Building Execution into Strategy

Transcription

1 Building Execution into Strategy How St. Vincent s Health Services Effectively Adapted to Changing Times The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA Society for Healthcare Strategy & Market Development

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3 Situation 25-year collaborative relationship with a large primary care practice that had grown up at St. Vincent s Good news/bad news What s the risk?

4 Problem In 2014, group sold to hospital s competitor creating potential for undersized primary care and ambulatory network

5 Key Strategic Challenges and Strategies Key Challenge Strategy Initiative Undersized ambulatory and physician network to support assets and manage populations Secure Local Market and Prepare for Population Health A. Primary Care Network Development 1. Unified Physician Platform/Local CIN/Primary Care Institute 2. Anchor group partnership B. Retail/Consumer Focus

6 Primary Care Institute Primary Care Institute (PCI) created in 2014 Convened a multi-disciplinary team: Strategic Planning - Finance Physician Enterprise - Marketing Real Estate - Design & Construction IT - Nursing Behavioral - Community PCPs ACO

7 From the data emerged a vision

8 Rigor to Execute Primary Care & Ambulatory Network Strategy A. Strategic Intent: Creating a Primary Care Institute B. Modes of Growing Primary Care Capacity C. Approach to Geographic Areas of the Market

9 Implementation Primary Care Institute Implementation A. Scope of Work B. Management Structure C. Committee Charters and Membership D. PCI Steering Committee Agendas

10 Modes of Growth Group A: Provider Recruitment Group B: Long-Term Provider Pipeline Group C: New Access Points & Clinical Services Group D: Engaging Healthcare Consumers Prioritized each of the modes within the groups

11 Primary Care Institute Implementation: First and Second Moves = First Move = Second Wave Workstream Executive Lead Accountable Implementer Status A. Provider Recruitment Gleckler/Schek MSG Recruitment Gleckler/Schek Scifo/Willey/Flavell Work Underway PHO Recruitment Gleckler/Raskauskas Hunt Work Underway Recruitment into Indep. Practices Gleckler/Schek Flavell Work Underway B. Long Term Pipeline Schek Fogel Quinnipiac SOM Schek Fogel Work Plan Developed FHC Preceptors Schek Fogel Work Plan Developed C. New Clinical Services Schek Fogel Diabetes Center of Excellence Schek Fogel Work Plan Developed Investments in Geriatrics Schek Fogel Work Underway SNF Partnership Schek/Raskauskas Fogel / Hunt Not started FQHC Partnership Schek Fogel/Hoey Exploratory Phase D. New Access Points Gleckler/Schek/Auger Urgent Care Billing Model & New Sites Gleckler/Schek Scifo/Willey Work Underway Investments in current MSG sites Gleckler/Schek Brown/Willey Not started Fairview Site Auger/Schek Scifo/Willey Work Underway Stratford Auger/Schek Scifo/Willey Work Underway APRNs/PAs Gleckler/Schek Scifo/Willey/Fogel Not started Retail Partnership Auger Work Underway inquicker Auger Willey/Scifo Work Underway Healthgrades Auger Marker Work Underway evisits and Telemedicine Auger Not started 11

12 Key Success Factors Defining intent (secure the core) Creating case across organization Securing alignment on priority Capital Interdisciplinary team Priorities (moves, milestones, check-ins) Strategy leaders and operational leaders working in tandem

13 No worthwhile strategy can be planned without taking into account the organization s ability to execute it. Larry Bossidy Execution, 2002

14 Hurdles, Method, Tools BUILDING EXECUTION INTO STRATEGY

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16 Building Execution into Strategy How to ensure a well-designed strategy converts into effective implementation Hurdles: Why we hate to change Overcoming the Hurdles: Fair Process, Trust and Commitment, Voluntary Cooperation

17 First, you must have the right strategy. Blue Ocean Strategy 17

18 What do you need to thrive in changing times? A real strategy A well-defined, integrated, cohesive approach A clear, simple story What s your hook? Blue Ocean Strategy 18

19 All strategies ask Which customers or markets? What distinguishes us? What value proposition? Why key processes give us competitive advantage? What are the human, technological or organizational enablers of the strategy? Blue Ocean Strategy 19

20 Red Ocean Strategies are bloody! To win you must grab a bigger share of the market. Very Competitive. It s a zero-sum game! One wins, the other loses. Blue Ocean Strategy 20

