Health care reforms are here to stay and the pace of change is accelerating as State and Federal budget deficits continue to put pressure on government to reduce the cost of Medicare and Medicaid services. These “reforms” mean less and less revenue will be available to Hospitals and it’s going to force all Hospitals to squeeze out efficiency from their processes while simultaneously improving quality and service levels. The challenge is substantial and it requires a clear and focused strategy as well as the ability to execute that strategy quickly and effectively. Unfortunately “strategy execution speed” is not the hallmark of health care.
Can your organization successfully execute key strategic objectives with great speed? Can your organization react quickly to change? Here is a quick exercise that I suggest you try. Consider the phrases outlined in this article and then take note of how often you hear them said in “hallway” and “water-cooler” conversations; take special note when you hear these phrases uttered at standing committee meetings and/or at meetings whose purpose is “solve problems” or manage new initiatives.
“We already tried that and it didn’t work”
This phrase is very typical and very troublesome. If this is an often uttered phrase by your key managers, you can be assured that you have serious barriers to organizational improvement. It denotes a resistance to change and innovative thinking and it’s a clear sign that the organization has not encouraged the right behavior in managers.
A variation of this phrase is used in best practice organizations but the context and intent are completely different. In those organizations you will hear the phrase said like this: “We tried that and had problems; what can we do differently this time? What did we learn from that experience? “
Need I say more?
The “we already tried that” phrase is often accompanied by another related common phrase: “You don’t understand how this place works”
What exactly does that mean? Well loosely translated it means “Listen idiot, we operate in silos and we like it that way, you worry about how your department operates and I’ll worry about how mine operates. I’m not about to change”.
Did that translation make sense? By the way if you are an executive you probably don’t hear this phrase as much as your underlings but keep your ears perked as you walk by conference rooms and you will hear it enough. It’s a clear reflection of behavior that you need to start changing, today! That change happens by setting an example. People don’t care what you say they see what you do and then they behave accordingly.
“I’m working on that issue and we should resolve it soon”
This phrase is somewhat related to the “We tried that before and it didn’t work” phrase. Some organizations have learned that an outright resistance to change is not acceptable so they massage the message a bit; a more sophisticated and nuanced way to say “bug-off”. Translated it means “Listen buddy, I’m aware of the issues but they are overblown, my department does a great job. It’s not a big problem; we will work it out ourselves or you will realize that it’s a minor problem and quit bugging me.”
This phrase is indicates your leaders are looking buy more time, after all if they keep promising that results are on the way and time keeps dragging on, sooner or later folks will lose interest and some other big issue will grab their attention – You buy some time and avoid accountability.
An easy foil to this delaying behavior is to ask that person to give you (in writing) the specific goals, related actions, and due dates for the resolution of that “issue”. It won’t be long before you see the issue resolved or that manager admitting that they need help to solve the problem.
“We already have a policy and/or a procedure regarding that issue”
Using this phrase is another great way to differ action. Never mind the fact that no one follows the policy or procedure – the important fact is that we have one! Why fix something that already “in theory”, is “fixable” via an existing policy or procedure?
Once Again trouble is brewing. Your employees use procrastination and road-block techniques to avoid needed change. The organization needs to do a better job in setting clear expectations and holding people accountable for specific metrics, if that was occurring, they would not have time to delay action.
Let’s consider two phrases often spoken by leadership or to leadership that indicate executives have to make more effort towards understanding change management and then encourage the right behavior.
“I know we need to change but we need to make sure we don’t get people upset, they have to want to change”
If you are a leader and you utter this phrase to your staff (especially if those staff are charged with making change happen) then you need to rethink how change management works and rephrase the message. Change is hard and you will often upset people. It’s also likely that the people who are the most upset are the people who truly need to change their behavior in order for the organization to succeed. A better conversation would go like this: “We have had plenty of input regarding this change and it’s clear that it is needed so we need to articulate the change very clearly, let’s make sure we all give the same message. I want the message the same and I want clear time lines and accountability for action, we need to get feedback and while we might make slight course corrections this change needs to occur as planned. I will give you whatever support you need to get this done.”
“We have way too many initiatives”
Take this one to heart as it probably your biggest hurdle in achieving a best-practice culture. Almost every health care organization has far too many initiatives. This tendency to create an unachievable list of initiatives and workload creates “martyr leaders”, leaders who feel that they carry the weight of the world on their shoulders and have so much to do that they have no time to think but only time to keep the great wheels of the organization churning. It becomes a culture that rewards actions for actions sake; there is no better example of this than the tendency of health care organizations to use only one metric when installing very expensive software – Did it get installed when we said it would be installed? Better to have the software installation hit the due date then to worry about if it added any business or patient value; let’s face it “We don’t have time to think about those complexities”.
Best practice organizations have few annual initiatives (objectives) because they realize the organization needs strategic clarity and focus. Better to get a few things done very well than to work on 50 objectives and accomplish very little. With dozens of annual objectives it is common practice for deadlines to slip, objectives to be watered down, and burn-out to occur across the management ranks. When the organization create focus and clarity of purpose by concentrating on a few key annual objectives it can hold people accountable for executing them as promised. The whining stops, the seriousness of hitting objectives sinks in, and the organization achieves a “can do” attitude.
There are many more phrases I could list but by now I think you get the message. Put on your listening caps and you just might discover some organizational “attitude” that needs correcting.