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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A Tribute to the American Worker

Labor Day means more than great BBQ and spending time with friends and family. For me, it is a celebration of American leadership, strength, and ingenuity.

In the days following World War II, when the economic strength and power of America was all that stood between the world and the return to the dark ages, Pope Pius XII said, "The American people have a great genius for splendid and unselfish actions. Into the hands of America God has placed the destinies of an afflicted mankind."

Wiederhold & Associates joins in the national tribute to the American workers who have made contributions and achievements to the strength, prosperity, and well-being of our country and the world. Happy Labor Day!

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Improving Trust Through Conversational Intelligence

It is my passion to equip people with the tools it takes to be successful. With that in mind, I have assembled a team of leaders that will help you gain the competitive edge you are looking for. One of the members of my coaching team is Joy Goldman.

Joy is an accomplished professional in leadership, physician development, coaching, and enhancing organizational effectiveness. I feel that you will find her insights useful and helpful.

-Jim

By Joy W. Goldman, RN, MS, PCC, Professionally Certified Leadership Coach

Research shows that 9 in 10 conversations miss the mark. Sometimes people may say to you, “I don’t have time to spend in deep conversations – they take too long.” By mastering Conversational Intelligence (C-IQ), what normally could take months or even years, can happen instantaneously. Below are three significant ways that Conversational Intelligence can impact your leadership success:

  • Enables quicker, deeper connections. We see higher levels of trust, of partnering, and of teamwork. Our world is moving from an I-centric world (focused on self and independent leader) to a WE-centric world (focused on teams and collaboration).
  • Provides frameworks for building TRUST. Trust is the human platform from which great conversations emerge. Patrick Lencioni identifies trust as the foundation for all effective teams. C-­IQ provides a new innovative framework for understanding how conversations shape our relationships, partnerships, our culture and our reality. C-­IQ introduces tools for creating higher levels of trust and higher levels of engagement, which strengthens partnerships, teams, and cultures.
  • A scientifically proven method for improving engagement. Based on Neuroscience Research- specifically the Neuroscience of Conversations, C-IQ facilitates the accomplishment of results, while also fostering enjoyment with the process.

C-­IQ provides us with deep understanding about how every conversation has an impact ­on our brain. With this understanding, we can prime our conversations for impact and learn how to develop trusted relationships. Building trust comes from practicing inquiry. Click here to read an article on applying self-inquiry to achieve your goals.

Would you like to learn how to master conversational intelligence or other enhanced communication skills? Contact Joy today.

Joy W. Goldman RN, MS, PCC This email address is being protected from spambots. You need JavaScript enabled to view it.

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Passion For Success: Expanding Your Network

Every journey starts with the right attitude, passion, and confidence.

Many people find networking to be challenging. Most people find a way to do the things they are passionate about. If you're not passionate about networking, it is possible that you simply do not see the wealth of value that comes from developing a healthy network.

I've interviewed over 1500 people in the last 23 years. Not just a surface interview, but an in-depth interview. I always ask the question, "Where did you find your current job?" In 70% to 80% of the cases regardless of level, people found their next opportunity through their network, a relationship built over years.

The Value of a Healthy Network:

  • Competitive Edge: A large and deep network will give you information, you could never reach in isolation. Too many of us become trapped within the four walls we work in.
  • Resources: Tap into subject matter experts, fill positions, and gain valuable Industry information from known, credible sources.
  • Reputation Management: Being attacked on the internet can tarnish your reputation. A large and deep network that supports and believes in you can minimize that situation.
  • our Next Opportunity: I can't tell you how many times an opportunity was offered to a particular person because they were known within their network and "believed it would be a good fit." You can secure your next opportunity and your career with little competition through networking.
  • Time in transition: It has been proven that there is a direct correlation between the size and depth of your network as it relates to the time you are between jobs. The better your network is, the shorter your transition will be.

Now that you understand why it is important to have a solid network, it should be easy to get passionate about expanding it. If you are unsure about where to begin, below are a few ideas to get you started

Keys to Expanding Your Network:

  • Be intentional: Dedicate yourself to at least two calls a week.
  • Choose wisely: Reach out to both people you already know but are not in regular contact with and new people you would like to connect based on your next career step, resources, influence, and information.
  • Plan your call: Do your homework- there is so much information out there that you shouldn't have any problem knowing with confidence your opening line or question.
  • Be Reciprocal: Give your audience as much value as they give you.

