How would you proceed if you were the consultant in this case?

Gateway Hospital is a 500-bed tertiary-care hospital located in a busy metropolitan area. In a recent employee satisfaction survey, the hospital scored well below the national norms on most scales. It has been experiencing higher than average turnover and vacancy rates. Recruitment for professional positions is very difficult because the hospital has gained a reputation as a bad place to work, especially for new employees; the term “eat their young” seems to be a prevalent description. Salaries are below the local market, as are annual pay increases. Many departments seem to have a critical shortage of staff, and closing services has been a recent topic of discussion.
Additionally, the financial picture of the organization is bleak. The payor mix has changed; Medicare cutbacks are affected the bottom line, as are changes in private insurance funding. Key physicians are beginning to take their services elsewhere as they sense the inefficiency of the hospital processes.
The various stresses appear to be having a significant impact on the overall morale of employees. Poor teamwork is rampant, and communication breakdowns seem to occur often.