Prepare Leaders for Long-Term Success

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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Executives- Read this if you made $100k or more last year

Last year your employer gave you a bunch of money- what did you do for it? If you cannot clearly answer this question, you are vulnerable. In today's competitive market it is imperative to create value for your employer. Employers have problems- executives are hired to solve these problems. You must be able to clearly demonstrate a ROI on your salary- otherwise you are simply unnecessary overhead. If you cannot measure improvement in profit, sales, quality, customer satisfaction, efficiency, or cost reduction from a year ago I guarantee your employer is wondering if they are getting commensurate value with the money they are giving you.

How do you create value for your employer? First, make certain you completely understand your boss's goals- they are your goals. Second, make sure these goals are quantifiable. Third, achieve those goals. If you rinse and repeat this process year after year you will continue to create value for your employer. In turn your employer will keep giving you fistfuls of cash.

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Value-based Care is Here to Stay

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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Leadership Success in Times of Uncertainty

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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Keeping your edge- staying marketable in today’s competitive environment

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:

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  • 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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Wiederhold & Associates Names Executive Director Of Leadership Coaching

After six years of partnering with Jim Wiederhold in growing Executive and Physician Leadership Coaching within Wiederhold & Associates, Joy W. Goldman RN, MS, PCC, PDC, has been named as Executive Director of Leadership Coaching.

"We not only want our clients to find their next job; we want them to excel and grow into the best leaders they can be," states Jim Wiederhold, Founder of Wiederhold and Associates.

"Now, more than ever, our world needs effective and values-driven leaders. Joy is a person that naturally embodies those characteristics and is passionate about passing on quality leadership characteristics to others."

Coaching is a natural complement to Wiederhold & Associate’s strong reputation for providing transition services to Healthcare Executives across the nation.

"As I’ve come to know Jim and his organization, I respect not only what they do, but how they do it," states Goldman. "In relationships, we used to hear about the 'six degrees of separation.' With Jim, that is often cut down to three degrees of separation, and that’s because he’s built his business around value and trust. People trust Wiederhold & Associates to deliver excellence in what they do and put their customers’ success first with a spirit that demonstrates integrity in all that they do."

In 2017, Joy has the privilege of serving as the President of the International Coach Federation (ICF)-Maryland Chapter. She will be leading ICF MD’s board in connecting coaches throughout Maryland; supporting their professional development, and promoting the coaching profession to those who can most benefit. She will be working with regional and global coaches to support ICF’s mission of leading the global advancement of the coaching profession. As part of this effort, she will be partnering with over 200 coaches throughout the globe when she attends the ICF Global Leaders’ Forum next year in Warsaw, Poland.

In the future, we look forward to sharing success as told in stories that are co-created with you, our clients. Nothing makes us happier than to celebrate YOUR victories.

Here's to your success,

Jim

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What was your value in 2016?

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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Safeguarding your Business History for 2017

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.

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Happy Holidays from Wiederhold & Associates

In lieu of mailing holiday cards, and in keeping with the spirit of giving during this time of year, Wiederhold & Associates has made a donation to a charity in honor of our clients, network members and friends for being a part of our lives this year. For 2016, we have selected the CURE Childhood Cancer charity as the recipient of our donation.

CURE focuses entirely on children's cancer efforts and funds the work of some of the best and brightest scientists in the field of pediatric cancer, as well as address the critical and urgent needs of patients and families. If you would like to learn more about Cure Childhood Cancer, visit their site at curechildhoodcancer.org.

We at Wiederhold & Associates hope and pray that you enjoy a happy and safe holiday season. As you enter the New Year, never forget what is most important: your faith, your family, and your friends.

Jim Wiederhold and
the Wiederhold and Associates Team

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Networking During the Holiday Lull

The time to kick your transition work into high gear is right now, while everyone is celebrating. The minute you finish reading this get out your list of healthcare executives you know.

Why? December is the very best time to raise your visibility and re-establish connections, personal AND professional. Don’t bring an agenda, apart from extending cheer and good will. Hand write a short note in a holiday card, even if it is just to say you hope they have a prosperous new year. And don't forget to hand address the envelope too. Don’t ask about job opportunities, instead sincerely ask about them. If you only know their email address send them a personalize note that way. But send something so they know you are thinking of them.

If you are asked about your work or your search, be ready with a short, honest and upbeat answer. Of course, follow the conversation if your colleague wants to talk about work, but don’t press it. This is networking of the joyful kind – strengthening bonds to your family, friends and community that will nourish you the rest of the year.

I suggested this a few years ago and here is what one of my clients experienced.

Try it and see what kind of response you get!

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2016 Is Closing... Did You Accomplish Last Year’s New Year’s Resolution?

Whether it’s personal goals or career goals, we’ve all been there – setting aggressive and ambitious resolutions, chasing after it, hitting setbacks, and eventually become unmotivated to continue.

It is important to set goals, but if you measure success only by achieving your next goal, you probably have not accomplished as much as you would like. Willpower alone is usually not strong enough to overcome setbacks which ultimately result in failure.

Change of Focus, Change of Heart

Scott Adams, the creator of the immensely successful Dilbert Cartoons, reiterates a Wiederhold & Associates approach to finding success. He states, “When you approach life as a sequence of milestones to be achieved, you exist in a state of near-continuous failure. A system, by contrast, is something you do on a regular basis that increases your odds of success in the long run, regardless of the immediate outcome. People succeed every time they apply their systems, in the sense that they did what they intended to do.”

