1. Moving Toward Excellence What’s In It for Physicians? 1,2,3 A Presentation for the Fairfield Medical Center Annual Planning Retreat Kendall L. Stewart, MD, MBA October 30, 2005

2. Why is this important? For those who are passionate about excellence, the pursuit is its own reward. 1 For those in highly competitive environments, quality is a competitive advantage. 2 A number of market forces are forcing health care leaders to pay increased attention to documented quality. While not yet a crisis, the chance to enlist in the quest for excellence is a clear opportunity for hospitals and physicians. This presentation will describe one hospital’s ongoing journey and the opportunities such a commitment creates for physicians. Beware. The pursuit of excellence is neither easy nor comfortable. 3 After mastering the information in this presentation, you will be able to –Describe three principal barriers to organizational excellence, –Identify the four foundations of organizational excellence, –Specify three strategies that will support your hospital’s move toward excellence, –Detail three approaches your hospital will adopt to build exceptional relationships with physician stakeholders, –Clarify three opportunities for physicians who choose to become engaged in the pursuit of excellence, and –Depending on your perspective, name three behaviors that will help you achieve your goal.

3. What are some of the common barriers to an organizational culture of excellence? Leaders who don’t “get it.” Leaders who are unwilling to “walk the talk.” Leaders who are unwilling to pay the painful emotional price. Leaders who are too impatient. Leaders who are too comfortable. Leaders who refuse to face reality. Leaders who are unwilling to forego “ladder climbing” for 5-10 years. Leaders who indulge in temper tantrums and blaming. 1 Leaders who are inadequately motivated. Leaders blinded by their own needs. 2 Leaders. Period.

4. What are the foundations of organizational excellence? 1,2 People Planning Process Performance

5. What practical strategies will promote the creation of a culture of excellence? People –Embrace discomfort. 1 –Identify champions. –Develop leaders. –Define the “Rules of Engagement.” 2 –Extrude negative leaders. Planning –Align the organization around your strategic values. –Adopt a framework for organizational excellence. 3 –Adopt a process improvement methodology such as Six Sigma. –Deploy a simple strategic planning process. –Take the long view. Process –Design and deploy an organizational change process. –Deploy leadership teams throughout the organization. –Deploy and systematically improve key processes for leadership, strategic planning, customers, knowledge management, human resources and process management. 4 –Empower a limited number of interdisciplinary process improvement teams. –Engage stakeholders in real work. Performance –Identify key performance indicators. –Demand comparative data. –Set measurable short- and long-term goals. –Insist on detailed action plans. –Deploy balanced scorecards or dashboards throughout the organization.

6. What strategies will excellent hospitals use to build exceptional relationships with their physician stakeholders? Deploy a robust recruitment and retention process. Design and deploy a physician relationship enhancement process. Create opportunities for physicians to invest in the hospital. Provide every compliant physician perk. Respond promptly to physician complaints. Improve physician efficiency. Increase physician convenience. Deploy a comprehensive physician back up service. Engage physician leaders in meaningful work. 1 Design and deploy a physician leadership development process. Communicate effectively. Ensure that executives are visible and available. Involve physician leaders in strategic planning. Clarify behavioral expectations. Confront inappropriate behavior. Manage conflict effectively. Create social opportunities. Organize a physician relationships leadership team. Document key physician relationship management processes. Maintain a physician database.

7. What opportunities for physicians will their hospital’s move toward excellence create? The opportunity to identify flawed processes The chance to help set organizational priorities The chance to improve the quality of your life as a result 1,2 The opportunity to improve your patients’ satisfaction with your service The opportunity to document your performance The opportunity to contribute and be part of the solution 3 The opportunity to learn new skills The opportunity to seize welcomed distractions The opportunity to build meaningful relationships with your colleagues The opportunity to experience the satisfaction of having made a difference

8. How should physicians respond to these opportunities? “I’m against improvement; I’m a miserable cuss, and I don’t intend to change.” 1 –Concentrate on being as negative, angry and resentful as possible. –Cut every corner you can. –Resist the measurement of anything. –When something is measured, tell everyone that the data is crap. –Spend as much time as possible in the physician’s lounge. 2 Page 1 of 4

9. How should physicians respond to these opportunities? “Improvement’s fine, but I just want to play more golf.” –Figure out what’s in it for you. –Ask directly for what you want and need—instead of expecting people to read your mind. –Say “no” to committee assignments instead of becoming dead weight that everyone else has to drag along. –Encourage those who are trying to make things better. –Focus on your work. –Remain emotionally detached. –Stop expecting to be a player. –Try to avoid giving stupid advice. 1 Page 2 of 4

10. How should physicians respond to these opportunities? “I want to make a substantial contribution over the long haul.” –Read one book a year about organizational excellence. –Enroll in your hospital’s physician leadership program. –Volunteer to participate in your hospital’s physicians scorecard project. 1,2,3 –Join a performance improvement team and pull your weight. –Prepare for meetings. –Learn how to ask the right questions. –Accept leadership positions. –Consider becoming a departmental Medical Director. Page 3 of 4

11. How should physicians respond to these opportunities? “I want to go whole hog.” –Earn an MBA. –Become a Baldrige examiner. –Become an expert and zealot in Safety, Quality, Service, Interpersonal relationships, or Financial performance. –Take a full-time job as a physician executive. –Trade the aggravations of clinical practice for aggravations of administrative practice. –Experience the joy of giving to those who will follow. 1,2,3 Page 4 of 4

12. Where can you learn more? Collins, Jim. Good to Great: Why Some Companies Make the Leap... And Other’s Don’t. HarperBusiness, 2001. Kazenbach, Jon R and Smith, Douglas K. The Wisdom of Teams: Creating the High-Performance Organization. HarperBusiness, 2003. Stewart, Kendall L., et. al. A Portable Mentor for Organizational Leaders. SOMCPress, 2003. Goleman, Daniel, Working with Emotional Intelligence, Bantam, 2000 Gardner, Howard, Changing Minds, Harvard Business School Press, 2004 Stewart, Kendall L., et. al. “On Being Successful at SOMC: Some Practical Guidelines for New Physicians.” Please visit www.KendallLStewartMD.com to download related White Papers and presentations.www.KendallLStewartMD.com

13. How can you contact me? Kendall L. Stewart, M.D. Chief Medical Officer Southern Ohio Medical Center President & CEO The SOMC Medical Care Foundation, Inc. 1805 27th Street Portsmouth, Ohio 45662 740.356.8153 stewartk@somc.org Webmaster@KendallLStewartMD.com www.somc.org www.KendallLStewartMD.com

14.   Safety Safety  Quality Quality  Service Service  Relationships Relationships Performance  What questions remain? www.somc.org