By David Berger

The pathway to success for digital health startups is challenging. Hospitals are often looked at as the point of entry for digital startups. Trying to work with large hospitals can pose challenges for early stage start-ups for several reasons:

1) Hospitals often are a part of larger systems. As a result, there are multiple layers to the approval process with multiple decision makers prolonging the sales cycle. In my experience as COO of an academic medical center the time from initial interest to contract can exceed two years. Furthermore, complex deployment processes add to the timeline for pilot implementation.

by Rob Thames

This is Part 3B of this three-part series.

Part 3A briefly reviewed four change methods. This Part 3B compares them to elicit insights.

Motivational Interviewing, Kotter’s 8-Step Model, Baldrige Communities of Excellence, and SEED-SCALE, reviewed in Part 3A, were selected to reflect and reveal the wisdom of a range of disciplines, applications at different levels (individual, organizational, community and population) and purposes to aid change practitioners in the thinking and doing of their craft. How can comparing these models elicit deeper insights to affect sustainable change sooner and better?

Good operations is good strategy. Operational excellence. Blocking and tackling. Within health systems, the ongoing importance of good operations should be highlighted as a foundational element of every strategic plan. Good operations is a “no lose” strategy that positions a health system for success regardless of the many external forces providing new challenges. Value-based contracting, risk-sharing and Medicare break even strategies are all dependent on the fundamentals of sound operations. Operational Excellence requires strong and improving performance across a broad spectrum of metrics related to safety and quality, customer service and cost efficiency.

By Dr. Michael J. Zappa

Focusing on joy, especially in work, is gaining momentum. It has my attention! It is clear to me that the mindset and habits are exactly what great leaders have and do and what developing leaders should concentrate on.

It is very tempting for any leader, especially those in healthcare, to focus on what’s wrong, what needs to be fixed. It’s time to view the situation through a different lens…we need to focus on the meaning and purpose of our work. This is a distinct advantage for those of us in healthcare, our mission is making peoples lives better.

Lessons from Global Health Development: Harnessing Methods of Change

By Rob Thames

This is Part 3A of this three-part series.

Read part 2.

This Part 3A briefly reviews four change methods and Part 3B will compare them. 

“I have no idea how to change anyone. But I carry around a long list of people in case I ever figure out how.” - Anonymous

Eliminate four billion dollars of waste from a large healthcare system next year. Increase the CMS TPS (Total Performance Score) for a hospital from the national average of 38.1 to 60 in two years. Reduce maternal, child and infant mortality in Nigeria by 50% in three years. These are large-scale improvement goals – at healthcare system, hospital and population health levels, respectively.

Why I find Rural/Small/Stand-Alone-Hospital CEOs so Impressive.

By Rodney Reider

“Stand alone” hospital presidents provide a great deal to admire.   

I was the lead in a recent strategic retreat and the CEO was incredibly impressive as I watched her interact with her board, her physician leadership and her administrative team.  Once again it rekindled my awareness of how small hospital CEOs have to do it all.  They are the engaged in the community, lead in the facility, influence the physicians, head Human Resources, know all the staff by name and can even be involved in the revenue cycle, IT and compliance departments.

By Dr. Michael J. Zappa

All leaders will openly admit that they could not do their job without their team. However, as humans, I’d bet that most of them, in a moment of frustration, have thought “it would be easier if I just did it myself.” Why? Because influencing people is a gradual process, not simply a decision with immediate results.

Accepting the reality that no matter how brilliant or hard-working you are, you will always need your team which means you need to learn how to influence them.

When faced with failure, what does a responder do? As an expert/advisor, you have a choice: correct the specific failure or strengthen the system (Taylor, Just and Lasting Change). To make this decision, it is critical to discern: is this an event-induced “disaster” – Ebola, Tsunami, Hurricane – or is it a chronic, systematic, or lifestyle-induced failure? In medicine, the difference is how a physician treats a patient with emergency trauma vs a patient with a chronic disease. The global relief vs development challenge has a healthcare leadership parallel: rescue or strengthen.

by Michael J. Zappa

Enhancing our own leadership development along with the novice and advanced leaders on our teams is mission critical in healthcare today. The environment that we are challenged to be successful in is very harsh — increasing the cost of technology and pharmaceuticals, the ever increasing cost of labor, on top of declining reimbursement.

By Rand O’Leary

The healthcare environment continues to undergo rapid and profound change with mergers, acquisitions and new business models forever changing the landscape of how we lead and deliver healthcare for the next millennium. In my previous article, I discussed the concepts of leading your team through complex problem solving. Today the focus is on you, the leader, how you successfully navigate yourself through new relationships, complex reporting structures and multi-entity healthcare business models.

