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Healthcare Leadership: A Discourse

Healthcare Leadership:  A Discourse

Tag Archives: hospital management

It’s the Same Old Story – Everywhere You Go

16 Tuesday Jun 2015

Posted by Scott Southard in Uncategorized

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business leader, business management, business solutions, communication, health care management, hospital management

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Although it is outside of my context, I can’t help but hear Paul Simon sing: “Keep the Customer Satisfied” when I’ve told my teams—regardless of the make-up of that team and their pay grade, status, and job responsibilities—that we all must practice good customer service each and every day.

I remind them in team meetings and individually that by giving all of our patients good customer service that we build relationships, encourage communication, cut down the number of missed appointments, and improve results for everyone involved.

I’m sure that I don’t need to lecture anyone in healthcare that this is one of the three components of the Institute for Healthcare Improvement (IHI) Triple Aim of optimizing health system performance. Many of us feel that this point drives the other two. Specifically stated, we need to:

Improve the patient experience of care (including quality and satisfaction).

In healthcare (as it is in retail and other businesses), the customer who presents himself with a physician’s order or walks into the shop is easily identifiable. What I’ve done in my training is to make my staff aware that everyone—including not just the patients and referral sources, but also their peers at work—are customers. They all deserve to be approached and catered to as valued customers.

This refrain echoes the Golden Rule, but I feel that it rings just as true as ever. And, like practicing the Golden Rule of “One should treat others as one would like others to treat oneself,” I understand that compliance is not always easy. The challenge here, however, doesn’t lessen the importance of this goal.

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Can you teach good customer service? Is it innate? Can you change people’s behavior?

In the military, boot camp goes over and over certain actions that usually do not come naturally to most men and women: think bayonet drills.   It is said that when you are placed in a challenging situation, you will not survive by resorting to your instinct; the constant drilling makes sure that you, instead, fall back on your training.

With this mantra in mind, I teach and regularly review chosen relaxation exercises with my patients. This repetition, I’ve found, assures that my exercises become embedded, nearly second nature, and effective for my patients who are striving to find peace following trauma.

Good customer service training is critical and it is imperative that all of your staff knows what you mean and what is your expectation for their performance.

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Social workers beware! Being empathic, caring and approachable is not always the same as good customer service. These traits, however, are key in establishing a relationship, but don’t necessarily line up with how your organization wants you to perform.

For many new trainees, learning an organization’s protocols and approaches may feel foreign and so patience and nurturing needs to be built into the education. Written manuals that are distributed to staff to review and be quizzed on periodically in the first three months is pretty standard and can serve as a benchmark for the trainer to know what lessons need more explanation and who needs more education.

The leader/trainer, at the same time, becomes a model of customer service.

Like children, we all watch and imitate senior staff especially in jobs that are new to us. At the same time, if we identify inconsistencies or a loophole, like teenagers, we will exploit it and shrug off the earlier lessons. After all, as a wise man once said, “A man hears what he wants to hear and disregards the rest.”

So here is another challenge in leadership: Walking the talk.

Not unlike conscientious parents, leaders nurture, provide guidance, show patience, and present opportunities for growth to our staff. Furthermore, leaders do not show preference to one staff over another or abuse the power one pay grade or hierarchical position has over another.

–

How do you measure customer service success?

Can it be done with customer endorsement, new referrals, new revenue sources, improved patient satisfaction scores, or low staff turnover?

The answer is yes.

But time, two to three years, is important to pass with the implementation of customer service education to truly determine if it is the leadership approach is making the difference, rather than a slow feedback loop for collecting data or a delayed accounts payable system.

Strive to be that Bridge Over Troubled Waters. (Sorry, Rhymin’ Simon)

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Making Yesterday’s Vision Tomorrow’s Reality

19 Wednesday Feb 2014

Posted by Scott Southard in Uncategorized

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business leader, hospital management, leadership, leading, management, vision

ImageDo you want to reach out and help your fellowman and see the difference 100% of your efforts make on humanity? 

A few of my friends have joined overseas missions and can tell you firsthand what that feels like.  The rest of us may have a different story in treating patients here stateside.

