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Chief Culture Warrior: A Transformational Professional & Personal Role for Senior Healthcare Strategists Kathy, Steve and Ken (a.k.a. Lewton, Seekins &

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Presentation on theme: "Chief Culture Warrior: A Transformational Professional & Personal Role for Senior Healthcare Strategists Kathy, Steve and Ken (a.k.a. Lewton, Seekins &"— Presentation transcript:

1 Chief Culture Warrior: A Transformational Professional & Personal Role for Senior Healthcare Strategists Kathy, Steve and Ken (a.k.a. Lewton, Seekins & Trester) Society for Healthcare Strategy and Market Development October 4, 2007

2 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 groups 3.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 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

3 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

4 It’s not the best of times to 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

5 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”

6 ENTER the Chief Marketing/PR Officer now starring as..... Chief Culture WARRIOR

7 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

8 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

9 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.

10 Being a Chief Culture Warrior: Four Principles from Real Life

11 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

12 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

13 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.

14 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.

15 A look at the wars and warriors …a short survey about culture management in healthcare organizations

16 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

17 The war: How necessary is culture change?

18 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

19 Commitment to change

20 How we manage culture

21 How we manage…

22 Who’s actively involved?

23 Who’s on board and fully committed?

24 But 33% report that physicians are subtle naysayers or flat out antagonistic!

25 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

26 Respondent’s role in culture change

27 Satisfaction with role

28 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.

29 If you are NOT a leader… …If not, why not?

30 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

31 BUT FIRST – Some Stories Tales from the Front Lines: Successes and Failures

32 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

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35 September 15, 2007 Managing Outcomes Helps a Children’s Hospital Climb in Renown By REED ABELSONREED 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.”

36 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 ”

37 On being the AMA’s Conscience

38 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

39 Stories from the front  Tobacco Institute wants to meet with the AMA  Media Tours and openness  Media briefings and sponsorship

40 How to screw it all up  Trying to hide things from the media in a public world. Closing the openness.  The GE debacle.

41 The Service Success Story

42 Getting top management support  First, the CEO problem  Then tackle the rest of the gang: Bring data Bring strategy Find models Find tools

43 The Ritz-Carlton Formula  Make management visible  Put employee satisfaction first  Imprint the standards  Lineups: everyday, everyone

44 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

45 The Call to Action: Service First! We will provide quality healthcare through Service First! so that people choose Oakwood and its affiliated physicians.

46 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

47 The Huddle: A breakthrough communications tool  Systematic process for assuring group discussions every day

48 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

49 Do You Rely On Huddles for Information?

50 Patient loyalty scores: cause and effect?

51 PrePostChange 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

52 Chain of success starts with satisfied employees

53 The VanRinsven formula 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

54 And Now

55 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?

56 For questions or more discussion --


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