Enjoy the Journey

Not everyone will want to join your network, and that is ok! Keep trying. Expanding your network is a learned skill that will improve with practice. Develop a system that will help you recall information from past interactions and keep you on track to follow up in the future. As long as you are moving relationships forward, YOUR EFFORTS WILL BE SUCCESSFUL.

If you would like more tips of how to add value to your network including in-depth training on what makes a great network call, then let me know. I am ready to share my secrets to success!

Jim

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Putting the Execute Back into Executive

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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Character Creates Leadership Success

Leadership is such a broad subject with many important subcategories.

We are in a time of great challenge to our leaders both inside and outside of healthcare. Great challenge creates great stress. Our leaders live and work in a fishbowl and must realize that every move they make whether it's verbal or nonverbal will be noticed and analyzed.

Good leadership, as with anything else, starts with character. Everybody wants it, but it has so many definitions. Everybody sees a lack of it in others but not in themselves.

I'm in the process of reading the book, "Louder than Words," by Andy Stanley. I'm not finished with the book but I'm enthralled with the subject matter. It focuses on the definition of character. Because I'm faith-based, I will adhere to Andy's following definition:

Character is the will to do what is right, as defined by God, regardless of personal cost.

So easily stated, it's so difficult to achieve. Perhaps it's like mastery, we strive for it, but never get there. For others who are not faith oriented, I would suggest defining what the right thing is but not changing the second half of the definition.

Leadership Starts Here: Doing the Right Thing

Secondarily, leaders did not get to where they are today without utilizing strengths that have made them successful. But under stress, those same strengths can become weaknesses. Beyond that, everyone has certain "derailers" that can be triggered by stress as well as other influencers. By giving into these triggers, the ability to keep good character intact becomes difficult.

Recognition, or awareness, of the "derailers" is not always present within the leader. Leaders should develop feedback mechanisms that they can rely on and will accept. Gaining awareness of these triggers/influencers is a highly valuable personal investment. Once these triggers are identified, passionately pursue how to change them.

In stressful challenging times, these two components are essential to successful long-term leadership.

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Fourth of July

>
As we celebrate our nation's Freedom
we honor the courageous men and women
who are dedicated to preserving it.

Wishing you and your loved
ones a Happy 4th of July!

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Throw Darts Not Hand Grenades

When interviewing, please keep in mind one simple rule- answer the question. An amazing number of people think that when they have the microphone (answering an interview question) they can talk as long as they want about whatever they want in an interview. This is understandable as candidates are excited and want to sell, however it’s a turn off to the interviewer.

Throw darts when interviewing- be concise, brief and use facts/numbers to support your answers. If they want more information, they will ask. Remember- the interviewer has a list of questions they want to get through. They can’t get through the interview if the candidate takes five minutes to answer every question. This is a major turnoff and it signals the candidate isn’t in tune with the employer’s needs.

To answer the question is to be a good listener. If someone asks you a yes/no question- answer with a yes or no answer. Listen intently to the words they are using and ask for clarification if need be. Don’t forget to mirror the interviewer- if s/he is a fast talker, then talk faster. If s/he is a slow talker, then slow down. The goal is to make a connection by listening and answering the question. Finally, only practice makes perfect when interviewing so practice with family, friends and colleagues and remember to throw darts, not hand grenades!

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Opportunities in Urgent Care

Healthcare expenditures in the U.S. exceed $2.9 trillion each year, representing more than 17.4% of the GNP(1). It should be noted that 80% of this expenditure is associated with chronic disease and, therefore, it is no surprise that Population Health is addressing the identification of at-risk populations and patients with early stage chronic conditions, not to mention the growth of our aging population. With Healthcare Reform driving the shift from volume to value, Urgent Care Centers (UCCs) represent a key care component of the Patient Protection and Affordable Care Act (PPACA) as well as the IHI Triple Aim that directly impacts access/convenience and reduced costs.