–

Civilization has its costs and following certain rules, regulations, and standards—for better or for worse—are mandated.  Prior to receiving my first job offer to work in a hospital, I’ll never forget the words uttered by my soon-to-be boss:  “You will need to get a haircut and lose the beard.  The revolution is over.”  Gulp! 

Needless to say, I did just that and so began my long career in health care.  I also found that in the decades that proceeded “work casual,” that the expectation was that I would wear a sport coat or suit and tie.  Yes, even on Friday and even on the weekends when I was called in.

Where all think alike, no one thinks very much.  –Walter Lippmann

Before you pass judgment on my stuffy professional genesis, please take a few paces backwards and look at the context in which this appearance edict was given. 

In the 1970’s, it was a world in which people had certain expectations when they went to the hospital.  They wanted their nurses to wear hats and starch white linen, their physicians to wear suites and/or white coats, and their professional staff to look… well… professional.  Just like when you visited a bank, you want to see your banker dressed conservatively because you expected him to handle your money in a conservative manner.  Likewise, you wanted your medical care to be provided in a starched, antiseptic, and professional manner.

A few years ago, I was told by my younger peers to dress down more.   It didn’t feel right, but I finally adjusted to wearing corduroy pants and shirts without ties.  The feedback from my patients was complementary and welcoming.  Oh!

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It is the primary job of a leader to identify and clearly explain the context of the why, the what, and finally the how.  This can be a moving target. 

I mentioned in an earlier blog of the important role of an organization’s mission, vision, and values.  This blog will discuss the application of the vision.  The vision shows the direction where the organization wants to go.  (And, by the way, you dress for the job you want, not just for the job you are currently assigned to perform… your career vision, if you may.)

A leader not only looks for opportunities to talk about their organization’s vision with individuals, teams, and with groups, but he/she must have a plan to walk the talk.  This walk is not linear, however, and will demand that the leader take an active role to make the vision a reality.

I recognize that a vision statement can seem fully formed and organic in the sense that an organization grew in this direction pushed by forces such as reimbursement, staff, location, and other variables.  Yet, I have found that planning is key to making a vision manifest. 

Before a leader starts out, they need a detailed outline—with specifics if possible—of the plan from the start to the goal, with measureable benchmarks along the way.  A plan should always take into account competition and other obstacles. 

If a leader doesn’t have marketing savvy—or does not have a marketing professional on the team—now would be the time to find someone with these skills!  A marketing professional should be schooled in making messages and visions come alive, and in ways not considered by people with other strengths (a leader doesn’t know everything, and a wise one recognizes that!).

As an example to the work involved, let’s discuss the efforts needed to fulfill a vision for a health care organization to become a regional leader in sports medicine. 

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Currently, the orthopedic and sports medicine arena is hotly contested. 

Customers and patients of such a program are a highly desirable target for health care organizations.  These customers are usually in good physical shape to begin with, tend to be highly motivated to stay physically fit, and once injured work hard to get back in the game. They also have better outcomes from surgery with no to few readmissions, and (also importantly) tend to have good payer sources.  Being active, they will probably spread their good results to others.  Positive word-of-mouth advertising, as we all know, is the very best way to market a product. 

Once a plan is in place, a team needs to be formed.  A sports medicine team will usually be made up of sports medicine physicians and/or orthopedic surgeons, high school athletic trainers, sports performance instructors, physical therapists, physical therapy assistants, and exercise physiologists.   

Physician involvement is crucial for any program in a hospital or health care setting to succeed as anyone pulling together a new program can attest.  Not only can their practice reflect the vision in another practical and results-driven way, but also customers and hospital administrators will listen more closely to what they have to say over the din of competing voices.

The physicians and the others on a team need to understand the vision, the plan, and their role.  In forming a team to actualize this vision, a leader may identify a “champion,” or maybe there will be a few “champions. “

Champions are unusually motivated spokespersons who understand the vision and the plan and can articulate it in a way that recruits and motivates others.  A champion will prove to be a great advantage to a team for moving the vision forward with their commitment towards the program’s success.  It is, however, not unusual for the leader to be the champion at first, to show what the role looks like and identify ad hoc champions or champions for specific tasks.

