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Healthcare Leadership: Ask for the Ball

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"Winners always want the ball when the game is on the line." This quote from the movie "The Replacements" has stuck with me even though the movie is otherwise forgettable. I find the quote so apt in today's healthcare industry. I believe the "game is on the line" right now when it comes to healthcare. We know that current healthcare provider business models are not sustainable in the long run and so the "he game is on the line."

There is ample evidence that the demand side of healthcare has changed already and is expected to continue to shift. Inpatient volume growth is near zero often with extreme unexplainable swings. Providers are caring for large numbers of observation patients, cases which are difficult to accommodate effectively within the operational structures of many hospitals. Outpatient volumes are continuing to grow, but providers need to make vital decisions about how and where to best serve the growing numbers of outpatient consumers. Crafting strategic responses to these challenges would be difficult enough, but most providers have also identified huge amounts of costs that need to be taken out of their organizations to meet the threats to the top line. These costs targets are far in excess of what can be taken out of the organization by the usual means of curtailing discretionary spending and mass reductions in personnel.

So what responses are we seeing to these enormous challenges? Too often we are seeing leaders waiting for more certainty in their markets and the regulatory environment before acting. Further compounding the difficulty in forming an organizational response is the fact that these problems cut across many of the traditional operating structures of most hospitals. Managers throughout the organization see the problems as outside of their span of authority and don't feel they have the requisite knowledge to take on these challenges. Accordingly, little action is being taken and time is running out. What can be done to break the impasse?

My premise is that managers throughout provider organizations need to step up as winners and "ask for the ball" This doesn't mean that the leader retires into his or her office and comes out weeks later with the solutions carved in tablets of stone. Here's what I think this process of "stepping up" should look like:

  1. Show that you can assemble a multi-disciplinary team of individuals from across your organization. Select your teammates wisely and not simply from the senior leadership ranks. You'll want fresh ideas and out of the box thinking. If the organization is doing annual Leadership and Talent Reviews of managers and key personnel this should be an easy task of scanning through these reviews to identify who might be ready for a stretch assignment with your team.
  2. Prove that you can manage, inspire and foster a common vision of change across your team. Paint the vision of the "burning platform" for change. This is more than painting a dire picture of the future. Painting the negatives without reassuring leaders than they can succeed is counterproductive. Give the team the confidence that they are empowered to develop solutions to the daunting problems facing the organization.
  3. Challenge the team with specific targets to be met. At GE we call this "start with the answer." This concept changes the dialogue from what can we do incrementally, to what we need to do to meet the needed. To use a football analogy, you don't want the team running plays that will produce a field goal when you're behind by a touchdown.
  4. Be bold and work with your team to develop a firm view of the future of healthcare in your market. Don't simply accept that the "expert" view of the market will come true and fully fit your local market dynamics. With any of the assumptions that you make about the market trends don't forget to ask what it will mean if these key trends don't unroll as expected.
  5. Help your team to suspend their "not invented here" tendencies and reach out to experts inside and outside the healthcare industry to collect and evaluate the best ideas for strategies that can be deployed in your organization. Engage outside assistance as needed to help develop and deploy strategies to meet the challenges of high performance in cost, quality and access. Assemble best of breed solutions to fit your view of the market and test the sensitivity of your solutions to varying market conditions and trends.

While there's no denying that the challenges are huge, I believe that the major mistakes to be made are in waiting to begin this transition. Start now, be a winner, "ask for the ball!"


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