chief culture warrior: a transformational professional & personal role for senior healthcare...
TRANSCRIPT
Chief Culture Warrior: A Transformational Professional &
Personal Rolefor Senior Healthcare Strategists
Kathy, Steve and Ken (a.k.a. Lewton, Seekins & Trester)
Society for Healthcare Strategy and Market DevelopmentOctober 4, 2007
Yet forces demanding change are ever more powerful and insistent
1. Continued rise in spending has made payers ever more insistent
2. Focus on “quality” now has a life and momentum of its own• Only choice - create your own quality measures or adopt those
from third-party groups3. Demand for true patient satisfaction also difficult to ignore
• Patients believe that they are entitled to humane, respectful treatment, and know how to complain when they don’t get it
• Dial 1-800-LOCAL TV REPORTER
Election year politics add to the drumbeat And with a small but highly visible group of hospitals actually
making progress and headlines -- harder for the rest of the pack to avoid the inevitable
The trifecta Of business, politicians & patients
can no longer be ignored nor held at bay.
True transformation is the only guarantee of survival in the long-term
It’s not the best of timesto push for change in HCOs
Employees – those who aren’t fleeing – are tired, frustrated, cynical
Physicians are at worst, antagonistic and outright competitors to the HCO; at best, apathetic.
Which means powerful leadership is absolutely essential
Change – let alone TRAnsformation – doesn’t come easily to HCOs
By nature resistant to change Built on policies, procedures, process – “We’ve
always done it/never done it THAT way” Medical care has always focused on careful study,
cautious research, “first, do no harm”
ENTER the Chief Marketing/PR Officer now starring as . . . . .
Chief Culture WARRIOR
CEO Can’t Do It Alone CMPOs are:
• Trend spotters -- hear the drumbeat, collect and “own” the data, sense the danger that failure to change can bring
• Have needed tools for telling and selling – defining and describing the new vision, and persuading
• Work effectively with management peers and medical leaders who will be critical forces in transformation
• Already so close to the CEO that they can bring him/her on board, prep him or her to be the spokesperson for change
CPMO CCW = New role, new focus
Changing focus from external customers to internal workforce
Working with physicians more as a collaborator, partner, supporter
Taking more responsibility public and legislative affairs, payer relations, etc.
Going beyond data to working side-by-side with operations and nursing to find and sell solutions
Culture is determined by what we do….it is memorialized by what we say.
Both are important, but one must precede the other.
TO Be change agent,Instead of communicator:
First Be the doer,Then the sayer.
Being a Chief Culture Warrior:
Four Principles from Real Life
Step 1: Know where the HCO is NOW
HCOs often try to move people toward the new vision, with no clear sense of where the people are in terms of attitudes, opinions, morale, commitment, etc.
But because transformation is a highly complex process that has many moving parts• Can’t benchmark without a starting point• Can’t create compelling messages that will move people
to change behaviors if you have no idea what they know, believe or care about
Step 2: Assess organizational readiness
Comprehensive internal research effort that focuses on the variables that are most likely to affect ability to change.• Need to assess attitudes, needs, concerns and
commitment of key players such as middle managers and first line supervisor
• Physician research may need to be deeper and broader
than in a typical MD survey
Step 3: Strategic priorities = foundation
Culture needs a foundation – must match strategic priorities and desired market positioning • Customer service strategy means focusing on the
behaviors and skill sets that will deliver customer satisfaction.
• Quality positioning requires addressing organizational effectiveness.
• Low cost position means focusing on efficiency No HCO can afford to focus on just one strategic
priority and totally ignore other key factors -- BUT one driving imperative makes transformation easier because there’s a vision and a purpose that support the need for change.
Step 4: Bring it all together
The CPMO transformed into Chief Culture Warrior can lead transformation
• With a clear vision of strategic imperatives and
• With deep and broad understanding of the organization and its people as they are now
• With effective marketing and communications strategies and tools to change attitudes and behaviors
• And by partnering with operations execs who will lead the effort to re-tool policies, procedures and processes.
A look at the wars and warriors
…a short survey about culture management in healthcare
organizations
The Warriors
Survey of all meeting registrants plus list of selected senior practitioners - 31 responses
50% response from registrants All but a few at VP/SVP level 2/3 marketing/communications 1/3 planning 1CEO 60% are 20+ year veterans. Only 2 less than 10
The war: How necessary is culture change?
0
10
20
30
40
50
60
Vital tosurvival
Critical toStrategy
Respondent
CEO
Sr. Team
Key platform of your organization’s desired culture
Customer service/satisfaction (16) Employee engagement/satisfaction (8) Clinical quality (6) Other mentions:
• Recruiting/having best employees• Physician satisfaction• Facilities• Efficiency
Commitment to change
0
10
20
30
40
50
60
70
80
Total Partial Negative None
Respondent
CEO
Sr. Mgmnt
Physicians
How we manage culture
0 10 20 30 40 50 60 70
Managers heldaccountable
Part of EE training &development
Happens on its own
Formal activity withdedicated resources
How we manage…
0 20 40 60 80 100
CEO defines andmanages culture
Culture justhappens
Culture is managed
Culture is in plan
Have strategic plan
Who’s actively involved?