A simple shift in focus from goals to systems will ultimately help you find the success you have been longing to realize. The sense of accomplishment that comes from working the system each day creates a momentum that will carry you to the next goal. You may find yourself achieving goals faster than ever before with a new found personal invigoration.

As you plan your New Year’s Resolution, set your sights on implementing new systems for success instead of a milestone to be achieved. If you would like to discuss what systems could propel you the furthest fastest, give me a call. Together, we can map out a plan to that will put you in prime position to achieve your 2017 personal and career goals.

Here's to your success,

Jim

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Where's me money?!?

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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Executive job seekers- why your Master’s degree and years of experience aren’t good enough

If you think your Master’s degree and experience alone will translate into landing that great executive job, you will likely find disappointment. Why? Simple - everyone else in the candidate pool has a Master’s degree and experience. You need to stand out from the crowd. How does one do this? By communicating your value proposition. What are you known for? What is your brand? What is your calling card? What measurable results are you known to achieve? These are the questions you must answer and clearly communicate in order to make yourself stand out in a sea of executives.

Don’t make recruiters and hiring managers figure things out on their own - it is up to you to communicate your brand, value, and worth. Don’t assume people read every word of your resume - they likely do not. You must stand out by communicating why you are valuable to an employer

How do you identify your value proposition? Ask others. Read your prior evaluations. Look at results in the following areas: service, quality, people, community, growth, finance. Identify themes in your resume.

Remember- organizations have problems and executives have solutions. Communicate your brand by communicating the types of solutions you’ve solved for your employers.

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Prepare for an A+ Interview

I've done a lot of interview coaching over the last 22 years. If I were to grade my clients' beginning interview skills, most people would have a starting grade somewhere below average. This is by no fault of their own. It is common to not do well on things that are not practiced.

Working with my clients, I can raise the interview grade from a 'C' to an 'A' by practicing these basic principals before, during and after the interview.

Pre-interview, you must focus on tactics that will brand you in the most positive way. The goal is to have those who interviewed you to say these three things about you:

  1. Excellent interpersonal skills
  2. Is results oriented
  3. Aligns well with the position

Creating this perception starts with preparation. Begin by understanding the five top critical elements of the opportunity so that you are able to address them with current experience and success. Also, develop an effective two-minute presentation which includes humanization, elevator, and your differentiation/value statement.
[ Click here to learn how to develop your 2-minute presentation.]

As you enter the interview, introduce yourself with confidence. Confidence, not arrogance, can set a positive perception from the beginning. As you engage in the interview, pay close attention to the person speaking and begin to mirror to match tempo, breathing, rate-of-speech, directness, etc. This makes each one comfortable with each other and sets the correct filter. Also, know exactly the statement you will make or the open-ended question you'll ask. By demonstrating your interpersonal skills, you give yourself the greatest opportunity to connect with and engage your audience.

When the interviewer engages with you, take your time to understand what is being said before you respond. Generally, people are so caught up in the world of listening to respond that we miss a vital part of the question. Answer questions concisely, close information gaps and enhance the answer when it adds value to the original thought. Always tell the truth but word it in a win-win presentation. This will provide consistency throughout the interview and keep you in a positive position.

Post interview, review how you did with the goal of improving for the next one. In order to lock in your follow up you need to ask yourself these following questions.

  • Did the interview go well? If so, specifically why?
  • What could I have done better?
  • What did they focus on?
  • What did I learn about them on a personal level?
  • What value did I bring to the interview?
  • What and when is my next step?

Imagine what would happen if you took the time to practice and prepare a well-executed interview. It could be a significant way to separate yourself from the crowd in a very competitive market!

If you would like more in-depth coaching to help you make the most out of your next interview, do not hesitate to reach out to me directly.

Here's to your success!

Jim

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Drive the C.A.R.

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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Regain Momentum in Your Career

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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Can your resume be understood in less than 10 seconds?

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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7 Steps to Effective Crisis Management

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.

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The Secret Source of Great Leadership

When I picture a great leader, I picture someone who never lets their temper get out of control, no matter what problems they are facing. I think of someone who has the complete trust of their staff, listens to their team, is easy to talk to, and always makes carefully informed decisions.

What I have described is an emotionally intelligent leader.

Emotional intelligence is the ability to be keenly aware of your own emotions, and the emotions of those around you. These individuals are aware of the root cause of their emotions and how their emotions affect those around them.

According to Daniel Goleman, an American psychologist who helped to popularize Emotional Intelligence (EI),
there are five main elements of emotional intelligence:

Self-awareness --- Self-regulation --- Motivation
Empathy --- Social skills

The more that you, as a leader, manage each of these areas, the higher your emotional intelligence.

To be effective, leaders must have a solid understanding of how their emotions and actions affect the people around them. The better a leader relates to and works with others, the more successful he or she will be. The good news is, Emotional intelligence can intentionally be developed.

We are facing a critical era of transformation in healthcare and success is entirely dependent upon strong leadership. As you rise through the leadership ranks you must master Emotional Intelligence as a key component if you hope to become a great leader.

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Physician Alignment and the Triple Aim

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.

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