In all the years I have served healthcare organizations, I have always been perplexed by hospitals that thrive against all odds and others that wither with clinical and financial resources that would suggest otherwise.
Recently, I met two relatively young brothers who have been extremely successful in business. They own or are partnered with businesses I can barely understand. Now they have turned their attention to healthcare. I am reluctant to share their names, because one of their many well-established business principles and practices is to maintain a very low profile in general, and with the media in particular. Every time I have met with them or discussed a proposal on the telephone I have come away with a deeper respect for their maturity and mastery of a business philosophy that is breathtaking in its clarity. They are bereft of arrogance or hubris. To the contrary, they are sensitive to the people they work with and honor peoples’ lives with respect and dignity.
From all that I have observed and learned from these two individuals, there is one lesson that stands out as first among equals -- clamor for success. What does that mean? The dictionary describes clamoring as vigorously advocating for a better set of conditions. Clamoring is characterized by fanatical commitment and purpose. As applied to business, it is that energy that drives consistent improvement and fends off the status quo. It is the drive to exceed the expectations of customers, employees and business partners. It is the commitment to never pay more for a unit of production than is necessary. We hear these expressions in hospitals all the time, so why is there a difference? These gentlemen mean it. They live it. They are determined to clamor for success, and they are intense.
As I sit at their feet and learn, I can see the answer to my opening question. Many hospital leaders clamor for success, but some do not. Seeking to exceed customer expectations is either a cliché or a fury of thoughtful energy and action. It is one or the other. It cannot be both.
It is with a little bit of "kidding on the level" that I often describe the plight of many hospital CEOs. They get up at 5:30 a.m. and make their way to the 7:00 a.m. Medical Staff Executive Committee (MSEC) meeting. Sometimes the physicians at the meeting, facing their own practice challenges and often unwittingly, spend two or more hours taking out their frustrations on the CEO. Staggering out of the MSEC, the CEO goes to his or her office to meet with Mrs. Schmedlapp (former patient) who has persistently worked to get on the CEO’s calendar. In very earnest terms she explains some moral outrage that occurred when she was a patient in the hospital. Nurse Sprocket spoke to her in a harsh manner, and it made her feel bad. The CEO takes copious notes and promises to look into the matter. At 10:30 a.m. the CFO arrives with more bad news. Somehow the Medicare labor adjustment for the hospital was misstated in the budget, and the hospital will have to make up $600,000 in this year’s budget . . . somehow . . . some way.
The CEO is very assured that they will find a way to do this. At 11:45 a.m. the CEO leaves the building to make a noon presentation to the local Rotary Club. The CEO is not interested in the presentation, and, as it turns out, the Rotarians are not very interested either. At 2:00 p.m. the CEO returns to the hospital to meet with an eager member of his/her staff. This staff member enthusiastically delivers more problems to the CEO’s desk and gives the CEO every opportunity to do the staff member’s job. From 3:00 to 5:30 p.m. the management team assembles for the weekly staff meeting. Most of the meeting is characterized by not making essential decisions, throwing sand on each other and finding a way to avoid controversy. At 6:00 p.m. the CEO arrives at the local country club to have a dinner meeting with a group of physicians to focus on growing discontent about some ill-defined problem. The essence of the meeting is that the physicians just "don’t feel the love like they once did." At 10:00 p.m. the CEO arrives home. He/she is emotionally and physically exhausted. The entire day can be described as a "bucket full of busy."
The CEO who clamors for success finds an alternate approach. He or she finds a way to make the calendar work for the benefit of all stakeholders. Everyone in the organization is encouraged, even coached, to clamor for success. A new and different kind of energy is infused into the organization. People no longer seek to achieve goals. They clamor to exceed the goals. Teamwork replaces politics. Each person in the organization is given a clear understanding of what it means to be a success. To achieve "clamoring for success" requires a change in the culture. To effect this change requires intelligent effort, patience and time. It cannot happen without the CEO going first. Then the senior management teams needs to go through a process of looking at previous efforts in a fresh and imaginative way. Next the department heads need to be enlisted to clamor for the success of the hospital. In truth, it is the department heads that truly run the hospital and control the culture. It is here that the most intense efforts to modify the culture must take place. It can be done if there is the will, determination, consistency of purpose and dedication of appropriate resources.
This is a very different way to run a hospital. Many hospitals do this now. Many do not. If you are in the "do not" column, take this as encouragement to reconsider the organizational priorities and the manner in which business is conducted. Clamoring for success is organizationally infectious if presented and coached properly. Catch the fever.
Jan Jennings
Republished with permission from the Hospital News Group
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