Between UCCs and retail medical clinics that are in stores like Walgreens, CVS and Target, convenient care is approaching 10,000 sites throughout the U.S. The Urgent Care concept originated in the late ‘70s and has proliferated in recent years, fueled by a shortage of primary care physicians and overbooked primary care offices, long emergency room wait times and the high cost of emergency room care. This leaves patients frustrated and feeling like they have no place to turn when they have an immediate need for medical attention but their condition is not an emergency. In fact the Centers for Disease Control and Prevention stated in 2012 that nearly 80% of visits to emergency departments were due to a lack of access to other healthcare providers(2). The niche market of urgent care therefore has a huge opportunity to make an impact.

To the credit of many physicians, they saw and are trying to meet the community need of access at lower cost by starting and owning a majority of the UCCs. These UCCs are designed to function for the convenience of the consumer on a walk-in, no appointment basis and be open for extended hours.

Health Plans, large Medical Groups, Hospitals and Health Systems are realizing the importance of establishing this type of convenient care model and have different strategies for providing Urgent Care such as building their own or affiliating with existing urgent care operators as strategic partners in providing quality outcomes at a lower cost with greater satisfaction.

For Hospitals and Health Systems, UCC affiliations are mutually beneficial. They can relieve excess volume in the hospitals’ overcrowded emergency departments and, by virtue of having a lower volume it will result in a reduction of the hospital write-offs. These relationships will generate downstream referrals for the hospitals when there is a need by the UCCs for a higher level of diagnostics, when specialist referrals are required and when patients with conditions requiring emergency care show up first at the UCCs and need to be directed to emergency departments. UCCs can also assist hospitals by functioning in the capacity of discharge clinics to reduce the hospitals’ readmission rates.

For Primary Care physicians and Medical Groups, there can be a delay of weeks or months for patients getting appointments. The number of aging patients with chronic diseases is increasing as well, making the timely delivery of care challenging. These physician groups can look to UCCs for arrangements to cover after-hours or for vacations as well as for more patient-convenient certified laboratory collections and testing, imaging, suturing, in-house medication dispensing and durable medical equipment.

For Health Plans, UCCs pose a more cost-effective alternative than emergency rooms. Additionally, as it pertains to population health, it is crucial that the respective electronic health records interface so that at-risk patients can be identified and treated for early stage chronic conditions. An EHR would allow a seamless connection with an ACO or a Medical Group as well.

In conclusion, UCCs that are appropriately integrated in the healthcare delivery system will effectively meet the intent of the ACA and Triple Aim by providing greater convenience, satisfaction, reducing cost and be integral in achieving Population Health.

(1) https://www.washingtonpost.com/news/wonk/wp/2014/12/03/heres-exactly-how-the-united-states-spends-2-9-trillion-on-health-care
(2) http://www.cdc.gov/nchs/data/nhis/earlyrelease/emergency_room_use_january-june_2011.pdf

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Harness the Power of Your Network

The perception of networking is generally thought of as something only needed when in transition.

Many don't realize that deepening and growing your current network consistently, even when gainfully employed, provides resources as well as some insurance for the future.

There is a direct correlation between the depth of your network and the length of your transition.

Individuals with strong networks don't seem to be in transition very long. These individuals realize a couple of things:

  • A large network is not enough, it must have depth. Depth refers to relationships that are more than business or transactional. Deeper relationships are developed by consistency, sincerity and making deposits. A deep network can provide resources, new ideas, and a potential competitive edge.
  • It's much easier to make connections when you are gainfully employed. There isn't any pressure so the relationship can develop at its own speed.
  • Networks need to be diverse. Connecting with people from various niches, age groups, genders, and ethnic groups within a targeted industry provides the best opportunity for success.
  • Making networking a part of your daily or weekly schedule keeps those skills at peak performance. Frequent connecting in small increments is better than larger increments infrequently utilized.

    Harness the power of your network and your career will progress further and more effectively.

    Jim

    Connect with us on LinkedIn and join our Active Network Program.

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Interview Advice; It's Not About You

I remember conducting an interview for a key leadership role and the candidate kept talking about results and accomplishments from their former job that did not correlate with our environment. We were turned off almost immediately. Remember - organizations have needs, people have skills. Your job is to clearly communicate that your skills are a match with the employer’s needs. You must fully understand why the organization is hiring for the position. What are the key skills and competencies needed? What are the measurable goals that define success?

