It is quite common to see in various magazines, emails, or on LinkedIn,
a listing of the 10 top challenges that CEOs believe they are facing in
the healthcare industry today. They often call this list the: “what
is keeping them up at night” list. Although recognition of current
challenges is important for health systems, hospital boards, and leadership
teams, this is not enough.
The proof that this is the case lies in the fact that the “challenges
list” provided by a wide array of CEOs across the healthcare sector
has changed very little over the last decades. We hear and read over and
over again about the lack of primary care providers, declining inpatient
volumes, decrease in profitability, variability in clinical outcomes,
lack of strong physician-hospital integration, and fragmented care due
to lack of coordination across the care continuum. So why do the challenges
identified years ago still remain the major problems today? The answer
is clear. The principles embedded in 'Management 101' must be
implemented, overseen by strong, collaborative leadership teams who have
established a culture focused on outcomes verified by pre-determined measurements.
The Basics of Management Implementation and Execution
Although these principles are well known, the implementation of successful
action plans are sorely missing in many boards and leadership team processes,
and this, in turn, significantly undermines positive outcomes and forward
movement of the healthcare entity on its journey to excellence. So then,
what must the trustees, the CEO, and the leadership team do to ensure
that management teams feel empowered to address the challenges they are facing?
I submit the following:
- For each challenge identified, the barriers which must be overcome to eliminate
each challenge must be articulated;
- Action plans must be developed to address each of the barriers, and listed
in priority, placing the most probable successful plan at the top;
- A responsible party, preferably one person, should be identified for each
- Metrics should be identified that, when reached, would indicate the plan
had been successfully implemented;
- A timeline for completion for each action plan should be identified;
- A spread sheet should be developed, and appropriately communicated both
verbally and in written form, which lists each action plan, the responsible
party, the timeline for completion, and the metrics for success;
- Regular progress reports should be reported in the appropriate forums,
and if success is not being demonstrated, the plan of action to address
the persisting challenge should be repeated, and/or the plan altered as required.
These basic management steps to overcome the challenges facing many healthcare
providers today, becoming high quality, low-cost, and easily accessible
providers, seem so obvious and relatively easy to put into place.
However, it that were the case, the challenge list would significantly
change from year to year, with new challenges replacing the old ones that
have been successfully addressed. So, perhaps it is the leadership component
that is missing!
The Basics of Leadership Implementation and Execution.
Although leaders must have an array of competencies to be successful, below
are four that are critical to successful implementation of action plans
to eradicate or minimize an organization’s challenges:
- Develop a company culture which empowers management to be focused on measurable
outcomes for all tactics of the agreed upon strategies;
- Through continuous education, both formal and informal, constantly be developing
an internal talent pool of people who eagerly want accountability for
achieving positive outcomes, knowing that they may implement innovative
ideas and that the risks associated with such will be tolerated
- Encourage long-term thinking at the board, leadership team, and management
team levels, using potential case scenarios for envisioning potential
futures which may unfold. It has been shown that scenario planning can
help leaders become more comfortable with the ambiguity of the future,
paying more attention to the pre-determined subtle signs that change is
on its way, and for outlining various action plans to address the resulting
- Commit to constant communication. Our team believes, and has implemented
extremely successful change when both the rationale for change, and the
future vision that the change will create is communicated in multiple
forums, both verbal and written forms, over and over again. We call this
"connecting the dots". We also have examples of where ignoring
these basic principles has resulted in significant, and avoidable, failure.
It is clear the lack of understanding of both the reasons for and the
directions required to address challenges is a major issue today and is
why leadership and management teams have few faithful followers.
It will take both strong and effective leadership, as well as “execution
oriented” management, to make the challenges list change year to
year and reduce in number. We agree with the great philosopher when he
wrote, “plans without actions are like books without words”.