21 Blue Ocean Strategy is A way to make the competition irrelevant by creating a leap in value for both the company and its customers. Blue Ocean Strategy 21

22 Why are they so hard to implement? Ask your leadership

23 The brain hates change!! Change creates pain in the brain! Blue Ocean Strategy 23

24 Comfort of the Herd--Culture 24

25 Birds of a Feather Flock Together

26 Power Of Habits We love to think that we are full of free will. But, we really are driven by our habits.

27 But, You Need To Change

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30 In All of History The Seven Basic Plots Overcoming the Monster Rags to Riches The Quest Voyage and Return Comedy Tragedy Rebirth But thousands of ways of telling the story.

31 Dianne Had a Great Story St. Vincent s was the fallen hero that needed a Rebirth. With the data in hand, they went after it with great struggle, obstacles, hurdles and hope that they could quickly tackle the well-established competitor, who used to be their best buddies. Against great odds they overcame the monster and restored the patients to their rightful home at SVMC.

32 Ok, so you have a great strategy and it has become a wonderful inspiring story. Now what? HOW TO EXECUTE A GREAT STRATEGY?

33 Strategy Faces Hurdles The Cognitive Hurdle: Waking employees up to the need for a strategic shift. The Resource Hurdle: It is assumed that the greater the shift in strategy, the greater the resources it requires for execution. The Motivational Hurdle: How do you motivate key players to move fast and tenaciously to carry out a break from the status quo? The Political Hurdle: As one manager put it, In our organization you get shot down before you stand up.

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35 Overcoming Hurdles It is only when all the members of an organization are motivated to support a strategy, for better or worse, that a company has a chance to stand apart as a great executor. That means your strategy needs a strategy!

36 To Execute on a Strategy Minimize risks. Inspire trust and commitment. Inspire their voluntary cooperation. Build execution into strategy from the start.

37 Must Build Engagement

38 Reach into Fair Process. Fair process is key variable between successful strategic implementations and those that fail.

39 Power of Fair Process Based on research People care as much about the justice of the process as they do about the outcome itself. Satisfaction with the outcome and commitment to it rise when procedural fairness is exercised.

40 How Do You Do Fair Process? Begin with building strategy into people s buy-in up front. Engage the team in the strategy-making process. People trust that a level-playing field exists.

41 Inspire them to cooperate voluntarily in executing the resulting strategic decisions.

42 Voluntary Cooperation More than mechanical execution. Don t want people to do only what it takes to get by. Going beyond the call of duty. Go beyond their own abilities, even subordinating own self-interests to execute resulting strategies.

43 Three E Principles Engagement Explanation Expectation Clarity

44 Why Does it Matter People emotionally seek recognition of their value. Not as employees but as people who want to be treated with full respect and dignity and appreciated for their individual worth.

45 Ignore Fair Process and they will.. Feel intellectual indignation. Not share ideas and expertise. Hoard their best thinking and creativity. Undermine and Sabotage the process. Not trust the strategic decisions being made.

46 Good Strategy Execution Is based largely on motivating-people. Requires you to overcome organizational hurdles. And win trust with fair process. Demands a holistic approach to formulating the execution of the strategy.

47 Glassdoor, 2013 research of 2000 employees

48 What did they do? How did St. Vincent s convert a great strategy into a winning execution?

49 Timing This was a crisis. No need to wait for a crisis to implement a strategy really well.

50 Reflecting Back on the Process Engagement The WHO (Interdisciplinary Group) Explanation The WHY (Build a New Network) Expectation Clarity The WHAT (Results of the Work Together)

51 Progress Report PCI = Launching Pad & Landing Pad 4 new urgent care centers, total 8, all with online scheduling capability New PCPs in the market E-visits launched in 2016 Multiple service line initiatives Joint ventures

52 Primary Care Special Needs - 13 Urgent Care Specialty Cardiology

53 Questions

54 Thank You! Dianne J. Auger, Senior Vice President, Chief Strategy Officer St. Vincent s Medical Center Dianne.Auger@stvincents.org Andrea J. Simon PhD, President and CEO Corporate Anthropologist Simon Associates Management Consultants asimon@simonassociates.net Facebook.com/simonassociatesmanagementconsultants Blue Ocean Strategy 54