It is important to note here that with champions or no champions, a leader must keep engaged in the direction that the product is developing making sure that all efforts are fulfilling the vision.  A good leader should not be accused of being asleep at the tiller!  Ultimately all of this—the good, the bad and the ugly—will be a leader’s responsibility.

With a prepared leader, a solid and motivated team with the desired skills, potential champions, a plan that allows for unanticipated variables, a mission, and an inspiring vision, an organization is off to a good start with an itinerary and a destination.

—

I lost a former colleague and we all lost a wonderfully caring therapist and a quality human being this January.  He had a reputation for coloring outside of the lines in order to get the job done, but that combination of free-styling-high-energy and healing skills made him all the more wonderful.  Although we hadn’t talked in a few months, I will miss Henry Tim Heemstra, LPT as will the many patients and friends he made through almost four decades of practicing. 

Pedal on, Tim.

Leadership as a Calling

23 Monday Dec 2013

Posted by Scott Southard in Uncategorized

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business, business management, hospital management, leadership, Scott Southard

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Policeman: Do you have any disgruntled employees?

Nathan Arizona Sr.: Hell, they’re all disgruntled. I ain’t running no damn daisy farm. My motto is “Do it my way or watch your butt!”

Policeman: Well, do you think any of them could’ve done it?

Nathan Arizona Sr.: Oh, don’t make me laugh. Without my say-so they wouldn’t piss with their pants on fire.

From “Raising Arizona”

With all my heart I want this fictional film character to just stay that:  fictional.

I would guess that we have all had a boss like Nathan Sr.  Without a detailed character sketch, one can see that he saw his employees as something less than human and pretty stupid at that.

Reflecting on why I chose a career path of leadership—a path that is never linear and more vulnerable to sniping than even Nathan Sr’s employees—I wonder how I arrived there.  One explanation I have is that much like the claims I’ve heard from priests, I’ve always felt that I, too, had a calling.  I had a call to leadership.

Early memories from elementary school include being asked by teachers to keep an eye on the other students when they left the room and being elected class president and editor-in-chief of the school newspaper.  Junior high and high school was more of the same with being elected to positions of leadership to sports teams, band, varsity club, and the executive board.  I took much of this for granted and just figured it was because I had an inclusive personality, I wasn’t afraid to speak up, and that I was more responsible than my peers.

One key experience one summer with the Leadership Development Corps of the State YMCA of Michigan at Camp Hayo-Went-Ha gave me the opportunity to learn about the responsibilities of leadership with my own group of campers.  Leading a group of boys, often only a few years younger than me, and not my peers from high school that retreated to their homes and families at the end of each day, made me realize the power of being a role model and of being a dependable support person during the long stretch of summer.  Honestly, this model of teenagers leading teenagers, had the potential of becoming “Lord of the Flies”, but it didn’t go there.  What I found was that I could be more than a benevolent big brother or a surrogate parent.  I was the leader most boys wanted: fun, positive, supportive, protective, zero tolerance to meanness, patient, and available.  I saw how quickly trust developed between us and I learned about the stuff of which I was made.

I liked what I discovered about myself and how it made me feel.

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Now health care operational leadership, like camp counseling and like parenting, if you are doing it right, never really stops.

If your job is to oversee more than one shift or you have staff working every day of the week, you need to be available whenever they may need you.  On my designated times off, I first wore a pager and then a cell phone so that I could be alerted immediately in times of emergencies or sick staff or issues that couldn’t wait until I got back to my job the next morning or on Monday.  There have been several occasions when I had to leave a movie theater to answer a call and times I had to go in to help with coverage or talk to a physician or an athletic director.  Could this be considered a hassle?  Sure, but it is part of the job and I know that my staff, often flying solo, needs me to be no more than a call away.  I know that this is the kind of leadership I would want and so it is the standard to which I hold myself.

I’d like to make it clear that I make myself available not just to my fledgling staff, but also for those who have been out in the field for decades.  I have to be, after all, a role model for all of my staff, displaying by example my dedication to the job, to them, and to our organization’s goals.

