Journal of Healthcare Management - September/October 2015 - (Page 312)

O P E R A T I O N S A N D S T R A T E G Y A Rapidly Adaptable Management System John S. Toussaint, MD, CEO, Thedacare Center for Healthcare Value, Appleton, Wisconsin A s healthcare organizations nationwide are compelled to move from volume-based payments to a value-based system, one thing has become painfully clear: Most of these organizations are not equipped for flexibility. We cannot change at the required rate. One CEO told me recently that we need a rapid adaptability system and we don't have one. One problem is that healthcare leaders are typically managing dozens, even hundreds, of initiatives. Few of these projects are delivering better value for patients and most rarely lead to sustainable change. A new unified management system is needed. After years of studying the transformation efforts of more than 160 healthcare organizations in 16 countries, I have found that a framework exists for a rapid adaptability system. This framework is a daily management system that requires fundamental change at both the frontline and leadership levels. This column will address the core elements of this management system. LEADER PREWORK Before a new system is built, some personal prework is required. An organization's leaders must agree on the need for and purpose of the work. Moreover, they must focus their efforts. I have observed leaders deploying an inordinate number of key performance indicators (KPIs). KPIs should be the critical few measures, but I have seen cases in which 50 or more KPIs were at play, creating a muddle of expectations. Organizations need five to eight key metrics that everyone can understand and rally around. I call this true north. For example, at the Children's Hospital of Eastern Ontario in Ottawa, Canada, leaders identified five metrics, one of which is the number of days children wait for tests and appointments. The current goal is to slash that number by 50,000 days over the next 2 years. It is a clear, immediate goal. Prework, then, is creating an organization's true north and then reducing the number of strategic initiatives. I recently observed a senior leadership team that had 248 strategic initiatives. Senior leaders created the initiatives, but the work was actually done by middle management. As a result, the manager's day was spent putting out fires and performing tasks related to senior executive strategy instead of helping frontline caregivers improve the patient experience. Winnowing initiatives down to the critical few is an essential role of senior management. However, accomplishing this requires persistence because it is difficult to take things off the plate. Some of the most difficult prework is the personal side of change. If you pride yourself in coming to the rescue, being the hero, and setting people straight, your 312

Table of Contents for the Digital Edition of Journal of Healthcare Management - September/October 2015

Journal of Healthcare Management - September/October 2015
Interview With Richard J. Umbdenstock, FACHE, President and CEO of the American Hospital Association
A Rapidly Adaptable Management System
Worksite Wellness: Culture and Controversy
Integrating Strategic and Operational Decision Making Using Data-Driven Dashboards: The Case of St. Joseph Mercy Oakland Hospital
What Determines the Surgical Patient Experience? Exploring the Patient, Clinical Staff, and Administration Perspectives
A Review of Electronic Hand Hygiene Monitoring: Considerations for Hospital Management in Data Collection, Healthcare Worker Supervision, and Patient Perception
Using Hybrid Change Strategies to Improve the Patient Experience in Outpatient Specialty Care

Journal of Healthcare Management - September/October 2015