When looking at a position, the first step is to obtain a copy of the position description and read it multiple times - highlighting pertinent sections that clearly demonstrate the reasons why the position exists (goals, skills, competencies). Organizations want to win- you help them win by clearly communicating how your skills are a good match to meet their needs. When speaking with the employer or recruiter, make sure to communicate your specific (numerical) career accomplishments that clearly demonstrate past success that match with the employer’s needs. Jobs exist to solve problems and meet needs- show them you can do both.

Matching your skills with an employer’s needs is nothing more than good listening. Make sure you understand the needs by reviewing the position description, taking notes when speaking with recruiters or hiring managers, and highlight your specific accomplishments that match their needs.

Check out this site for more help with sharpening your skills to match an employer’s needs.

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Memorial Day Remembrance

We call a lot of people heroes but the ones that always will be on the top of my list are the men and women who defend this country. Freedom has a cost, a very dear cost, and they're willing to pay the price for us every day. The challenges I face every day pale in comparison to the ones they face.

No matter what your view on the war is, we must always support our troops. I pray we never treat our troops the way we did for those that returned from Vietnam. I pray for a day when there will be no more wars.

Let's celebrate, honor, and remember the men and women who have paid it all for this country and our freedom.

Jim

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Tell Me About Yourself

Tell me about yourself… (hint - you only have two minutes!)

The famous question, “Tell me about yourself.” This is not an open invitation to incessantly talk for minutes on end about your life from start to finish in exquisite detail. I used to think everyone else thought my life was as interesting as I thought it was - wrong! The fact is, no one really cares (that much). You have two minutes to answer this question. And, it needs to be a structured answer that includes the following:

  • Humanizer - make a connection and be likeable/personable
  • Career progression - make sense of your career moves
  • Value proposition - what are you known for?
  • Personalize - what do you like to do? Make a connection and humanize.

If you only remember two things, simply be brief (around two minutes) and clearly communicate your value proposition. What are you known for? What is your calling card? Remember, organizations have needs and people have skills. Be clear about your skills and match them with the organization’s needs.

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Your Career is a Journey

Plan Ahead and Manage Effectively

From my experience working with executives over the past 27 years I have learned a great deal about how executives tend to do a poor job in managing and planning for advancing their own career.

Before I share my observations with you on advancing your career, let's define manage and plan:

Manage: Be in charge of, administer, run
Plan: Decide on and arrange in advance

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.

Gaining the Right Focus

It is also not uncommon for well-meaning professionals to overlook particular skills that create the opportunity for advancement. Even if they were lucky enough to have a mentor, most of that effort and time was focused on expertise rather than the soft skills necessary to become an excellent leader. Aiming at the right target will yield the best results.

How much more successful would you be if you knew
how to plan effectively and manage your career?

Please join us for our upcoming webinar on May 25, at 2:00PM ET, where I will be sharing key ideas that will help you put momentum back into your career journey.

Learn More

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The Nursing Leadership Challenge

Everyone recognizes nursing plays a huge and vital role in our hospitals and healthcare systems today. Nursing, like any other area of healthcare, needs experienced coaches and mentors.

Please remember the optimum word here is experienced.

Here are some of my observations from my 27 years of healthcare experience:

  • The aging of America will create more need for nurses and nursing leadership.
  • Nurses don't seem to be very well represented in the CEO role.
  • Because of their training, they seem to struggle with their assimilation into that role.
  • Nurses move up into management roles within the nursing department because they were good nurses which doesn't always guarantee they'll be good managers.
  • 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.
  • The chief nursing officer role is not attractive to younger nurses developing their careers.

Wiederhold & Associates believes that Nurse Leadership is an important area to invest in. We know that the very skills that make effective nurses (great communicators, creative problem-solving abilities and leadership acumen) are also the skills that make great leaders. With proper guidance, the transition into a senior leadership role can be very successful.

To maximize the success of our nursing clients, we have partnered with Nursing Leadership Coach Diane Scott. With her strong clinical background, Diane has a deep understanding of the nurse executive role.

Diane explains, "Senior nursing leaders usually are in charge of the majority of theworkforce 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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Do You Know Your Numbers?