0 10 20 30 40 50 60 70
PR
Marketing
Planning
Committee
Pt. Care
HR
Physicians
Line mgrs
Coo
CEO
Who’s on board and fully committed?
0 10 20 30 40 50 60 70 80
HR
Internal Comm
PR/Comm
Marketing
Planning
Board
Physicians
Employees
Nursing
Mid mgrs
Top mgrs
But 33% report that physicians are subtle naysayers or flat out antagonistic!
Barriers to change
Not a priority(10) Time and money (8) Inertia (6) Other mentions:
• CEO• Size & complexity • Physicians• Lack of commitment• …and at least 30 others
Respondent’s role in culture change
0 10 20 30 40 50 60
Contributer
Key teammember
Leader
Satisfaction with role
0 10 20 30 40 50 60
Somehwat/verydissatisfied
Somewhatsatisfied
Very satisfied
Those who play an important role in culture change are mostly (80%) satisfied with the support of others in organization but LESS SO with time and resources to do the job.
If you are NOT a leader…
0 20 40 60 80 100
Organizational apathy
Overworked
Burned out trying
Lack expertise
Asked but denied
Someone else leads
Do you want to be?
…If not, why not?
Issues you want to talk about – and we will . . . . .
Getting top management support How to create the burning platform Implementation & how to make it stick How to push change through the ranks How to get consistency System decentralization Hiring right How to drain the swamp when you’re up to your
bubpkus in alligators
BUT FIRST – Some Stories
Tales from the Front Lines:
Successes and Failures
Cinci Children’s: A Classic Case
New CEO, from manufacturing, said quality will be our strategic position
And we start with safety And he got docs on board And the board on board And now safety IS the DNA of CCHMC
September 15, 2007
Managing Outcomes Helps a Children’s Hospital Climb in Renown
By REED ABELSON
CINCINNATI — Although it is nearly 2,000 miles from Boise, Idaho, Cincinnati Children’s Hospital means to make a visit here worth a patient’s journey.
Not content to play a regional role, the Cincinnati Children’s Hospital Medical Center has emerged as a national name in pediatric medicine, drawing patients from distant cities like Boise.
Lacking the prestige of other well-known pediatric centers, Cincinnati Children’s had to learn to compete on something else, said Dr. Charles Homer, the chief executive of the nonprofit National Initiative for Children’s Healthcare Quality.
“The something else is quality.”
On the other hand . . . . .
Major multi-state healthcare system Interviews with employees on attitudes and
morale “Quality – the ‘new initiative’ du jour “First it was guest services, then patient
satisfaction, then Six Sigma, then quality, then CQI, then TQM . . . . . . . .”
On being the AMA’s Conscience
On Being the AMA’s Conscience
It all started innocently enough Establishing a culture of openness in an
organization of control freaks The freedom of one to question
• No ratting and no pulling the punches
Stories from the front
Tobacco Institute wants to meet with the AMA
Media Tours and openness Media briefings and sponsorship
How to screw it all up
Trying to hide things from the media in a public world. Closing the openness.
The GE debacle.
The Service Success Story
Getting top management support
First, the CEO problem Then tackle the rest of the gang:
• Bring data• Bring strategy• Find models • Find tools
The Ritz-Carlton Formula
Make management visible Put employee satisfaction first Imprint the standards Lineups: everyday, everyone
Creating the burning platform
If you have a crisis, revel in it
If you don’t have a crisis• Lead by inspiration• Model the competition
The Call to Action:Service First!
We will provide quality healthcare through Service First! so that people choose Oakwood and its affiliated physicians.
Implementation: Make it stick - even if you’re big, complex,decentralized
Clear vision, definitions and standards New processes to support new cultures
• HR policies and practices critical• Reliable tracking systems• Accountability mechanisms
Disciplined, methodical rollout plan with standardized communications
The Huddle: A breakthrough communications tool
Systematic process for assuring group discussions every day
Guiding principles
Simplicity: 5 to 10 minute meeting Consistency: everyone, everyday, every
shift Interactivity: discuss Service First!
Standards Motivational: reinforce personal values Fun: engender team spirit
Do You Rely On Huddles for Information?
Patient loyalty scores:cause and effect?
Pre Post Change
Consumer Top-of-mind Awareness 36.3% 44.2% 7.9
Consumer Preference 31.2% 41.6% 10.4
Market Share 35.3% 38.9% 3.6
Profitability -2% 1% 3pts
Other Major Gains
Chain of success starts with satisfied employees
The VanRinsvenformula for victory
Hire right Do “onboarding” by top leadership in person Create “emotional engagement” Show physicians that an environment of
engaged employees is in THEIR best interest
And Now . . . . . . . .
Issues you want to talk about… Getting top management support How to create the burning platform Implementation & how to make it stick How to push change through the ranks How to get consistency System decentralization Hiring right
Oh, and what about those damn alligators?
