Becoming a world class healthcare system is hard. In Studer Group’s system partnerships, our role is to help system leaders navigate what is inherently a tough journey. There are natural distractions that keep leaders from achieving the results they want. They may be dealing with high turnover, communication barriers, and misaligned goals. Studer Group has a guaranteed framework to overcome these barriers, but it takes time and dedication to execute because it takes commitment and buy-in from leadership to make it work. My job is to be an expert in that model to help system leaders achieve their goals and see sustained organizational results.
There are four primary areas of focus on which I recommend system leaders focus to accelerate their results.
In today’s healthcare environment where we have to operate as efficiently as possible, an engaged workforce is a must. Engaged employees are much more responsive to organizational transformation than disengaged staff. In fact, far fewer resources have to be applied to change initiatives in organizations that have buy-in from their workforces. Trying to shift a culture or execute an operational strategy without an engaged workforce is like trying to drive with the parking brake on. You’ll burn a lot of fuel, put dangerous wear and tear on your system, and still not get where you intended to go.
We don't have to decide whether or not to focus on engagement. That's a given. Engagement – of patients, clinicians, employees, and leaders - is a core competency for healthcare right now. If you want to see lasting change across a system, you must first ensure your leaders, clinicians, and employees are on board.
Consistent and Frequent Communication
Maintaining alignment – both strategically and operationally – while balancing increasingly limited resources with the changing dynamics in the healthcare landscape is of the utmost importance for leaders of healthcare systems. When you add hundreds of operational leaders to any plan, it becomes more complicated. While smaller hospitals could have conversations with every leader in two hours, in a large system, reaching all leaders could take months.
Often, the biggest hurdle in system-wide alignment comes at the point where unit or department leaders have to influence the behavior of their staff. In many cases, leaders will resort to their comfortable leadership style and what they have done in the past, which may not necessarily align to organizational strategy. When implementing a complicated change initiative, it is vital that all leaders throughout the system are carrying the same message to create consistency and hardwire the change. You don’t want 700 leaders managing change with 700 different approaches. In our work with large systems, we help partners to focus on leadership competency. In Studer Group’s Evidence-Based LeadershipSM framework, the first phase is to align priorities, and then to develop leaders. There's not one strategic priority that won’t depend on aligning frontline staff. And you get to that alignment by ensuring leaders are well-prepared to carry organizational strategy to the front lines.
Ensuring all leaders and employees in a system have timely and clear communication is another crucial component of an effective system-wide strategy. Rather than reacting to news as it happens, assume that you will have relevant items to share at least every quarter, and schedule a regular forum to communicate with employees. When you have regular employee forums, staff know that time is sacred and the information will be important. Set up the structure so that your staff expect regular and transparent communication. These sessions are where they should get their news. At the forum, communicate only the important things. If you cut out the noise, you leave less room for misinterpretation.
It is also vital to set up your leaders to deliver a great message. Seton Healthcare Family in Austin, Texas, has a great best practice for communication. Leaders have created what they call “Ascension Texas News” (ATN), a YouTube forum that has increased their employee forum participation rate to over 90 percent. The communication format doesn't have to be in person or via email, but you want to reach as many employees as possible. At Seton, leaders are shown the “ATN” YouTube videos at Leadership Development Institutes before it is broadcast to all staff. Leaders go through a worksheet that helps them to think through how to best deliver the key messages to their employees while considering what questions they might get and how they should answer them. They can get any information or clarification they might need in advance of speaking with their staff. Representatives from Seton presented on this best practice at What’s Right in Health Care® in 2016.
Reward & Recognition
Reward and recognition is another best practice for improving and maintaining results across large systems. From a coaching standpoint, we are always sprinting to our partners’ first big success. Because when they get a taste of that, it changes the identity of the culture. It changes their perception of what's possible. Reward and recognition fuels healthcare professionals' passion. And that's a game changer.
Reward and recognition is based on outcomes and results -- not effort. There is not one person that doesn't think that they are giving it their all. One large system I worked with did an amazing job of rewarding and recognizing the right things. They would publically recognize units or individuals that met their goals during their employee forums. Even though they might celebrate 30 people in a meeting, each recognition was very specific and personalized to reflect what was accomplished. Leaders want to be called out in that meeting. Individual reward and recognition carries a lot of weight in large systems because it is easy to get lost in the rank and file of such a vast workforce.
Also, don’t underestimate the impact of hand-written thank you notes sent from a leader directly to the home of an employee. As with other rewards, notes should specific and highlight the desired behavior. What gets rewarded get repeated.
Want to get breakthrough results in a system? Hold people accountable. In systems, I often see leaders that have never gotten results but are allowed to linger. The first year that organizations have an objective, measurable evaluation in place (like Studer Group’s Leader Evaluation Manager®), operational conversations start to change radically. Being held accountable for results makes people step out of their comfort zones. I'm not going to arbitrarily change to get those best-in-class results. When leaders start reaching out to have conversations about barriers and best practices across the organization, it takes results to the next level.
The good always want to get better. The first step toward sustained system results is realizing that no matter how well you know the system, an alternative perspective from an expert outside the organization is going to add value. We all have limitations in accurately assessing our internal environment. Partnering with an expert to enhance your perspective is smart. Organizations that are serious about getting results welcome the fresh eyes.
Results won’t happen overnight, and they won’t happen by accident. Healthcare organizations today do not have the expendable income for strategic trial and error. You have to look in the mirror and ask yourself, how invested are we in making this change? With the information available today, executive leaders must honestly assess the extent to which they have fully committed to executing a strategy that will make them better.
Michelle Bright is a Studer Group coach with over 20 years of experience in healthcare, primarily in organizational development and strategy divisions, with extensive work in large catholic healthcare systems. She has also worked in rural health facilities with an emphasis in critical access.
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