Adding Value in a Hypercompetitive World ERIK STEELE, D.O. UNECOM 1987 MARTINS POINT HEALTH CARE

Transcription

1 Adding Value in a Hypercompetitive World ERIK STEELE, D.O. UNECOM 1987 MARTINS POINT HEALTH CARE

2 Who are you? Quick show of hands Med students? Nurse practitioners? Physician Assistants? Physicians? In private practice? Solo practice? Group 5 or less? Group more than 5? In hospital-owned practice Other? 2

3 My experience in healthcare Family doc, health system exec, hospital CEO, yada yada yada But through more than 20 years in this work, leading thousands of people, interviewing hundreds of candidates for CEO jobs, executive jobs, attending physician jobs, physician leader jobs, resident and fellows jobs; reviewing and doing over a thousand annual performance reviews, looking at dozens of responses to Requests for Proposals, WHAT HAVE I REALLY BEEN DOING? 3

4 I have been looking for TALENTED PEOPLE Have a pulse and pretty good Relatively easy to find Role skilled Lower end social skills Stress degrades interpersonal skills Change challenged Happy doing what they are supposed to do Valuable if good, but not invaluable Valuable asset the organization Relatively hard to find Team skilled High end social skills Don t wig out under stress interpersonal skills actually improve Change adaptive Constantly trying to add value to what they do Invaluable sweat blood to get and keep them 4

5 As a health system exec and hospital CEO I have been looking for TALENTED ENTERPRISES Good business enterprise: Common and not hard to find Generally capable May want to get better I would replace them with lower cost provider of same core services if I had the choice Great business enterprise: Uncommon and hard to find Intensely good Driven to get better Irreplaceable? their higher cost is worth every penny 5

6 My old view It was about the talent of the individual and the organization But: Have seen many smart people tank themselves or their organizations Good enterprises fail because they could not adapt to new market circumstances Smart and capable physicians fired because they could not adapt to changes in their work and workplace Smart and capable CEOs fired because they could not lead through change Physicians groups doing good work fired and replaced because their competitor looked like a better deal Physician groups bought out and / or switching hospitals and tanking bottom lines of the places they left 6

7 Consistent pattern among most of those failures. Difficulty adapting to changing internal and external environment Failure to recognize change happening around them Really, really good people and enterprises can fail here: Kodak Ousted physician groups Long list 7

8 New view Smarts and talent not nearly enough, especially in this time of: Growing competition from a range of competitors who can provide your services for less cost, at greater convenience to the patient, for greater value? Disintegrating business models Intense competition for the best paying patients Cost pressures that are an inexorable glacier grinding us down and eroding viability Etc AND. 8

9 A different kind of change than in the past Faster than we have been used to Less predictable than we have been used to Coming from different directions than we have been used to Coming from more directions than we have been used to In sum - TOO MUCH FOR ANYONE TO BE ABLE TO RELY ON PREDICTIONS OF THE FUTURE 9

10 The New Talent We All Now Need To be able to adapt rapidly to change you were unable to predict, and execute quickly on our adaptations to the new environment: As individuals As organization leaders and owners and employees As professions Ie: Darwin 21.0 change fast or die 10

11 Wake up exercise business case and plan The person to your left is your partner in your small family practice / big family practice / health system. If on the end of the right row, partner with end of row person above or below you With that person come up with 4-5 ways you are going to adapt to the major competitive threat described in the business case Be prepared to share your 4-5 ways with the rest of us 10 minutes 11

12 Business case discussion Tell us about your team s scenario and your 4-5 changes 12

13 What do most enterprises focus on in such scenarios? They focus on the things the services, etc The facility dress it up? New services Telemedicine? Walk in care? Botox Whatever Access? Same day / next day Saturday and evening hours 13

14 Focus FIRST on the ability to choose and execute on the things Change is too fast and unpredictable to know whether the things you pick are the right ones Whatever were the right things today might not be the right things for next month So focus first on becoming a healthcare enterprise with the ability to design and rapidly execute on adaptive change 14

