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 action plan;
- 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 disruptions.
- 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”.