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The more I watch “leaders” and read about leadership—and there are more articles on the internet dedicated to detailing what elements are necessary to being a leader then you could read in a life time—I am always a little disappointed. See, I find this cookbook approach to leading deceiving.  Unlike baking a pie, one does not simply fold all the “necessary ingredients” into any one container with the anticipation that another leader has been made.

Employees know when they are being lead or being managed or being manipulated.  Creating teams, instilling a vision, and guiding people in developing their careers, takes the care and attention that I found manifesting in myself as a State YMCA LC and camp counselor.  Wouldn’t it be a perfect world if our managers treated us like someone’s son and daughter that they have the responsibility to protect, educate, and nurture as opposed to being a human resource?

Yet, you’re right about one thing thing though Nathan Sr.  I need to do a better job watching my butt.

Thriving Amongst Giants

28 Tuesday Feb 2012

Posted by Scott Southard in Uncategorized

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business management, hospital management, Scott Southard, ScottSouthardmm, small business, thriving amongst giants

The United States is witnessing an unprecedented number of acquisitions, mergers, and seemingly unbridled growth of mega-health care organizations.  Undeniably there are fewer health care dollars now than a decade, or two, ago.  Larger metropolitan hospitals are merging their boards in order to dominate their region’s industry.  Smaller hospitals are finding that their traditional community-orientated health care model is no longer financially viable.

If you are a small or even mid-sized hospital, what do you do when a larger health care organization sets its sights on your market?

Two things you don’t do:

  1. Continue to do what you have been doing because it has been working just fine.  This is the complacency model.
  2. Attempt to go toe-to-toe with matching services.  This is the suicide model.

In both cases, the larger organization will find ways to beat you.  Simply put, they have more resources than you in money, people, influence, and time.

So what do you do?

  1. Create a new product or innovative approach and strongly market it so that any attempt to do the same will seem lame and duplicitous in comparison.
  2. Find a niche product that would require too much effort and expense for the larger organization to duplicate.
  3. Don’t be afraid to use the “local card” when marketing.  Examples include:
  • We are part of your community…
  • We know you and your family…
  • We share the same values…
  • We only care about you…
  • We are friendly, familiar, and part of your community…

Many consumers still respond positively to supporting community and locally-focused providers even at the expense of flying in the face of the old adage that the true experts are at least a 50 mile drive from home.

A giant is at the door of your hospital, what do you do?

Creating a Win Win

06 Friday Jan 2012

Posted by Scott Southard in business communication

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communication, competition, healthy workplace, hospital management, Scott Southard, talking to your boss

A cartoon Bubbles laments:  “Why can’t we all just get along?” and for that moment, I know how a Power Puff Girl feels.

An unanticipated consequence of having other managers in the same department is the competition for limited resources.  If the goals of the department are uncertain, if the department priorities constantly change, if communication is spotty from the top down and then across the lines, and if I’m left to guess on what criteria my performance is judged, I will error towards hoarding what I have in resources:  staff, money, equipment, time, contacts.

I think that its this uncertainty within my own department combined with the uncertainty of the national economic scene that fuels my anxiety and brings out what others may interpret as my competitiveness.  There is no question that I’m competitive, but this is something else.  This high octane mix of uncertainty makes me a self-centered manager and an ineffective negotiator much less a collaborator.

How do I get above and beyond this troubling state of inefficiency?

My strategy is about forming and maintaining relationships:

  1. First and foremost is keep talking to your boss about the organization’s and his priorities.  Ask him how you fit in the larger picture.  Find appropriate opportunities for all of the managers to hear this information at the same time.
  2. Insist on regular meetings with your fellow managers to keep communication flowing.  If your ploys for meetings are ignored, stop by, often unannounced, with or without an agenda.
  3. Form your own informational network with managers and directors from within the organization and find opportunities to strengthen and extend this network.

One truth I have uncovered is that mangers aspiring to be leaders can’t always depend on their own perceptions and efforts and then hope to overcome all opposition by slugging it out as a solo act.  Success depends on keeping your boss informed, making connections, and building new programs with the power of dialogue and consensus.

Communication – