal of Nursing Administration. She has been named one of The Great 100 Nurses of Northwest Florida and one of 40 Most Influential People in Healthcare by 904 Magazine in Jacksonville, Florida. Graduate, Wilkes University, Wilkes Barre, Pennsylvania Doctoral Studies, Penn State University, Centre County, Pennsylvania

Jennifer Krippner

Chief Experience Officer

Jennifer Krippner is a leading expert on patient experience and relationship centered care. Jennifer has more than 20 years of expertise in strategic planning, patient experience, physician development and employee/community engagement. She’s passionate about building connections and relationships. Prior to her lead role at IHE, she was a director of physician development and guest/public relations at Maple Grove Hospital in Minnesota. While there, she led staff-driven patient experience advisory teams and developed projects that directly contributed to consistent top tier performance in key patient and staff satisfaction results. Jennifer is a fierce advocate for connecting things, concepts and people, seen and unseen, that positively move the patient experience forward. Jennifer stands apart for her personal commitment to helping hospitals and health systems build a culture of excellence that leads to the delivery of exceptional patient-centered care. She is dedicated to guiding a differentiated human experience that optimizes outcomes for patients, individualizing services to address unique needs, and helping to restore joy and purpose to caregivers. While Jennifer takes great pride in her work, her true north remains her family, friends and relationships she develops. A graduate of the College of St. Benedict, she holds a Bachelor’s Degree in Liberal Studies/Communications.

Mike Seyfer

CEO

Mike leads health consultancies focused on brand and organizational transformation. He is CEO of both Hailey Sault, the digital performance marketing firm for health and wellness brands, and IHE, creating performance driven cultures with enhanced well-being, greater stability, and new capacities for growth. He is co-founder of the Believe in Better Project, an annual workshop bringing together some of North America’s leading health visionaries to perpetuate the continued transformation of a healthcare system in crisis, is co-host of the Hailey Sault “Believe in Better” podcast, and a frequent speaker on the subjects related to brand and cultural transformation. Away from work, Mike and his family of five live out Hailey Sault’s purpose of “creating a healthy world” by soaking up life between northern Minnesota, and Sun Valley, Idaho.