By Gay Nord

There are likely more articles, books, blogs and seminars pertaining to Leadership than any other subject. In addition to our formal education and training as a leader, we have learned leadership traits from mentors, bosses, and other leaders over the years; we’ve learned what aspects of leadership we admire, and consider motivating and successful, AND...WHAT ASPECTS WE DON’T.

As a leader, leadership is not about you. Leadership is about those you serve and support, those you impact around you. I’ve learned over my career that command and control may yield short term gains in performance, and in emergent situations may be needed. However, if the goal is to create and sustain a high performing, forward thinking and dynamic organization and one that attracts the best talent, managing through fear and intimidation will not cut it. Relationships, trust, loyalty and truly caring about people, will build a resilient, loyal, high performing organization. Read Full Article.

By Rob Thames

Part 1 of a three-part series 

“We cannot solve our problems with the same level of thinking that created them.”― Albert Einstein 

In the U.S., some refer to healthcare system change as an oxymoron. It is complicated. It is hard. And while progress has been made, we have a long way to go.

It happens. The organization is off plan…by a lot; and it is not the first time. More than a modest correction or a “wait until next month.” Many factors were likely involved, but the relentless dynamics of the market have overwhelmed a longstanding management team. It is akin to a cyclist who has slipped back from the peloton due to chronic cadence deficit – and now the gap is widening.

As discussed in the blog, Healthcare Can Not NOT Change, healthcare is a business. And, considering the economic contribution they make throughout their region, it is big business. With each hospital closure that hits the media, it is not simply the services provided that is at issue, but the financial impact to the community as well.

By Rand O’Leary

Leading and working in healthcare has always been complex, never more so than in today’s healthcare environment. Increased regulations, government reforms, alternative based payment models, rising consumerism and expectations have come together in a perfect storm swirling around the industry. On top of this, the world economy has become a destabilizing factor as we realize now more than ever how interconnected we are to our world partners, almost a giant game of Jenga, where one false move by a world leader could topple the whole tower.

By Rand O’Leary

Leaders are expected to be creative problem solvers, challenge the status quo and visualize problems before they occur. Your success as a leader is largely dependent upon how quickly you seek improvement in broken processes, develop new procedures and maximize efficiency and effectiveness.

Below are three tips to help you stay in front of the curve when managing your people and organization through change and drive results:

By Roger Barnhart

One can not, not change – especially in business. And, though not always a popular perspective, healthcare is not only a business, it is big business. With many rural communities, the local healthcare system is the primary economic driver. It may sound harsh, but in business, it has been said that we are either growing, adjusting or dying.

As an avid fitness enthusiast, I can personally attest that I must either work to improve, or I will lose the progress I have made - requiring almost constant re-assessment and modifications to my programs. Especially as I age. What I was able to do 10, much less 20 or 30 years ago will no longer render the same results today. Very much like rural health.

These words can immobilize the most courageous of hearts.  Many at the clinical sites believe corporate exists to disrupt and provide self-enhancement for the corporate individual making the demand.  The incoming request often appears as a consistent disruptor to the local individual who is focused on the hospital, clinic or community issues.  As a non-corporate individual, you are at the site addressing immediate and multiple priorities.  The demands can range from concerns for improving patient care, addressing colleague concerns or responding to the corporate enhanced financial issues to name just a few of the more common daily agenda items.  In fact, you may even be reacting to a situation affecting the greater importance (?) of your immediate supervisory interacting environment (i.e. keeping your local boss happy).  Whatever the corporate demand at the time, it can seem to distract from the work necessary to be successful at the site.  Furthermore, from the limited view in field, the request can sometimes make no sense as to its timing or priority except “Home Office needs it now.” 

by Rand O’Leary

oday’s healthcare environment is shifting at an ever-increasing pace. The transition to community health focused care is both daunting and challenging for most organizations.  Now, more than ever physician leadership can play a crucial and important role. 

Setup Your Physician Leaders for Success 

Before we begin, it’s foundational to understand how physicians view leadership.  Physicians are trained to work independently, they value their autonomy and can be reluctant to delegate authority.  All good qualities if you’re the patient.  My colleague once said me, “these trauma surgeons are sure difficult to work with.”  My response, “Of course they are. They are trained to take charge, assess situations quickly and be right, every single time.  And If I’m critically injured, that’s who I want taking care of me.” But yes, when we ask them to take on the mantle of administrative leaders, they need our help. 

Over the years, I’ve heard many stories inspirational stories on leadership, one of my favorites involves President John F. Kennedy and his first visit to NASA in 1962.  As the story goes, the President was touring the facility when he came across a janitor carrying a broom down the same hallway as the touring President.  Kennedy, a great lover of people stopped the and asked him what he did for NASA, not missing a beat he replied, “I’m helping to put a man on the moon.”