Chief Culture Warrior: A Transformational Professional

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Chief Culture Warrior A Transformational
Professional Personal Rolefor Senior
Healthcare Strategists

• Kathy, Steve and Ken
• (a.k.a. Lewton, Seekins Trester)
• Society for Healthcare Strategy and Market
  Development
• October 4, 2007

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Yet forces demanding change are ever more
powerful and insistent

• Continued rise in spending has made payers ever
  more insistent
• 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
• 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 dont get it
• Dial 1-800-LOCAL TV REPORTER
• Election year politics add to the drumbeat
• And with a small but highly visible group of
  hospitals actually making progress and headlines
  -- harder for the rest of the pack to avoid the
  inevitable

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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

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Its not the best of timesto push for
change in HCOs

• Employees those who arent 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

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Change let alone TRAnsformation doesnt come
easily to HCOs

• By nature resistant to change
• Built on policies, procedures, process Weve
  always done it/never done it THAT way
• Medical care has always focused on careful study,
  cautious research, first, do no harm

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ENTER the Chief Marketing/PR Officer now starring
as . . . . .

• Chief Culture WARRIOR

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CEO Cant 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

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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

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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.

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Being a Chief Culture Warrior

• Four Principles from Real Life

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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
• Cant benchmark without a starting point
• Cant create compelling messages that will move
  people to change behaviors if you have no idea
  what they know, believe or care about

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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

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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 theres a vision and a purpose
  that support the need for change.

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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.

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A look at the wars and warriors

• a short survey about culture management in
  healthcare organizations

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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

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The war How necessary is culture change?
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Key platform of your organizations desired
culture

• Customer service/satisfaction (16)
• Employee engagement/satisfaction (8)
• Clinical quality (6)
• Other mentions
• Recruiting/having best employees
• Physician satisfaction
• Facilities
• Efficiency

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Commitment to change
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How we manage culture
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How we manage
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Whos actively involved?
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Whos on board and fully committed?
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But 33 report that physicians are subtle
naysayers or flat out antagonistic!
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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

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Respondents role in culture change
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Satisfaction with role
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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.
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If you are NOT a leader
If not, why not?
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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 youre up to your
  bubpkus in alligators

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BUT FIRST Some Stories

• Tales from the Front Lines
• Successes and Failures

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Cinci Childrens 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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• September 15, 2007
• Managing Outcomes Helps a Childrens
  Hospital Climb in Renown
• By REED ABELSON
• CINCINNATI Although it is nearly 2,000 miles
  from Boise, Idaho, Cincinnati Childrens Hospital
  means to make a visit here worth a patients
  journey.
• Not content to play a regional role, the
  Cincinnati Childrens 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 Childrens had to
  learn to compete on something else, said Dr.
  Charles Homer, the chief executive of the
  nonprofit National Initiative for Childrens
  Healthcare Quality.
• The something else is quality.

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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 . . . . . . . .

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On being the AMAs Conscience
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On Being the AMAs 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

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Stories from the front

• Tobacco Institute wants to meet with the AMA
• Media Tours and openness
• Media briefings and sponsorship

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How to screw it all up

• Trying to hide things from the media in a public
  world. Closing the openness.
• The GE debacle.

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The Service Success Story

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Getting top management support

• First, the CEO problem
• Then tackle the rest of the gang
• Bring data
• Bring strategy
• Find models
• Find tools

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The Ritz-Carlton Formula

• Make management visible
• Put employee satisfaction first
• Imprint the standards
• Lineups everyday, everyone

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Creating the burning platform

• If you have a crisis, revel in it
• If you dont have a crisis
• Lead by inspiration
• Model the competition

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The Call to ActionService First!

• We will provide quality healthcare through
  Service First! so that people choose Oakwood and
  its affiliated physicians.

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Implementation Make it stick - even if youre
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

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The Huddle A breakthrough communications tool

• Systematic process for assuring group discussions
  every day

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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

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Do You Rely On Huddles for Information?
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Patient loyalty scorescause and effect?
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Other Major Gains
Pre Post Change
Consumer Top-of-mind Awareness 36.3 44.2 ? 7.9
Consumer Preference 31.2 41.6 ? 10.4

Market Share 35.3 38.9 ? 3.6
Profitability -2 1 ?3pts
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Chain of success starts with satisfied employees
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The VanRinsvenformula for victory

• Hire right
• Do onboarding by top leadership in person
• Create emotional engagement
• Show physicians that an environment of engaged
  employees is in THEIR best interest

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And Now . . . . . . . .
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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?

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For questions or more discussion --

• klewton_at_.LSTLLC.com
• ktrester_at_LSTLLC.com
• sseekins_at_LSTLLC.com