Do you know your numbers? (not just finance)

“It’s a nice day outside.” Does this mean it’s 65 degrees, 75, 82? It depends on who you ask. Unless you ascribe a numerical measure to something it will never be fully clear to an audience. So many executives I advise are not fully clear when talking about their career accomplishments- I’ve been guilty of this as well. “We grew revenue and patient satisfaction improved when I was at XYZ Health System” or “We set up this corporation, joint venture, committee, etc.” These are simply not clear statements when compared to, “We grew revenue by 35% and our patient satisfaction improved from the 12th percentile to the 67th percentile” or “We started a new joint venture that grew market share by 34% and grew net revenue by 40%”.

Many comparisons have been made between the airline industry and healthcare. The pilot knows where the plane is going by following specific numerical coordinates. Do you know your X-Y? What was the origin and destination of your last journey? This is communicated simply by knowing your X-Y’s in one or more of the following areas: service, patient safety, quality, growth, service line development, finance, community benefit, market share, cost containment, productivity, physician or employee engagement, turnover, etc. When X-Y’s are communicated well it sounds like this… “When I was at XYZ health system our HCAHPs went from the 23rd percentile to the 78th percentile over 4 years” or “During my tenure we reduced RN turnover from 35% to 16% in three years.

Organizations want results. If you clearly communicate that you achieve results, your chances for success improve when looking for your next job. Contact www.wiederholdassoc.com for more information on learning how to communicate your “X-Y’s” and taking the next step in developing your career.

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Elements of a Successful Turnaround Strategy

Hospitals/Health systems across the country are faced with increasing financial pressure including slow economic recovery, decreases in reimbursement, increases in uninsured or underinsured leading to increased bad debt write offs, and increased operating expenses.

Not surprisingly the result is more and more organizations that were financially sound find themselves either in financial distress or at least moving financially in the “wrong direction.” Turning around a hospital where finances are in decline requires extremely strong leadership from the top, ideally a CEO with prior experience leading a turnaround. This initiative needs to be supported by the hospital senior leadership team and board, and reinforced by engaged employees, physicians, and even members of the communities served by the organization.

Hospital turnarounds are not just about cutting costs. You can’t cut your way to long-term growth and profitability. You need to build programs that will financially support the hospital and meet the community’s needs through physician recruitment and capital investment. Cutting costs are a short term sometimes necessary endeavor, but long term success will only come from program volume and revenue growth.

It’s now essential in the current evolving environment to negotiate favorable contracts with insurers and other networks who control patient access and also consider the development of Accountable Care Organizations and other population health strategies. Finally developing key affiliations and networks with other hospital and healthcare providers are essential to strengthen your gaps in services and geographic coverage.

While no two turnaround situations are ever the same, just as no two sick patients are ever exactly the same, there are some common elements that all successful turnaround situations will have.

These elements includes the following:

  • A strong visionary CEO with proven experience in leading a successful turnaround.
  • A strong committed board that will support the CEO and put what is good for the long term survival of the hospital ahead of long-standing personal friendships and relationships and agendas and the short term pain and changes that may have to occur.
  • A good comprehensive and realistic turnaround action plan based on an in-depth assessment of the hospitals financial, operational, cost structure, market position and also physician and community perception and support. The plan should identify specific goals and objectives and actionable plans with quantifiable metrics and assignment of ownership.

Implementing the turnaround plan:

  • Implement plan with sense of urgency.
  • Monitor results and modify tactics where necessary.
  • CEO stays engaged / leads from “the front.”
  • Divides resources/removes obstacles/drive changes forward.
  • CEO and leadership team “walks the walk” and “talks the talk.”
  • Communication -- CEO establishes robust communication process so that employees & physicians are kept fully informed of changes occurring and why they need to occur and to gain their support for the long term benefit to the organization.
  • Publicize and celebrate the successes. Nothing breeds success, like success.

Going through a “turnaround” situation is one of the most stressful events for any healthcare organization to go through. With great visionary leadership and a good “plan” the organization will emerge not only more financially sound but with a “high performance” culture ready to move on new challenges.

You can see Davide Carbone's LinkedIn profile here

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Executive Skill: Reading the Tea Leaves

How often in my conversation with executives do I hear the statement, "he/she is good at reading the tea leaves" or "he/she is not so good at reading the tea leaves"?

What does it mean?

To me, it indicates a sense of external awareness of what's being said around you. When the action and the talk don’t align – you’d better take notice. Unfortunately, a lot of executives get so caught up in their own internal world that they are unaware of what's going on around them.

There's lots of evidence to support this lack of external awareness. In working with executives in transition, I often hear the statement “I never saw it coming.” As I review the details of their last 60 to 90 days of employment and then we review it together, the next statement I often hear is –“I should've seen it coming. Obviously, that executive didn't do a good job of "reading the tea leaves."

Now most of us are aware of the concepts emotional intelligence and political intelligence.

  • Emotional intelligence is the capacity to be aware of, control, and express one's emotions, and to handle interpersonal relationships judiciously and empathetically.
  • Political intelligence is a thorough understanding of the interpersonal and political dynamics that organizational structures create and to know how to make things happen within this context.

We define these concepts in terms of both nouns and verbs. As you know, a verb implies action, and both forms of intelligence must have an action to be of any benefit.

Both terms suggest a strong emphasis on the external environment as well as the internal environment. As mentioned, too many executives become overly focused on the internal environment. By practicing the art of emotional intelligence and political intelligence you will learn to pay attention to the external as well as the internal and increase your ability to read the tea leaves.

Happy Reading,

Jim

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What’s your value proposition?

Why should an organization hire you? What do you bring to the table that helps the organization win? What are you known for? If you aren’t communicating these answers briefly and succinctly (backed with facts), you are not standing out and will have a tougher time with your job search. Do not assume your experience and resume speaks for itself. Most people do not read every word of your resume- they scan it and size you up in a matter of seconds. Do not make people guess or leave it up to chance- tell them what you are known for and how you create value for organizations.

Almost 100% of the executives I speak with in my executive advisor role for Wiederhold & Associates do not understand and communicate their value proposition. This is nothing more than personal branding- think of yourself as a business. What brand messages are you communicating? Most people will believe you are who you say you are. For example, if you’re known for growing market share and you communicate this simple message (backed with facts), you have just communicated a brand message.

How do you identify your value proposition? Look at your career accomplishments and look for consistent results. It will likely come from results in service, patient safety, quality, net revenue growth, service line development, employee/physician engagement, turnover, cost containment, productivity, market share, profitability, turnarounds, community benefit or engagement, etc

A well communicated value proposition looks like this, “I am known as a turnaround expert. For example, in my last role I led a $20 million turnaround” or “I am known for getting results in patient satisfaction. For example, in my last role we improved HCAHPs from the 12th percentile to the 75th percentile”.

Be intentional and purposeful about your value proposition- if not it will be defined for you (or not at all). For help in crafting your personal brand, go to www.wiederholdassoc.com for a free consultation.

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"Manage Up" for Success

A big piece of onboarding is the ability to manage up- how you effectively work with your immediate Manager. My experience in this area indicates that we don't give this enough attention. The conflict that begins here usually ends up in one being asked to leave the organization or perhaps exiting too soon on their own.

Often, different styles, as well as egos, get in the way. Change the way you look at this relationship, and you will be more successful in building it. I haven't come across many people who “manage up” t extremely well, and it's such a necessary skill to one's future success. Embracing the employee/manager relationship is a critical skill to hone and managing up helps you master it.

Managing up means that you go above and beyond the tasks outlined on your job description. You continuously go the extra mile. Your job is to make your immediate manager’s life easier.

Ways to effectively manage up:

  • Listen well
  • Learn his/her style
  • Jump in when needed
  • Project a positive attitude
  • Deliver quality work
  • Keep him/her well-informed
  • Build key relationships
  • Sell/negotiate when appropriate
  • Recognize what he/she respects and honors
  • Create early wins
  • Execute great follow up
  • Establish a comfortable level of transparency
  • Establish the rules of effective pushback
  • When you have a challenge, always offer a solution
  • Communicate, communicate, communicate
  • Close information gaps
  • Have a voice beyond your boss
  • Keep commitments
  • Apologize when you are wrong
  • Don’t make excuses

Learning to effectively "manage up" can put you in a great position to align with your immediate supervisor, integrate effectively with the organizational culture, receive great recommendations, and ultimately help you on board effectively.

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