A courageous person takes an honest look at who they are. A powerful person acknowledges their weaknesses and strengths then understands how to use them both successfully.

Leadership involves building and maintaining a high-performing team. Anything that detracts from your ability to build a team also detracts from your performance as a leader. Behavior impacts performance.

Personality assessments are designed to measure traits/behaviors that are part of an individual’s make up. Organizations attempt to utilize these to assess both fit and performance in certain positions but the real value is that an individual can get real insight into their strengths, potential areas of opportunity, and motivators.

It is good to be able to understand, articulate and utilize your strengths. Think of these as the gas pedal in a car. When utilized properly, they will move your leadership forward. However, it is also important to understand when you’re putting your foot on the brake and negatively impacting your leadership journey. An effective assessment can help you understand what is propelling your journey and what is holding you back.

What Inhibits Your Success?

To help you understand your strengths and motivators as well as identify your risk factors, Wiederhold & Associates offers The Hogan Leadership Forecast Series. Through the series, you will receive a report designed to help you develop as a leader.

It will provide insights about your behavior and traits that showcase strengths as well as behaviors and traits that could potentially undermine or inhibit your performance. And if you’re committed to being the best leader you can be, we will help you determine the best way to enhance your awareness and make impactful change.

If you’re in transition, a seasoned executive looking to take your performance to the next level or a leader who is ready to get off the hamster wheel, the HOGAN LEADERSHIP FORECAST SERIES may be your next step to finding true success.

Learn more about Wiederhold & Associates

HOGAN LEADERSHIP FORECAST SERIES

Here's to your success,

Jim

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Introductory Comments:

The healthcare industry is at a crossroads. Consumerism, regulatory requirements, payer requirements, employer demands and other factors are driving forces for change in service delivery. Now is the time to get it right. We need to reduce cost, control utilization, streamline delivery of care, deliver care in a manner that exceeds patient expectations at all times, manage the health status of the communities we serve and demonstrate continuous improvement in achieving best in class clinical outcomes.

The industry, as a whole, needs to focus on the “Triple Aim” (low cost, service oriented and high quality). In doing so, we cannot neglect that we can only navigate the course to achieving value based results with a high performing team of leadership representatives, management representatives, physicians, other clinical providers and staff, thus achieving the “Quadruple Aim.”

We must engage and empower our clinical and non-clinical workforce to maintain professional satisfaction and reduce the risk of burn-out from expecting more without addressing resource requirements. It is not easy, but it can be framed in a simplified philosophy of Performance Excellence. Performance Excellence (Operations, Service and Clinical) is the gold standard by which healthcare teams will be measured.

Is your physician enterprise designed to allow every member of your organization to autograph their work with excellence?

Workforce (physicians, advanced practice providers, clinical and non-clinical staff) engagement at all levels of your organization is essential to move forward in today’s ever-evolving healthcare market. A Performance Excellence Philosophy provides the systematic methodology to engage your workforce in achieving results.

The Baldrige Excellence Framework (Healthcare): As Systems Approach to Improving Your Organization’s Performance empowers your organization to reach its goals, improve results, and become more competitive. The framework consists of the criteria, the core values and concepts, and scoring guidelines to use as reference, to self-assess, or as a basis for external assessment. Whether or not your organization is “award and recognition oriented,” today’s ever-evolving healthcare environment creates to perfect opportunity to take a step back and assess your ability to achieve value based results.

Through active inquiry regarding your organization’s culture, you learn and develop your ability to accomplish what is important to your organization. A community/customer/patient centered philosophy, along with the critical aspects of: Leadership/Governance; Vision/Strategy; Measurement, Analysis, and Knowledge Management (through data analytics); and Operational Work Processes and Process Management, allows you to evaluate how prepared you are to achieve VALUE BASED RESULTS.

Through internal ASSESSMENT you may find that your organization needs external resources to develop the necessary structure and infrastructure to achieve your VISION. Experienced leadership with a demonstrated track record of achieving results within physician enterprise organizations may be difficult to find. You may need Interim Leadership and Management Advisory Services with the Resilience to do the “initial heavy lifting” of positioning your enterprise for high performance.

Today we explore ways to assess your systematic approach for delivering value in your communities.

Assess Your Physician Enterprise through a Systematic Approach

You need a systematic approach to assessing your physician enterprise ability to achieve results. You need a framework to deliver value. The challenge is to critically assess to learn how you are accomplishing your vision and strategic priorities. Today we pose several key questions to begin to assess your organization’s readiness to achieve value based results.

Has your organization set a strategic priority for achieving value based results in your physician enterprise?

How has your organization set a strategic priority for achieving value based results? “Value Based Care is Here to Stay”:

Vision and Strategy-Questions to consider:

Is it important to your organization?
Have you established a shared Vision of physician integration to achieve value based results?
Is your organization prepared to create greater value in the communities you serve?
Does your organization have the leadership with the demonstrated competency of RESLIENCE to navigate the path to value?
Do you need Interim Leadership or experienced external advisors to assess and develop your physician enterprise ability to deliver value based results

Please see Assessing Your Vision and Strategies, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

It all begins with LEADERSHIP:

Leadership must promote a systems perspective. A systems perspective means managing all the components of your organization as a whole to achieve ongoing success. A healthcare system has many inter-related, but not always highly integrated, components. Each component must be led and managed to function as a high performing organization within the context of the entire system. Most importantly, your physician enterprise (whether an employed network or Clinically Integrated Network) must demonstrate a successful track record of achieving results.

Assess your leadership and management structure to achieve results:

“Achieve Results-Leadership and Management”

Question to Consider-Leadership:

Do senior leaders lead the organization, consistent with your systematic approach?

Please see Assessing Your Leadership/Management, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Governance:

How does your governance structure oversee your physician enterprise and address your organizational ability to achieve value based results?

Assess your governance structure to achieve results: "Governance”

Governance - Questions to Consider:

How does your organization ensure responsible governance of the physician enterprise?

How does your governing achieve accountability for:

• senior leaders’ actions
• strategic plans
• fiscal accountability
• transparency in operations
• selection of governance board members and disclosure policies for them, as appropriate
• independence and effectiveness of internal and external audits
• protection of stakeholder and stockholder interests, as appropriate
• succession planning for organizational leadership

Please see Assessing Your Governance, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Knowledge Management/Transfer through Data Analytics:

How do you measure, analyze, and then improve organizational performance?

Assess your Performance Measures to achieve results: "Knowledge Management/Transfer through Data Analytics”

Questions to Consider - Performance Measures:

How do you track data and information on daily operations and overall organizational performance?

How do you select, collect, align, and integrate data and information to use in tracking daily operations and overall organizational performance; and track progress on achieving strategic objectives and action plans?

Please see Assessing Your Knowledge Management/Transfer through Data Analytics, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Operations Management/Process Management:

How do you design, manage and improve your key health care services and work processes?

Assess your Work Processes/Process Management Methodology to achieve results: “Process Management-Achieve Value Based Results”

Questions to Consider-Work Processes/Process Management:

How do you design, manage, and improve your key health care services and work processes?

How do you determine key health care service and work process requirements?

Please see Operations Management/Process Management, to begin your assessment: You may also request a copy from: This email address is being protected from spambots. You need JavaScript enabled to view it.

Results:

A Performance Excellence Philosophy provides the systematic methodology to achieve results. Your organization will achieve value based results with unrelenting commitment from key stakeholders at every level.

You need a simplified approach to creating a culture of Performance Excellence to achieve results:

Question to Consider-Results

What are your health care and process effectiveness results?

What are your health care results and your results for your patient and other customer service processes?

Is your entire workforce engaged in achieving value based results?

Please see Assessing Your Results, to begin your assessment:

Key Take Aways and Next Steps:

• Assess and adopt a Vision of Value Based Care in your Physician Enterprise
• Implement a Culture of Performance Excellence
• Assess your Leadership/Management
• Assess your Governance
• Assess your Knowledge Management/Transfer (Data Analytics)
• Assess your Operations/Process Management
• Assess your Results
• You may need external resources to assist in assessment and development

Studies show that an average of 50% of newly hired executives not appropriately onboarded, either quit or were fired within their first three years.

A successful onboarding program accelerates the executive’s breakeven point on the investment the organization has made in talent acquisition and retention, as well as, aligns behavioral changes with organizational outcomes and goals. Results are just as important as the process.

Wiederhold & Associates Executive Onboarding Program

Wiederhold & Associates is perfectly positioned to be your partner in ensuring that your investment in new executives continues to reap long-term rewards, rather than ending up with the above-mentioned results. The Wiederhold & Associates team with 26 years of transition expertise in healthcare, focuses on tangible results in addition to ensuring a smooth transition.

Key Program Strategies Include:

• Defining roles and responsibilities
• Clarifying strategic results and creating new ones
• Managing expectations
• Building relationships and coalitions
• Managing intellectual and emotional reactions
• Maintaining balance
• Aligning and strengthening the leadership team
• Completing in-process assessments

Specific Areas of Focus Are:

• Executive’s personality and behaviors
• Alignment of goals/outcomes
• Building stakeholder lists
• Focusing on early wins
• Navigating organizational politics
• Learning organization’s culture
• Maintaining visibility
• Time management
• Balancing relationships/results
• Enhancing executive’s knowledge of the organization’s market
• Understanding organizational history
• Assessing skills and behaviors
• Building confidence
• Developing executive’s team dynamics
• Enhancing communication
• Creating a business journal
• Establishing a brand
• Empowering the executive’s voice within the organization
• Managing change
• Maintaining balance

To learn more about Wiederhold & Associates Onboarding Program, download a tri-fold brochure here.

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We wish you and your loved ones a safe and fun holiday weekend

High performing leaders in healthcare organizations of today are challenged with the uncertainty of healthcare delivery in the future. Many hospitals face a challenge among key stakeholders. That challenge is a brand/reputation shift toward value based care. Mission, Vision and Values typically reflect claims of high quality and customer service, but key stakeholders (physicians, patients, families, employers, payers and regulatory bodies) are not buying the slogans of the past. In today's world, healthcare providers must demonstrate that they are living up to the value based equation (low cost, seamless, patient-centric, high quality care). Stakeholder demand and regulatory requirements drive organizations to demonstrate measurable results in cost, service and quality.

Creating a performance excellence environment is a highly successful leadership approach to navigate the ever-evolving imperatives of service delivery. Value based results will be achieved through a leadership philosophy of performance excellence:

Engage your people: Develop Governance, Leadership and Management structures to engage your key players, especially physicians and other clinical thought leaders to lead the effort. Create a shared Vision of Achieving Value Based Results. Now it’s time to execute your shared Vision.

Evaluate your data; identify best practice: Engage all key players in identifying essential metrics to understand your current performance and identify opportunities for improvement in Operational/Financial, Service and Clinical performance.

Know your process and design your process (es): Utilize advanced process management methodologies to identify current processes that yield current results. Establish consistency in your process improvement methodology. Identify best practices. Design your processes to achieve results.

Hardwire/Standardize best practice, process design to ACHIEVE

Sustainable results will be achieved from your Action, if you are focused on Continuous Operating and Quality Improvement. Remember you may FAIL (“First Attempt In Learning”). Establish your culture of Performance Excellence. Start small, simplify, be resilient, be persistent and be unrelenting in your approach to achieving results. Be prepared to embrace “Polarity Thinking.” Every good conversation begins with good listening. Listen to your key stakeholders. Listen to understand, not to respond. Physician integration and value based strategies inherently present divergent opinions. Learn the power of leveraging Inquiry AND Advocacy: two critical leadership competencies. That’s how leaders achieve results.

Value Based Metrics:

The list of potential measures is endless. Identify what is important to your key players. Start with metrics that present and build a common understanding of current performance. Measure, monitor, report, analyse and improve your key metrics, focused on value: Operational/Financial Excellence, Service Excellence, and Clinical Excellence. A comprehensive list of potential metrics is available at: Mike Jones LinkedIn or This email address is being protected from spambots. You need JavaScript enabled to view it.

Key Takeaways:

• You have highly engaged employees, physicians, patients, family members, community representatives, employers and payers.
• You have defined a common and shared vision for your organization through gaining knowledge of your key stakeholders’ perspectives
• You have defined what outcomes you and your organization are trying to achieve in terms of Operations, Finance, Service and Clinical indicators
• You have measured your current performance
• Now you want to improve performance:

Everything is a process


Gain an understanding of your current processes


Identify your best practices


Design process to achieve best practice performance


Re-evaluate your performance to see if you are consistently achieving improved performance


Modify your processes when necessary to consistently achieve higher levels of performance


Hard-wire your processes to ALWAYS achieve best practice performance


Never stop monitoring to verify your preferred state performance/outcomes.


Never stop monitoring to verify your preferred state performance/outcomes.


Train for it (all Key Players)


Build consistency of approach

• Define your performance excellence culture
• Focus your leadership on the relentless pursuit of performance excellence
• Adopt your preferred methodology
• Formalize and standardize your methodology
• Listen to your key stakeholders
• Engage all parties in understanding improvement initiatives
• Gain understanding of performance through data analytics
• Design processes to achieve desired results
• Be prepared to Fail, but failing is your F (first), A (attempts), I (in), L (Learning).
• Achieve success in all you do
• Demonstrate that you are creating value based outcomes

Next Steps:

• View Additional Reference Information:
• In “Be an Inspirational Leader”, author Dan Nielsen portrays the incredible impact of inspirational leadership on your personal, professional, and organizational success. Read Dan Nielsen’s book: “Be An Inspirational Leader: Engage, Inspire, Empower”
• Management of healthcare providers’ reputation and brand dramatically changes with consumer demand for value. An organization’s reputation is subject to more than marketing campaigns. Social media and ratings services have significant impact on consumer perception of healthcare organizations. If you do not have on-going audits of your on-line presences and ratings, it is wise to complete and assessment and take corrective action, as necessary. To learn more about Reputation and Brand Management view the work of Claire Faucett with engage5w.
• Learn more about “Polarity Thinking” and the two essential leadership competencies of Inquiry and Advocacy. View the work of leadership coaches James McKenna and Cliff Kayser, sponsored by Wiederhold & Associates.

• For a deeper dive into fostering a culture of performance excellence with high levels of physician integration, alignment and engagement please read:
• Article #1: Value Based Care is Here to Stay
• Article #2: Achieve Results: Governance
• Article #3: Achieve Results: Leadership and Management
• Article #4: Achieve Results: Knowledge Management/Transfer through Data Analytics
• Article #5: Process Management-Achieve Value Based Results

We are facing a critical era of transformation in healthcare. As organizations strategize to find stability through turbulent times, managers, directors, and executives will feel added pressure to achieve continuous, dynamic results.

The success of each department will depend on a single crucial factor: Is there a "boss" or a "leader" in place?

A "boss" refers to an individual who is in charge of the employee or an organization. He exercises control over employees, orders, assigns tasks and duties to them and is entitled to take decisions on some matters. Bad bosses will motivate through fear tactics, defer blame to others, take credit for other's successes and bully members into producing results.

The term "leader" is defined as an individual who possesses the ability to influence and inspire others towards the accomplishment of goals. Communication coupled with integrity compel people to follow. Great leaders think about what their body language, facial expressions, and tone of voice communicate to their staff. They often take the time to say things face-to-face rather than through email in order to build trust, develop relationships, manage conflict, and encourage employees. Leaders pull the best out of each member and inspire group success.

It is important to note that the teams which produce the most effective and long-lasting results are the ones that are directed by leaders, not bosses.

"If your actions inspire others to dream more, learn more, do more and become more, you are a leader." - John Quincy Adams

Transform Bosses into Leaders

Where bosses fail, leaders prevail. If you've noticed that you have more bosses than leaders in your organization- all is not lost. Aspiring and current managers, directors or executives can begin improving their ability to lead. Wiederhold and associates offer specialized assessments as well as a number of training programs designed to develop quality leaders that are custom fit to your organization. If you are interested in learning more, just let me know.

Here's to your success,

Jim

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By Joy W. Goldman | Leadership Coaching

In the March, 2017 newsletter, I introduced the topic of trust and highlighted five ways leaders increase trust in their organizations. Today, I wanted to provide an overview of two very practical tools that can be used to engender trust in ALL relationships, regardless of how challenging you may find some to be:

Conversational Intelligence and Polarity Thinking

You can deepen your learning on Polarities during an upcoming Wiederhold & Associates webinar on Aug 1.

Wiederhold & Associates Webinar
August 1, 2017 - "Polarity Thinking"

Register ASAP to obtain needed pre-work for this interactive webinar

Click to pay Registration Fee

No Fee For Premium Active Network Members and current clients.

For more information contact This email address is being protected from spambots. You need JavaScript enabled to view it.

Judith Glaser in her book, Conversational Intelligence, asserts that ALL work is conducted through conversations. Think about it! Is there anything you do that does not involve a conversation? From a pure productivity perspective, think about the time you could save if most of your conversations were impactful.

During July’s webinar, Cliff Kayser and James McKenna, two phenomenal executive coaches, illustrated in their usual humorous way, one element of effective conversations: The power of leveraging Inquiry AND Advocacy: two critical leadership competencies. The May/June 2017 issue of Harvard Business Review included an article that talked about four key attributes that distinguished high performing CEOs: the ability to be decisive was one of them. As a leader, “telling,” and “advocacy” is essential in certain circumstances.

The most powerful leaders know how to leverage advocacy AND inquiry, and they know when they’re being effective, and when they risk derailment. Signs of an overuse of advocacy may include noticing that they are doing most of the talking and others aren’t offering their opinions; leaders may notice that their audience seems less engaged. In the extreme, they may also notice that not too many people are following them!

Glaser’s levels I and II conversations consist of “telling,” or using questions that are geared toward eliciting what the leader already knows to be true. They are using inquiry but only with a goal to validate their own thinking. Glaser discusses the more powerful level III conversation that is focused on “Sharing And Discovery.” Level III conversations ask questions for which the leader doesn’t know the answer to the question.

Sample discovery questions include:
1. Sample discovery questions include:
2. What matters most to you right now?
3. To resolve this conflict successfully, what would need to occur for you?
4. Tell me what I might not be seeing or understanding right now?
5. If we couldn’t fail, what would we be doing right now?
6. If we could better leverage Safety AND Risk, how might we better serve our customers/ community?

When leaders ask questions that come from a place of curiosity, we tap into our audience’s prefrontal cortex and quiet their amygdala, the primitive part of our brain, which kicks into high gear when we feel threatened. Creativity and trust come from our prefrontal cortex: through sharing and discovery conversations.

In healthcare, our habit is to look for problems. Simple problems often have a right or wrong answer. Complex problems/ situations rarely do and are better served by leveraging interdependent tensions or pairs: polarities. Come to the webinar in August to learn more about leveraging Inquiry AND Advocacy.

In future newsletters, we’ll also explore other healthcare tensions like:
• Mission AND Margin
• Confidence AND Humility
• Centralization AND Decentralization
• Standardization AND Customization

I look forward to our next conversation!

Joy W. Goldman RN, MS, PCC, PDC
Executive Director, Leadership Coaching
Wiederhold & Associates

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During a recent goal-setting cycle, I worked on setting reasonable, although loftier, strategic goal metrics due to significant LEAN expert resourcing for my management team to focus on making transformative leaps in process improvements rather than small, incremental changes. In analyzing the strategic goal area of preventable patient harm, the Patient Safety Composite observed to expected ratio baseline was 0.629. A ratio above 1 is undesirable and a ratio below 1.0 is highly desirable. So, 0.629 is excellent, correct? Instead of improving the stretch goal by 5%, we considered 10% improvement. That is stretch goal, chest pounding, we are doing a fantastic job material!

Amid this goal setting, I was at the beach watching the news and drinking a cup of coffee readying myself for a day of fellowship, bocce ball, and sun. The local station in Myrtle Beach, SC ran a story with some interviews regarding the Target Zero – South Carolina’s Highway Safety Plan 2015 -2018. The plan was developed by the SC Departments of Public Safety and Transportation with many stakeholders including the SC Highway Patrol.

At the time, South Carolina’s 5-year average highway mortalities were ~800 per year. Immediately, I thought what an audacious goal considering they do not have control of every aspect of the events – human error, human disregard for rules, or processes/design flaws/mechanical failures. Think about this strategy compared to preventable patient harm with a Just Culture mindset as illustrated below:

If South Carolina is setting a target of zero highway fatalities, what is preventing me/us from setting a target of zero for preventable patient harm? The way we analyze data with observed to expected ratios with results below 1.0 informs us we are doing better than expected and inadvertently depersonalizes this issue. At 0.629, we were knocking it out of the park. At the end of the day, it is about perspective. The interviews shown on the newscast drove this point home for me. The interviewers asked residents around South Carolina two separate questions regarding goal setting for decreasing highway fatalities. Please view the video for about 2 minutes (from WMBF News in Myrtle Beach, SC) here.

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Physician alignment, integration and engagement in integrated delivery systems are essential elements in navigating the complexity of healthcare service delivery. Healthcare organizations need a simplified approach to realize organizational vision of comprehensive and successful alignment and integration strategies. Creating a common Vision is essential. Healthcare organizations that focus on a vision of “maximizing success in the ever-evolving healthcare industry through physician alignment and integration” will ultimately build capability to meet and exceed consumer expectations in navigating the path to value-based care.

Today’s ever-evolving healthcare industry requires a comprehensive Vision of Integration. Execution of the Vision is best achieved through a Leadership Philosophy of Performance Excellence.

The first key element in fostering a culture of performance excellence is to define the “WHAT” that constitutes excellence, frequently referred to as “the Triple Aim” of healthcare:

• Operating/Financial Excellence (low cost, highly efficient and cost effective service delivery),
• Service Excellence (service delivery exceeding patient and family expectations), and
• Clinical Excellence (best clinical outcomes for every patient and patient population).

The next essential element of a performance excellence culture is to define the “HOW” organization will be led through:

• Stakeholder Engagement
• Knowledge Management/Knowledge Transfer
• Process Management

Organizations will not only achieve the “triple aim”, but will enhance performance through achieving the “quadruple aim” of healthcare. In addition to achieving traditional value-based results, a culture of performance excellence will yield higher levels of provider satisfaction and engagement while redefining service delivery.

As highlighted in previous articles:

• Value Based Care is here to stay and healthcare organizations must overcome multiple organizational gaps that may contribute to not fully realizing a vision of success in a high performing integrated delivery system. Here
• Key Stakeholder Engagement is essential to execution of a common Vision:
• Physician Stakeholders (as well as others) should be engaged in organizational Governance, especially among healthcare providers, is essential to success in a value based environment. Here.
• Physician Stakeholders should also be engaged in Leadership and Management to achieve sustainable results. Here.

This article expands on development of a Philosophy of Performance Excellence to achieve a vision of success through Knowledge Management/Knowledge Transfer. Measuring, monitoring, reporting, analyzing and improving performance begins with defining key metrics to create a common understanding. Internal and external benchmark measures are available through a variety of sources to build an improved understanding of:

• Operational/Financial Performance,
• Service Performance, and
• Clinical Performance.

Knowledge Management/Knowledge Transfer Through Data Analytics

The days of making claims of high-quality, service oriented and low cost care delivery are gone. Regulatory requirements and consumers of healthcare demand demonstrated proof. On October 14, 2016, the Department of Health and Human Services (HHS) issued its final rule with comment period implementing the Quality Payment Program that is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Program is intended to improve Medicare by helping you focus on care quality and focusing on making patients healthier (population health management). The Quality Payment Program’s purpose is to provide new tools and resources to help organizations to provide patients with the best possible, highest-value care. The Quality Payment Program has two tracks to choose from:

• The Merit-based Incentive Payment System (MIPS), and
• Advanced Alternative Payment Models (APMs).

Healthcare providers are required and must report key measures of performance in order to maintain a competitive edge and to maximize reimbursement for services rendered. Measures of performance should focus on Operations/Financial, Service and Clinical Excellence. Internal and external benchmarking of performance is imperative. The best place to start is to define your measures, based on industry standards. Engaging your Governance, Leadership and Management representatives, as well as other key stakeholders, in defining performance metrics is essential to gain a common understanding. Begin by gathering potential sources of industry standards (see table).

Knowledge Management/Knowledge Transfer Process:

The quest for appropriate data analytics to measure, monitor, report, analyze, improve and control can be challenging. Once sources of industry standards have been identified, engage stakeholders in organization-wide effort to define your measures of Operational, Service and Clinical metrics:

• Review and select meaningful measures:
• Verify the organizational capacity to measure, monitor and report measures:
• Be sure all metrics of performance are measurable.
• Operational and Financial Metrics are typically readily available, but may not be reported in an intuitive format with full-transparency across the organization and among key stakeholders.
• Service Metrics (patient engagement) should be standardized using a formal survey tool, administered by a vendor approved for use by The Centers for Medicare & Medicaid Services (CMS).
• Measures of Clinical Performance may present the greatest challenge:
• While sources of key measures are readily available, the ability to measure performance across all providers may be limited.
• Desperate systems in multiple healthcare settings increase complexity of data collection.
• Clinical information may be captured as free form text and may require manual/human intervention for interpretation.
• Manual data abstraction may present a high cost alternative to automated reporting.
• Lack of interoperability of information systems creates complexity.
• Clinical and claims data are not typically consolidated.
• The good news is: multiple vendors are available with advanced tools to aggregate data to support your efforts to measure, monitor, report, analyze, improve and control clinical performance.

• minimum level of performance,
• expected/goal level of performance, and
• Level of performance exceeding goal.

• A simple “stop light analysis” provides ease of review (see below):

What would it take to build your career strategically?

Nursing Leaders think strategically about the work they do, often considering the needs of their organizations, their staffs, and the patients they care for as their primary focus of their careers. Rarely, however, do they spend much time thinking about a personal strategy for their own careers.

Have you considered what you want for the next chapter of your career?

If you are in the middle of your leadership career or heading to the end of traditional employment, making the next phase of your career the most intentional and thoughtful of your life is within your reach. At Wiederhold and Associates, we have witnessed the tremendous outreach nursing leaders can have when they take their careers to the next level. Be it within the same position, or a new direction, the strategic career does not wait for opportunities to come along.

Strategic careers are often designed and created by individuals who have developed shifts in thinking that utilize an increased awareness of themselves to confidently self-determine their offerings and value. Learning to communicate that value to others is a key part of the strategy.

A personal career strategy is not a selfish endeavor. When a nursing leader combines passions, talents (or potential talents) with intention, many lives and careers can be changed for the better. It could be the most important work of your life.

Taking stock of new or unrealized potential is the work of our organization as we expertly coach leaders to understand their career trajectory and make self-determination strategic goals for the most optimal work experiences. We have been honored to work with great leaders and assisting them to achieve their potential is some of the most important work we do.

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The whole concept of networking is one of my favorite and most passionate subjects.

In prior articles, we have touched on many aspects of effective networking, whether in transition or not. Building a broad and deep network is so essential to one's success that it cannot be ignored.

What I have personally observed over a 28 year period and confirmed through colleagues is clear: We can't make it without solid key relationships. Many people will find expanding their network to be challenging, but with practice and effort, you can begin to make meaningful and fruitful connections.

Connecting Point: If you're going to get somebody to take interest in your phone call, you must differentiate yourself so they choose to respond to you. The connecting point is finding something that you share in common. This can be any person, place or thing. It requires homework but it also ensures greater success as you expand your network. Whether you connect on the first attempt, leave a message, text, or send an email. The connection point is the most powerful tool in developing a memorable network relationship.
Seeking Information: Obviously, expanding your network means making initial calls to people you've never connected with before. For those in transition, resist the temptation to focus on jobs until you have created a solid connection. Seeking information makes it easier for the other person to open the door to friendly conversation. That information could be around what this individual has done, an organization that you're exploring, or a location that you have an interest in. There are a lot of options here.
Value Statement: It is important that you understand and can articulate your value. When this connection is concluded, that individual should know that you and your team are good at what they do. Your network will not refer you to others unless they understand what you do and are confident that you do it well.

If you are looking for career advancement, you must become the most effective networker you can be. Include these three components when you're expanding your network and I promise you will find success.

Here's to your success,

Jim

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Are you looking to be promoted?

If getting a promotion is important to you, then it is time to sit down and look at the external and internal factors that will influence your strategy of advancement.

Define Your Target

The very first and most important step in your career advancement strategy is to define what success is to you. From my observations, too many individuals choose a path that is somebody else's dream rather than their own. It's how you define moving up that really counts. It's also hard to be passionate about a direction that isn't your dream.

Do Your Part

The internal factors are all about you. This is where you exert the highest level of control. Are you being intentional about putting yourself in a position to be promoted? [Click to read more]

Survey Your Surroundings

If you are seeking to move to the next level within your organization, there are a few items that need to be explored:

• How has this organization historically handled promotions?
• Do they generally promote from within or seek externally?
• What is the general timeframe for people to get promoted within the organization?
• Is the person you report to going anywhere?
• Does the person you report to have a history of mentoring his/her direct reports?

I call these external factors because you can only influence them not control them. Your answers to these questions may suggest that the only way you're going to move up is to move out. If these external factors align with an internal promotion, then you have additional steps.

• Have I asked my immediate superior what it takes to get to the next position?
• Did their answer have enough specificity to suggest that they had thought about this possibility?
• Can I continue to gain clarity around the possibility of promotion? (If you cannot gain clarity, then more than likely that's not a real possibility.)

By defining your goals, developing a strategy, and become intentional about executing your plan, you can increase your chances of advancement immeasurably.

Here’s to Your Success-

Jim

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According to the Bureau of Labor Statistics, 1.2 million vacancies will emerge for registered nurses between 2014 and 2022. In fact, the shortage is anticipated to be twice as big as when Medicare and Medicaid were introduced in 1965.

Nursing plays a huge role in the success of our hospitals and healthcare systems today. Developing and retaining great nurses has never been more important.

Untapped Talent

Many organizations have "diamonds in the rough" just waiting to be discovered. The very skills that make effective nurses such as creative problem-solving skills, exceptional communication skills, and emotional intelligence are the foundational building blocks required to make exceptional leaders.

However, being a good nurse doesn't always naturally translate into becoming good a nurse manager. Like many others who are promoted into management roles, nurses are generally not offered a great deal of assistance as they move into these new and challenging positions. Their raw talent must be inspired and carefully cultivated to become a thriving leader. With proper guidance, the transition into a senior leadership role can be very successful.

W&A Nurse Leadership Program

To maximize the success of our nursing clients, we have partnered with Nursing Leadership Coach Diane Scott, RN, MSN, ACC. With her strong clinical background, Diane has a deep understanding of the nurse executive role. Coaching is customized to every situation and organization, with outcomes driven models implemented to ensure success.

Diane explains, "Senior nursing leaders usually are in charge of the majority of the workforce of any healthcare organization. They are often promoted through the ranks and experience challenges with increasing their ability to critically think at their new leadership level. However, once they reach that level, the new challenge is the overwhelming desire to meet the mission of patient care and balance a seemingly polar opposite of managing the numbers, especially financials. They also struggle with developing a self-strategy for their career, finding it too self-serving and not patient driven.
The most successful senior nursing leaders learn that by increasing their own abilities, they can achieve their own potential, develop their managers as well as provide excellent patient care. In this way, everyone benefits under leadership that understands needs from the ground up."

At Wiederhold & Associates, we know an organization can optimally increase a nursing leaders’ capacity for successful outcomes through professional Nursing Leadership Coaching. It is the single most powerful way for a leader to achieve their potential for superior leadership, strategic thinking, and measurable results.

If you would like to learn more about our Nursing Leadership Program, download a tri-fold brochure here

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Physician alignment, integration and engagement in integrated delivery systems are essential elements in navigating the complexity of healthcare service delivery. Healthcare organizations need a simplified approach to realize organizational vision of comprehensive and successful alignment and integration strategies. Creating a common Vision is essential. Thomas Edison is quoted as saying “Vision without execution is hallucination.” My expertise in leading physician alignment and integration strategies leads me to believe: “Vision without execution is worse than having no vision at all.”

A vision of developing highly integrated, well-coordinated and person-centric care is essential to success in today’s healthcare market. Best practice in integration and alignment will begin with key stakeholder engagement in executing organizational vision. Physicians, as key stakeholders in care delivery, respond well to a establishing a common vision. Healthcare organizations that focus on a vision of “maximizing success in the ever-evolving healthcare industry through physician alignment and integration” will ultimately build capability to meet and exceed consumer expectations in navigating the path to value-based care.

As previously highlighted in Achieve Results through Physician Alignment, Integration and Engagement: Governance and Value-based Care is Here to Stay, multiple organizational gaps may contribute to not fully realizing a vision of success in a high performing integrated delivery system. This article expands on development of a philosophy of performance excellence to achieve a vision of success. The schematic shown above provides a roadmap for navigating the performance excellence journey toward becoming a fully integrated and well-coordinated care delivery system, focused on the value-based equation of healthcare.

Today’s ever-evolving healthcare industry requires a comprehensive vision of performance excellence:

• Operating/Financial Excellence (low cost, highly efficient and cost effective service delivery),
• Service Excellence (service delivery exceeding patient and family expectations), and
• Clinical Excellence (best clinical outcomes for every patient and patient population).

More importantly execution of that vision is imperative. Most healthcare organizations have developed a vision of service delivery that meets the value-based equation of operating/financial, service and quality excellence. Direct employment of physicians and other providers is one model of integration. Other models, including developing a Clinically Integrated Network, create other opportunities for integration and alignment. Either way, it is essential to build a culture of inclusion

Execution of an organization’s vision for the future is best achieved through fostering and developing a culture of comprehensive performance excellence. Measurable results are achieved when time and energy are devoted to:

• Key Stakeholder Engagement,
• Knowledge Management/Knowledge Transfer through data analytics, and
• Formal Process Management.

Physicians, as irreplaceable key stakeholders in care delivery, should be engaged in decision making and in charting the course for success. Physicians and other key stakeholders can quickly become disenfranchised when the vision of integration is not well executed. Having physicians actively engaged at the table to participate in decision making is essential. Whether healthcare organizations are focused on growing and developing an employed physician network, or seeking to align and integrate through other means, physicians should be formally and informally engaged in:

• Governance,
• Leadership, and
• Management.

Previous articles addressed physician engagement in Governance of the Physician Enterprise Organization. This article focuses on physician engagement in Leadership and Management.

Leadership and Management:

In addition to active engagement in governance, physician leadership and management is recommended. A dyad leadership model fosters a culture of engagement among physicians and support staff. The model includes physician leaders and operational leaders working in partnership at all levels:

• Executive Leadership (Physician Executive Leader and Administrative Executive Leader),
• Operational Leadership (Medical Directors and Operations Directors), and
• Operational Management (Site Lead Physicians and Operations Managers).

Physician leaders and managers in the dyad leadership model typically maintain an allocated time in clinical activities, in addition to allocated time in leadership/management activities. The prorated allocation of leadership/management time should be tailored to scope of responsibility and accountability.

An Operating Team, comprised of dyad partners at the executive and operational leadership level, should meet on a routine basis (weekly or bi-weekly) as a team to share ideas and build consistency within the physician enterprise. The Operating Team maintains accountability and responsibility for translating organization-wide goals and objectives to action. The team ensures that strategy is translated into operations. Action plans and tactics are developed to achieve strategic and operational results.

The Operating Team should meet with Site Lead Physicians and Site Supervisor/Managers on a routine basis to hard-wire operating norms. Regularly scheduled meetings of all Site Lead Physicians and Site Supervisors/Managers provide an opportunity to share best practices, build consistency and to give the practices a sense of being part of a group practice, as opposed to being isolated in individual practices.

Executive and operational leadership team members should develop a routine of rounding at all practice locations. Building relationships with practicing physicians, other providers and support staff is essential. Day to day problem solving is best achieved through active engagement of leadership, management and staff. Those who are closest to the delivery of care typically have the most innovative ideas for how best meet the needs of patients/communities services. Routine rounding also provides the opportunity for leadership to engage with patients and families to gain a better understanding of the patient experience.

An example organizational chart is provided below to give direction to leadership and management structure (see below). It should be noted that functional structure and infrastructure in the organization is most effective with limited layers of leadership and management, maintaining active relationships between leadership and staff. The organizational model is designed to expand horizontally, as opposed to vertically through creation of additional layers. Operational leadership should be tailored to the scope and diversity of specialty types within the group.

Support functions are essential to success of the physician enterprise. Finance/Accounting, Revenue Cycle, Marketing/Public Relations, Information Technology, Human Resources, Facilities/Maintenance, Purchasing and other support functions may be centralized on an enterprise-wide basis or may be structured in direct support of the physician enterprise. It should be noted that functions are highly specialized in support of a physician enterprise. Whether centralized or in direct support of the physician enterprise, it is essential for operational and executive leadership to engage directly with leadership and management of the support functions to develop a common understanding of organizational needs and performance expectations. It is recommended for support functions to be actively engaged with governance sub-committees.

Key Take Aways:

• Active engagement of key stakeholders is essential to fostering a culture of performance excellence
• Physicians can quickly become disenfranchised when not engaged in developing organizational vision
• Physician engagement and satisfaction in improved when organizational vision is well executed
• Execution is best achieved when the organization is focused on performance excellence in operations, service and clinical activities
• Developing and Fostering a culture of performance excellence requires governance, leadership and management

Next Steps:

• Knowledge management and transfer through data analytics:
• Determine the most important operational, service and clinical data analytics needed
• Process Management through formal methodologies:
• Determine the process management for the organization
• Develop leadership, management and staff to focus on processes to:
• achieve results,
• standardize operating norms,
• reduce variation, and
• hardwire best practices.

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In its 2016 global CEO survey, Price Waterhouse Coopers reported that fifty-five percent of CEOs think that a lack of trust is a threat to their organization’s growth.

Stephen M. R. Covey, in his book: “The Speed of Trust,” asserts, "The ability to establish, extend, and restore trust with all stakeholders – customers, business partners, investors and coworkers – is the key leadership competency of the new, global economy."

Paul Zak, in the January/February 2017 issue of Harvard Business Review and the feature article: “The Neuroscience of Trust,” states that employees in high trust organizations are more productive, have more energy at work, collaborate with colleagues and stay with their employers longer than in low trust cultures. Regardless of industry, your job as a leader is to create a culture of trust.

In our work with clients, we coach them around the following five behaviors which are scientifically proven to promote trust:

1. Model transparency and vulnerability: While it may seem ironic, there is great power in admitting when we’ve made mistakes. In healthcare, we strive to create just accountability cultures. The most powerful and impactful leaders are those who stand up in front of their organizations and tell stories about their mistakes and the critical learning from those mistakes.
2. Leverage inquiry AND advocacy: Judith Glaser, in her book: “Conversational Intelligence,” describes three levels of conversation. All are necessary in certain circumstances, yet we tend to overuse the first two: telling, and trying to convert others to our perspective (levels I and II), and we underuse the last: transformational discussions (level III) with a mutual sharing of perspectives and an attitude of curiosity. This sharing stimulates our pre-frontal cortex which allows for our most creative thinking. “Imposing our perspective: telling behavior” can trigger another’s primitive brain (amygdala) and can result in fight, flight, or freeze reactions. Through coaching, one of my clients re-defined the 80/20 rule where it now means that she talks only twenty percent of the time and listens eighty percent of the time. The impact on her engaging with others, her talent selection success, and her ability to make strategic decisions has been powerful.
3. Identify and honor your values: What do you stand for? As I coached a physician client, she discovered that her words and actions were not honoring what she said she held as most important. She was torn between caregiving needs for her aging mother and her work demands. Through coaching, she transformed her thinking from reactionary: worrying what others might think, to purpose-driven: honoring private time AND work responsibilities.
4. Make it easy for others to provide you constructive feedback: the higher you go in organizations, the fewer people there are who feel comfortable providing you constructive feedback. My clients expect that I will offer observations of their behaviors and/or thinking that is interfering with their leadership effectiveness. One simple question you can ask on a routine basis is: “What can I do differently that would support my being a more impactful leader?” And then do it.
5. Deliver on promises and do NOT promise anything you cannot deliver: Sometimes as leaders we believe we must respond immediately to a request. In doing so, we risk promising something that we later determine is less of a priority or can’t be done. Trust means following through with commitments.

While not always easy, leaders who are committed to creating a culture of trust will continue to be disciplined around these 5 behaviors- especially in hard situations. As employees become more emotionally engaged with leadership, productivity and retention will naturally increase.

Joy W. Goldman RN, MS, PCC, PDC
Executive Director, Leadership Coaching
Wiederhold & Associates

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Culture of Performance Excellence: A simplified Approach

Physician alignment, integration and engagement in integrated delivery systems are essential elements in navigating the complexity of healthcare service delivery. Healthcare organizations need a simplified approach to realize organizational vision of comprehensive and successful alignment and integration strategies. Creating a common Vision is essential. Thomas Edison is quoted as saying “Vision without execution is hallucination.” My expertise in leading physician alignment and integration strategies leads me to believe: “Vision without execution is worse than having no vision at all.”

A vision of developing highly integrated, well-coordinated and person-centric care is essential to success in today’s healthcare market. Best practice in integration and alignment will begin with key stakeholder engagement in executing organizational vision. Physicians, as key stakeholders in care delivery, respond well to a establishing a common vision. Healthcare organizations that focus on a vision of “maximizing success in the ever-evolving healthcare industry through physician alignment and integration” will ultimately build capability to meet and exceed consumer expectations in navigating the path to value-based care.

As previously highlighted, multiple organizational gaps may contribute to not fully realizing a vision of success in a high performing integrated delivery system. This article expands on development of a philosophy of performance excellence to achieve a vision of success. The schematic shown above provides a roadmap for navigating the performance excellence journey toward becoming a fully integrated and well-coordinated care delivery system, focused on the value-based equation of healthcare.

Vision and Execution

Today’s ever-evolving healthcare industry requires a comprehensive vision of performance excellence:

• Operating/Financial Excellence (low cost, highly efficient and cost effective service delivery),
• Service Excellence (service delivery exceeding patient and family expectations), and
• Clinical Excellence (best clinical outcomes for every patient and patient population).

More importantly execution of that vision is imperative. Most healthcare organizations have developed a vision of service delivery that meets the value-based equation of operating/financial, service and quality excellence. Direct employment of physicians and other providers is one model of integration. Other models, including developing a Clinically Integrated Network, create other opportunities for integration and alignment. Either way, it is essential to build a culture of inclusion.

Execution of an organization’s vision for the future is best achieved through fostering and developing a culture of comprehensive performance excellence. Measurable results are achieved when time and energy are devoted to:

• Key Stakeholder Engagement,
• Knowledge Management/Knowledge Transfer through data analytics, and
• Formal Process Management.

Physicians, as irreplaceable key stakeholders in care delivery, should be engaged in decision making and in charting the course for success. Physicians and other key stakeholders can quickly become disenfranchised when the vision of integration is not well executed. Having physicians actively engaged at the table to participate in decision making is essential. Whether healthcare organizations are focused on growing and developing an employed physician network, or seeking to align and integrate through other means, physicians should be formally and informally engaged in:

• Governance,
• Leadership, and
• Management

This article focused on physician engagement in Governance of a Physician Enterprise Organization. The article in this series will focus on establishing Leadership and Management Structure to execute the organizational vision.

Governance:

Hospital organizations have been inviting physicians to be members of governance structures for many years. In addition to representing medical staff activities, physicians can help foster a physician friendly culture at the board level. Gaining the physician perspective of hospital operations and embracing input will contribute to an environment of high performance. Physicians are typically viewed as customers of hospital based services.

Governance within a physician enterprise organization (employed model or clinically integrated network) requires a very high level of engagement among physicians. Physician enterprise organizations have a profound impact on a physician’s practice and physician’s entire livelihood. A high level of governance to oversee and provide direction is needed. A physician led governing board is recommended. Physicians should be viewed as key stakeholders and leaders in care delivery.

While physician governance is recommended, organizations may adopt a formal governing body with corporate bylaws which define scope of responsibility and accountability, or less formal governance oversight in an advisory capacity. Scope of responsibility and accountability of the physician led governance and reserved powers of higher governing authority at a system-wide level must be clearly defined. The majority of governing body membership should be comprised of physician members with predetermined representation from medical and surgical specialties from within the group. Administrative leadership is tasked with facilitating and directing physician governance through a high level of trust and credibility.

The Governing Body of a physician enterprise organization may be structured to include the physician led board, as well as several sub-committees with defined functional oversight as defined by committee charters:

• Policy and Procedure
• Regulatory Compliance
• Physician/Provider expectations:
• Productivity
• Access
• Guiding principles related to citizenship and behavioural standards
• Quality performance
• Service performance
• Operational/Financial performance.

Sub-committees of the governing board are recommended to foster a broader level of engagement and participation among physician members of the group. The board may consider delegation of oversight to subcommittees to create focus and subject matter expertise through measuring, monitoring, reporting and improving performance. Sub-committees to consider include:

• Finance Committee
• Oversight of provider productivity
• Oversight of financial measures
• Capital allocation and approval
• Oversight of Revenue Cycle
• Clinical Quality Committee:
• Regulatory required quality reporting
• Non-regulatory quality improvement activities
• Growth Committee:
• Growth Committee
• Provider manpower planning
• Provider recruitment and selection
• Provider retention
• Provider engagement and satisfaction
• New service development
• Service Excellence/Patient Experience Committee:
• Patient experience survey process
• Patient experience expectations
• Patient experience improvement initiatives
• Informatics and Automation Committee:
• System selection
• System implementation
• System performance and optimization
• Physician Compensation Committee
• Create a common understanding of fair market value for physician compensation models
• Create incentive based compensation and align with value
• Communicate broadly among all physician members of the group
• Payer Relations and Contracting Committee:
• Contract negotiation
• Engagement in value-based initiatives

Key Take-Aways:

• Active engagement of key stakeholders is essential to fostering a culture of performance excellence
• Physicians can quickly become disenfranchised when not engaged in developing organizational vision
• Physician engagement and satisfaction in improved when organizational vision is well executed
• Execution is best achieved when the organization is focused on performance excellence in operations, service and clinical activities
• Developing and fostering a culture of performance excellence requires physician engagement Governance of the Physician Enterprise

Next Steps:

• Assess and design the Leadership and Management structure of the physician enterprise to enhance the performance excellence culture
• Knowledge management and transfer through data analytics:
• Determine the most important operational, service and clinical data analytics needed
• Process Management through formal methodologies:
• Determine the process management for the organization
• Develop leadership, management and staff to focus on processes to:
• achieve results,
• standardize operating norms,
• reduce variation, and
• hardwire best practices.

Connect with Mike on LinkedIn.

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Everyone has a passion for something. When networking with others, make it a point to find the other person’s passion. Why? People like talking about what’s important to them. How do you find out what’s important to them? Ask them. Ask what they do for fun. Ask about their family. Ask what they would do if they weren’t in their current job. Ask where they volunteer. Then simply listen. Many times you will find what’s important to other people is also important to you. That’s your connection.

When discussing yourself be sure to include information that could be potential connecting points- spouse’s name, children’s names, where you grew up, where you went to school, what you like to do, etc. Recently I was speaking with an individual about adding this type of connecting information so I mentioned my wife was from the Twin Cities area. I explained the rationale for sharing such information by stating this would be our connection if his wife happened to be from the Twin Cities. What did he say next? His wife is from the Twin Cities- that is now our connection.

People instinctively want to connect with other people. Listen for people’s passions, make meaningful connections and you’ll network successfully./p>

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Wiederhold & Associates currently partners with healthcare systems to support their succession planning process. One organization we are working with is unique in their foresight in planning for critical impending retirements. They recognize the need to invest on a longer-term basis to prepare their leaders for future success. Joy W. Goldman RN, MS, PCC, PDC, Executive Director of Leadership Coaching is leading the charge.

"We not only want our clients to achieve their next career goals; we want them to excel and grow into the best leaders they can be. Now, more than ever, our world needs effective and values-driven leaders." - Joy W. Goldman

As we work with our client systems, we know that we need to leverage confidence AND humility; individual interests AND team interests; a centralized AND decentralized focus; safety AND risk. We challenge ourselves with these polarities as we challenge our clients and client systems.

"In working with one client, I took the risk of saying, 'It seems that you’ve been waiting for permission and approval to make a move. When are you going to take matters into your own hands and just act?' While difficult to hear, this challenge caused an empowering shift in the client. His words, after having time to process this, were: “I feel like a phoenix rising!” -Joy W. Goldman

Our mission is to groom and develop agile leadership that is able to intelligently navigate the challenges and changes that our industry is facing. We look forward to partnering with you as you strategize your succession strategy for long-term success.

