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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The Internet has changed the game for job seekers. The paper resume has been swapped out for a LinkedIn profile. Face-to-face meetings have been replaced with Facetime. Your local word-of-mouth reputation is small potatoes next to someone with a well-developed online presence. When it comes to the Internet, you are who Google says you are.

Fact: 92 percent of recruiters “Google” potential candidates according to a social recruiting survey. LinkedIn is the clear favorite, with 94 percent of recruiters searching it to find top talent. Potential employers also look at Facebook, Twitter, Google+ and really anything that search engines render when your name is entered.

Can you take control of your online reputation?

Be Informed. Monitor your personal brand. The first step in protecting and building your online brand is by knowing what is being said or has already been said. It’s impossible to control everything that is written about you, but even though you can’t always control what is published, you can at least know and respond to it.

Monitoring your personal brand is a two-step process. First, you figure out what is being communicated around your personal brand currently. Second, create a positive plan to improve it, build upon it.

Easy ways to monitor your reputation online:

• Google Yourself – do this at least once a month. Look for your name not only in the search results, but also the image search, news search, and video search.
• Create Google News Alerts containing your name. You can find this screen under google alerts. Note: you will have to establish a Gmail address.

How to repair and build your online reputation:

You’ve Googled yourself and found that there is at least one article that really gets in your craw. Perhaps it’s misleading, a lie, or just not flattering, and it is published on a website you have absolutely no control over. You want to wave your magic wand and just make it disappear. What can be done?

1) Get legal involved. You may have a case if:

• Defamation has occurred. For instance, someone has published a false statement that is damaging to the company or person.
• Google will remove links from search results when presented with a court order, even though they’re not legally required to do so. (Internet publishers of third-party materials may not be required to remove links, unlike offline publishers.)
• Legal action will come at a high price, on average $5,000-$10,000 per article and may not work.

2) Create and publish online through news publications and social media platforms such as LinkedIn. This is the most effective way to rid yourself of unwanted search results over time. How it works: Say you have a negative news article you want to push off the front page of the Google search results. The more content you publish with your name mentioned the more likely positive search results will be rendered when your name is searched. It should be noted that it takes time to push negative articles down the list and off the first page of results. This is due to a number of complicated algorithm factors, all dependent on Google’s rules surrounding credible content. For example, it will be much easier to bury an article posted by a local or regional paper than it would an article or video posted on CNN. Reason being is that the more credible or popular the site is, the more weight Google gives it. So your goal should be to match or overtake the negative article with your original content published on equally credible sites.

Key Take-Aways

• Always be aware of what is being said about you online. If nothing is being said, you are uniquely positioned to create a positive online reputation by populating the Internet with content and online profiles where you are in full control of the message.
• If you do have a negative online reputation, it’s never too late to start the repair process. Ignoring it won’t make those links disappear and the problem will still exist five years from now. Better to take the time now to start rebuilding your presence online.

Developing one’s career is multifaceted and takes time, energy and intentionality. In a competitive market one must differentiate. Here are five ways to stand out and help your career develop over the long-term:

• Grow your network- it’s about who you know and who knows you. Spend time each month connecting with new people to expand your network. 70%-80% of jobs are found through networking.
• Know your value proposition- what is your calling card? Communicate this through words and actions. Include tangible results when communicating your value- not just phrases like “hard-worker” or “loyal”.
• Help others- don’t always make it about you. Help other people find solutions to their problems. Give referrals to recruiters.
• Perform in your job- help your boss win. Create value for the company and your boss.
• Have a learner’s mindset - never stagnate. Learn new skills and never stop growing. Become indispensable.

Respond on this blog what you would add to this list!

Thanks,

Greg

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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If you find yourself in transition one of the worst things you can do is limit your job search. Do not say things like, “I don’t want to live in . . . . that part of the country,” or “That job is too small”. There are several reasons to cast a wide net:

1. Practice. Getting a job is totally different from doing your job. If you’ve not interviewed in the recent past (6-12 months) you will be rusty. Casting a wide net gives you interview practice.
2. Confidence. Getting in multiple job searches builds your confidence and confidence sells.
3. Leverage. Which sounds better- “I have nothing going on,” or “I’ve had 3 interviews in the past two weeks.” The latter makes you look marketable to others.
4. Networking. Every time you enter a job search you get an opportunity to start meaningful relationships with recruiters, executives and hiring managers. 80% of jobs are won through networking. These relationships pay off in the long run.

You have nothing until you have a job offer. Work to get the cards in your hand and do not ever turn down a job that you don’t have. Cast a wide net in your job search- you will be surprised to see what you catch. For professional help with your transition, please contact us at www.wiederholdassoc.com

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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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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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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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As an executive it’s easy to lose touch with staying marketable in today’s competitive environment. We all get busy doing our own jobs- it’s easy to forget about maintain and growing our network, keeping a current resume, and understanding the needs of employers. Here are a few tips on staying marketable:

>

• Perform in your present job. Create value for your employer. Be intentional about achieving the results that your employer desires.
• Build and maintain a network. Ideally you want to make 5-10 phone calls per week to grow an active network.
• Help others, including recruiters and colleagues. Helping others is a simple way to maintain your network.
• Maintain (or better yet, have a professional do it) a current resume. Resumes change every 2-3 years. You want to stand out and appear relevant. You do not want an old resume as this makes you look out of touch.
• Know and communicate your value proposition.
• Know your number (X-Y’s). How have you moved the needle on service, quality, growth, market share, profitability?
• Grow professionally. Earn a degree, certification, or extra training.

If you need to sharpen your competitive edge, contact us at www.wiederholdassoc.com to learn more about staying marketable in today’s competitive environment.

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Do you have years of experience or one year of experience, repeated each year? We want to grow each year and create real, tangible value for our employer. Now is the perfect time to write down and record the value you created in 2016. I’m not talking about serving on committees, task forces or anything that is activity based or simply spending time. I’m talking about real results- the kind your employer pays you to produce.

Take a look at improvements over the year in the following areas:

• Customer service,
• Employee engagement,
• Community perception,
• Quality,
• Sales,
• Revenue growth,
• And profit.

Any noted trends or themes (especially across multiple years) become your value proposition. This is what you’re known for - your personal calling card.

As you look forward to 2017, make sure to build on your successes in 2016 while working on any developmental gaps. We want to continuously grow and develop as this helps shape and improve the value we bring to our employer.

Happy New Year!

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One of the most important housekeeping tasks that executives have a tendency to ignore is creating a personal backup of professional achievements. By this I mean the Tier 1 and Tier 2 achievements that show how you have made the organization better.

Many times our clients struggle to come up with hard data for their resume because they neglected their personal information file cabinet. Very often separation is sudden and there is NO chance to look at past strategic plans, or board reports for the numbers or percentages.

Even if a report is confidential to the system you should be writing down your accomplishments somewhere to make sure you have access to your information in the future.

Create and keep an updated list of contact information for superiors, peers and subordinates for every job in the last ten years.

Don’t let another year go by without making sure you have access to your ever increasing list of accomplishments.

What your boss, Mr. Krabs from SpongeBob Squarepants, and Rod Tidwell from Jerry Maguire have in common and why you should care.

“Where’s me money?!” as Mr. Krabs would say. That is exactly what your boss is thinking but won’t ask given today’s decorum. As we learned in graduate school at the University of Minnesota, “it’s not about the money… it’s about the money”. Yet no one wants to talk about money- it’s uncomfortable. Try and ask people about their bank account, salary, or taxes and you will get some awkward reactions. Likewise your boss and the company you work for don’t want to look bad by overemphasizing finances. Don’t let this fool you as your company lives or dies by its profitable growth. That means your boss is counting on you to drive profits and make more money.

A system CEO once told me, “You know it’s very hard to get fired when you’re making budget.” I got it - message delivered. How can you deliver? First, cover your own costs. You better produce enough revenue to cover your salary or else you are vulnerable. Next, if you manage a budget you want to grow revenue at a rate faster than expense growth (positive spread ratio).

Finally, make sure you communicate to your boss the actions you will take to drive profitability. This builds trust as your actions turn into results. Remember- the bottom line is the bottom line. Pay attention to it and it will pay dividends for your career.

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Circumstances. Actions. Results. (C.A.R.) Recruiters want to hear that story.

When a recruiter asks you about your tenure or a specific challenge you’ve faced, remember to drive the C.A.R. Too many people wax on about their experiences as just that - experiences filled with activity. Recruiters and hiring managers want to hear about results, not just activity.

A good response looks like this, “When I arrived at XYZ Health System our operating margin was -6%. Over three years we implemented two new service lines, recruited 24 physicians, implemented productivity standards for all departments and closed an unprofitable service that wasn’t meeting community need. As a result our operating margin is now 7%.

If you are not clearly communicating the circumstances, actions and results you are not fully demonstrating your value.