15 15 In other words don t focus on putting lipstick on the pig. Focus instead on developing the pig s ability to apply lipstick, or pearls, or a tutu to change, including from pig to cow

16 The adaptive, high performing enterprise Leadership Build the right culture for adaptive capability Management structure and process Examining your enterprise s navel Ravenous for input Ravenous for the right talent Constantly adding value for customers 16

17 The adaptive, high performing healthcare enterprise starts with leadership 17

18 Enterprise leadership and management is different from enterprise ownership Owner not always the best leader May be the best leader but not the best manager Cannot be an adaptive, high performing healthcare enterprise without excellent leadership committed to excellence in leadership below you Leadership is a professional skill that must be developed and improved, not conferred by a medical degree 18

19 Build an adaptive culture Build a culture that part of everyone s job is to improve the job Train staff and leaders in change management Incentivize creativity and innovation by staff Develop sound communication practices that work in both directions up and down the enterprise 19

20 Build an adaptive culture Encourage individuals and groups in the enterprise to think and contribute, challenge, try and fail Failing is better than not trying, and they try and fail without fear Built PDSA / other performance improvement cycles improving quality is a built grinding forward process, not luck or 20

21 Management structure and process Defined management structures and processes, so leadership can hear / identifying issues / goals / changes that need to be made, get multi-disciplinary input, make decisions, and then operationalizes change including training, etc 21

22 Management structure and process This is an enterprise skill that is developed, used repetitively so you get good at it It is self improving It is unafraid to tear itself apart and rebuild it 22

23 Examining your enterprise s own navel They can examine their own navel data systems, digitized information. If you have to wait for an insurer to tell you what your mammogram rate is you are not an adaptive organization They do examine their own navel well and fearlessly. They can run data, do basic analysis, etc and if cannot do it on their own, get someone to do it Willing to destroy current models, methods, etc they have an ethical and organizational true north but there are no other sacred cows 23

24 Ravenous for input Constantly gets input - from staff, from customers, from the environment, from literature, your barber, whatever Know who their major customers are, act as though they are about to be stolen because they are Constantly seeking customer input in order to improve not dumb enough to only listen to their own opinions about what customers want. Eg: Patient advisory council, regular meeting with major employer reps 24

25 Ravenous for the right talent Have a pulse and pretty good Relatively easy to find Role skilled Lower end social skills Stress degrades interpersonal skills Change challenged Happy doing what they are supposed to do Valuable if good, but not invaluable Valuable asset the organization Relatively hard to find Team skilled High end social skills Don t wig out under stress interpersonal skills actually improve Change adaptive Constantly trying to add value to what they do Invaluable sweat blood to get and keep them 25

26 Eg: Recruit the right providers 100 physician candidates A. 90 are clinically good B. 70 are A and pleasant to work with C. 50 are A, B, and pleasant to work with through adversity D. 30 are A, B, C, and are change adept E. 20 are A, B, C, D, and CAN help lead through change F. 15 are A, B, C, D, E, and WILL constantly seek to improve their work and the enterprise G. 10 are all those things AND will help lead those changes in a positive, effective way EVERY OTHER ENTERPRISE WANTS THOSE 10, including the ones who work for you now 26

27 Constantly adding value for customers Constantly looking at customer s needs including business customers and partners for opportunities to add value of working with the enterprise Surprise customers with added value that has not been requested constantly looking to add value to being a customer 27

28 Constantly adding value Know that if they are not doing that, some other enterprise is going to find a way to come between them and their most important customers 28

29 Summary Smarts and talent are not enough must be able to adapt rapidly in a chaotic, hyperdynamic, progressively competitive healthcare market Focus on the ability to change first to adapt - and then on the changes you think make sense Leadership, culture, management structure and process, navel study capability, ravenous input hunt, ravenous talent hunt, adding value for customers 29

30 On the drive home today, and to work Monday, think about How does all this apply to you? How does all this apply to your enterprise How fast can you execute on changes you want to make in your enterprise? Is that fast enough to really compete in your market against a good competitor? And 30

31 Super Bowl Win Number 7 31

32 Questions and Comments? 32