Jim

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Simplified Approach through Physician Alignment and Integration

Value Based Care is defined as provision of services that are low cost, highly efficient, service-oriented and provide the highest quality outcomes. Consumer expectations of values in the healthcare industry will continue to increase. Serving healthcare needs of a community that meet and exceed consumer expectations is complex and multi-faceted. The healthcare industry needs a simplified approach to address complexity and move toward a coordinated care delivery system. Healthcare organizations must first define a compelling vision for coordinated care delivery. Execution of that vision is best achieved through a leadership philosophy of performance excellence.

The schematic shown below provides a roadmap for navigating the performance excellence journey toward value-based care (see schematic). This introductory article, the first in a series, outlines a vision for maximizing organizational success in the evolving healthcare industry through physician alignment and integration. A consistent and simplified leadership philosophy is provided to assist in execution of a strategic vision. Organizational gaps that may interfere with achieving organizational vision are also identified.

Vision and Execution:

The journey begins with:

• Strategic vision for the future, and
• Execution of the strategic vision through a leadership philosophy and organization culture of performance excellence.

The culture of performance excellence focuses on measurable results and outcomes in three main areas:

• Operating/Financial Excellence,
• Service Excellence, and
• Clinical Excellence.

Performance excellence is best achieved when time and energy are devoted to:

• Key Stakeholder Engagement,
• Knowledge Management/Knowledge Transfer through data analytics, and
• Formal Process Management.

Organizational Gaps:

Physicians and other providers are often not fully aligned with hospital organizations. Competing interests among physicians, other providers and hospital organizations may exacerbate misalignment. Hospital organizations know they need physician alignment and integration strategies. Many hospital organizations are unclear regarding scope of physician alignment and integration strategies. Some hospital organizations tend to view integration as a model of employment only, when there is a vast array of physician integration models.

Each hospital organization possesses a unique climate and organizational culture for effective physician integration. Execution of physician integration strategies may lack depth of understanding. Structure and infrastructure needs for effective strategy execution are often underestimated. Governance, Leadership and Management representation among physicians and other providers is necessary, but often ignored. Significant variation in level of engagement exists among key stakeholders in healthcare delivery. High levels of engagement in organizational change are needed among leadership, management, physicians, other providers and staff, as key stakeholders in the delivery of care. Common understanding among key stakeholders is often lacking.

Traditional healthcare leaders may have a tendency to exert “control” rather than engage physicians and other providers when focusing on organizational initiatives to improve care delivery. In addition, development of multi-disciplinary teams to focus on organizational initiatives may be difficult. Multi-disciplinary teams are especially prone to experiencing team dynamics of forming, storming, norming and performing. Many organizations have a low tolerance for the highly productive storming phase of team development, especially when physicians are involved. Embracing physician input is imperative.

Many healthcare organizations have not adopted a meaningful and comprehensive process management methodology. There may be tendency to focus process management efforts within the confines of the hospital organization. Process management initiatives must become much broader in scope, must address care delivery across the entire continuum of care, and must focus on enterprise-wide initiatives, including care delivery in physician offices. Application of a formal and reliable process management methodology is often underestimated. Establishing an enterprise-wide process management approach requires vision, and investment of time and money. Physician stakeholders, being scientifically trained, tend to naturally adopt process management principles. The investment in education and training may be substantial. A multitude of models exist and it may be difficult to select and sustain a consistent approach that is embraced by all key stakeholders.

There exists an ever-increasing emphasis on service, cost and quality outcomes. Government payers are increasing regulatory requirements, but those requirements may not be universally understood. Variation in understanding among key stakeholders may exist. Non-governmental payers may institute additional requirements and variation adds complexity and lack of common understanding. Employer demand for reduced healthcare costs, while providing service oriented and quality services, creates another set of demands on healthcare providers. Suppliers and vendors to the healthcare industry lack a comprehensive view of what is needed to improve service delivery.

Traditional hospital based healthcare organizations are deeply grounded in meeting the needs of the communities in which they serve. Traditionally, hospital based organizations have long and established histories of serving patients at times when they are most in need of life saving intervention. Consumers and payers of the healthcare industry expect an effort to create healthier communities and to reduce high cost, episodic and acute interventions. Healthcare systems are not always well positioned to meet comprehensive consumer expectations beyond episodes of care. Healthcare systems have traditionally survived and measured success, based on payment models that encourage utilization of high cost, revenue producing services. The path to managing the health status of communities at lower cost requires engagement and alignment of services outside of the acute care setting.

Key Take-Aways:

The future of the healthcare industry is uncertain. Care delivery is complex and multi-faceted with organizational gaps impeding the journey to designing and developing healthcare systems to meet ever increasing consumer expectations of value. The healthcare industry will continue to experience constant pressure to modify and change current care delivery systems to meet rising consumer expectations. Navigating the journey to coordinated care delivery across the full continuum of care requires strong vision for the future and a refined leadership philosophy.

This article provides a simplified approach to defining a compelling organizational vision. The need for a leadership style and organizational culture of performance excellence are outlined. Gaps in traditional organizational approach are also highlighted. The schematic below provides a roadmap for comprehensive improvement.

Future articles will provide additional detail related to how to lead the performance excellence journey to achieve an organizational vision of the future.

Next Step: Evaluate the company’s governance, leadership and management structure to identify opportunities for meaningful formal and informal engagement.

Performance Excellence Roadmap toward Value Based Care

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These are extremely challenging times in healthcare.

We know changes are coming, but no one has a clear understanding of what those changes will be. When change happens, people look to their leaders to navigate them through. Are you prepared to be a successful leader in a time of such uncertainty?

Leadership Keys to Thriving Through Change:

Keep Consistent

Organizations should develop five key objectives and stick with them. Resist following the latest fads and avoid adding multiple new objectives. Overwhelming your people with too many objectives creates the “deer in the lights syndrome” and can hinder forward progress. Giving consistency will give your employees a feeling of security and will build both confidence and trust.

Solidify Trusted Relationships

Everything you read about America today suggests that the trust level of employees for their leaders and organizations are at an all-time low. It is imperative that you solidify relationships within all your key groups: Superiors, peers, and direct reports.

While you work to solidify interior relationships, also work to build relationships with experts outside your organization and possibly outside your industry. Connect with others who faced similar uncertainties and learn how they maneuvered through challenging situations

Be Agile and Adaptable

Remember, doing the same old things will get the same old results. Changes are coming quickly, and leaders must actively prepare. Some may consider hiring an executive coach to equip them with better leadership tools and enable them to produce better results.

Supersize the Soft Skills

According to the Carnegie Institute of Technology, 85% of your financial success is due to your personality and ability to communicate, negotiate and lead. Shockingly only 15% is due to technical knowledge. Communication, integrity, and empathy will pay dividends in the form of loyalty and engagement of your team. Encourage diversity of thought and embrace collaboration. Balance confidence and humility. By utilizing your soft skills, you will create an environment that each member can invest their best into and will cause the whole organization to succeed.

Change brings opportunity so don’t be afraid to take some risks. Great leaders became great because they could successfully navigate through the challenge of change. Utilizing these keys will allow companies not only to survive but also to seize the extraordinary opportunities that arise during periods of immense uncertainty.

Jim

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