Look for examples in the following areas:

• Service
• Quality
• Growth
• Finance
• People and Community

The C.A.R needs to be driven on your resume and when speaking with recruiters and hiring managers- make it a part of your lexicon. The root of the word executive is to execute. We must achieve results as that is why we are hired.

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Though desiring to advance, many healthcare professionals have plateaued in their career and are unsure how to regain momentum. Obviously, they had an idea of where they were going when they started, but never took the time to actively and consistently plan and manage their careers which have resulted in advancement delays.

It is also not uncommon for well-meaning professionals to overlook particular skills that create the opportunity for advancement. Healthcare professionals can progress in their careers, but only if they position themselves for success.

I describe career planning like building a straight fence. You define where you want to go and then identify the points and steps it takes to get there. Each step moves you closer to the next one not farther away.

Here are some "fence post identifiers" that you will need to define as you are planning your career advancement:

• Why do I want to be successful?
• What is my definition of success?
• What are my career goals?
• What leadership or technical experience do I need to achieve those goals?
• What leadership or technical skills do I need to move to the next fencepost?

It is logical to think that improving your abilities will automatically advance you to the next fence post. Unfortunately, most executives often focus on mastering hard/technical skills and overlook developing soft/leadership skills. This critical misstep can delay career success considerably. Mastering soft/leadership skills like communications, conflict management, effective messaging, emotional intelligence, relationship building, etc., can be a highly effective way to move your career forward.

Career advancement requires a plan that includes the development of both hard/technical and soft/leadership skills to be successful. If you would like help honing in on these skills, give me a call. Together, we can map out a plan to that will help you regain your momentum and put you in a position to achieve your goals.

Heres to your success!

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I advise executive clients for Wiederhold & Associates and I don’t read every word of every resume. Do you think every recruiter and hiring manager does? Chances are they are not. One recruiter told me he takes about 10 seconds to size up a resume. A good resume first and foremost needs to stand out. Many executives have the same tired, basic resume format they’ve been using for fifteen years. Many people think it’s safe to have a resume like everyone else’s- that is certainly true. However, if you want to stand out, your resume first has to stand out.

What makes a good resume? One that the reader can paint a clear picture for the reader within 10 seconds. Stand out. Clear value proposition. Numerical accomplishments that hit as many pillars as possible. As an executive I bring in expertise to the organization when called for, so why don’t more people hire professional resume writers? They, like I used to believe, think they can write their resume on their own. For a nominal investment you can have an expert market your most valuable money-making machine - you. Resumes change every 2-3 years and you and I are not experts in that field. Make it easy on yourself and hire a great resume writer to make your candidacy stand out and clarify your value proposition.

If you want your resume to stand out, contact Jim Wiederhold for professional guidance on crafting your own brand and value proposition.

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If you have worked in healthcare for more than a few years, you have probably seen at least one crisis develop in your facility. Although every incident can become a crisis, there are some that happen that can have lasting effects for the facility and everyone it touches. Crises can be from a natural disaster, human error, regulatory non-compliance, to equipment failure. All have the consequences of affecting human lives to negatively impacting the institution both financially and its reputation. What is common to all of these situations are how you and your team react to them. I have found common steps to ensure that you can react quickly, efficiently, and minimize the negative effects.

• Policies and Procedures – All too often, leadership recognizes that a crisis can happen, but few believe it can happen to them. Because of this denial, many leaders may read the administrative policies and procedures when they first come on board, and never review or update them at least annually. It is extremely important to know your crisis plans and review them annually. The time to become familiar with you plan is not in the middle of a crisis.
• Drill, drill, drill – The old saying, practice makes perfect is critical in the middle of a crisis. Practicing not only a disaster drill such as a fire or bomb threat, but also when JCAHO or the State comes in for an unannounced visit will go a long way to putting calm in the chaos. When everyone knows their role in the plan, everything goes much smoother. In addition, outsiders, such as inspectors or even the public, will gain a sense of calm and confidence in your team if everyone reacts according to the plan.
• Be the leader – If you are the one responsible for leading the institution, everyone will be looking to you for clues on how to react. If you seem rattled or unsure, your staff will also be rattled and unsure. If you present confidence and surety, the actions of your team will also demonstrate the same. If you are familiar with the plan and follow it, the crisis will play out more favorably than if you are unsure of your and your team’s role.
• Trust your team – They are there for a reason and should be experts in their roles. If you have practiced drills and ensured competence during a time of crisis, your team needs the space to do their job. Let them. It will go a long way to resolving the issue and building trust for the future.
• Communicate openly and honestly – There is a time and place to communicate what is going on in the facility, but when you do, and I recommend the leader of the facility being the spokesperson, being as open and transparent as possible can help stop rumors and defuse a potential media frenzy. The same message must be transmitted through all channels whether that is media, memos, or social media. Different messages will create confusion and distrust.
• Update often – If the crisis is one day, one week, or ongoing, keep everyone updated. A lack of communication will be filled with rumor and innuendo.
• Finally, debrief – When the crisis has passed, perform a thorough analysis of what happened and institute corrective measures.

You will experience a crisis in your institution. How you prepare and act during the crisis will define you as much as your success or failures as a leader.

I was recently attending a hospital association breakout session listening to two reputable healthcare systems present how they aligned their respective medical staffs to achieve quality outcomes. They demonstrated how they achieved reduced unnecessary admissions, reduced lengths of stay and the reduction of clinical testing and procedures. They specifically portrayed how they worked with their medical staffs to strive for best practice outcomes. Clearly the outcomes were impressive, but they neglected a key component of the Triple Aim: Reducing the per capita cost of healthcare.

Never once did they present actual cost reductions that their efforts rendered. When I posed the question about cost savings, the response I received from the two presenters was like it was the proverbial elephant in the room. They told me that they didn’t discuss cost to align their physicians “unless it was absolutely necessary”. They implied that they avoid it at all costs.

I disagree. My experience is that the cost of healthcare, or namely the waste in healthcare, needs to be shared with this key group of decision makers – our medical staff. Estimates of the money wasted on overuse each year range from around $200 billion to over $800 billion – between 10 percent and 30 percent of US health care spending. In 2010, the Institute of Medicine issued a report stating that waste accounted for thirty per cent of health-care spending, or some seven hundred and fifty billion dollars a year. The report found that higher prices, administrative expenses, and fraud accounted for almost half of this waste. Bigger than any of those, however, was the amount spent on tests that are overused, unnecessary or potentially harmful to patients.

Although it’s the “right thing to do”, I guess I can understand the presenters’ obvious trepidation to relate the cost savings to their physician partners. Sometimes it can be potentially career ending. For instance, I had a pulmonologist on staff that was a nightmare for our Case Management department. By himself, he accounted for 29% of all Medicare admissions and had a variance of the geometric mean length of stay for his patients of 2.5 days. His estimated uncompensated cost to the hospital was $1,818,300. Furthermore, we haven’t even touched on the cost of bad outcomes and malpractice cases, but I also had another surgeon on staff that was on the “watch list” for our Medical Malpractice carrier.

Sadly, both of these physicians were on the hospital’s Board of Directors and I paid the ultimate price for “doing the right thing”. They continue their ways unaddressed and I moved on.

Working with physician partners isn’t always negative, though. In the same institution the price being paid for physician preference items by my stand-alone hospital I had just become the CEO at was shockingly high. When I insisted that this egregious price difference for such things as cardiac stents and orthopedic implants be shared with the respective interventional cardiologists and orthopedic surgeons, the alignment towards the hospital point of view was overwhelming. Despite the fact that these physicians had close ties and relationships to the individual companies and/or the representatives, since they were astounded at the price difference they worked with the hospital to leverage an $8M annual savings for the same implants! It was the “right thing to do”.

My message is that reducing the cost of healthcare goes hand-in-glove with the other two prongs of the Triple Aim: improving the patient experience and improving the health of populations. You can be selective in how you share the cost information, but it must be shared with all decision makers in order to achieve the ultimate value.

Say the word “executive” to some people and it conjures up images of leather chairs and mahogany desks. In reality an executive’s job is to execute, or achieve results. At times we all get caught up in the storms that surround us- meetings, urgent issues, committees, etc. Just remember, never confuse activity with results. Like what? In healthcare we must achieve results in: service, patient safety, quality, growth, market share, service line development, cost containment, productivity, community benefit, employee/physician engagement, turnover, etc.

When executing, know where you are going. In order to execute you must have a X-Y goal in mind. For example, create a goal to grow market share from 22% to 50% in two years. If you are not clear where you want to go, how will others be clear? Relentlessly pursue your goal as that’s why we were hired- to execute and achieve results.

At the conclusion of your tenure with a given organization, know what you’ve executed. What was your X-Y in HCAHPs, profitability, turnover, market share, etc.? Clearly communicating these results to recruiters and hiring managers is the key to honing your value proposition. Remember- execution and results are the reason we get paid.

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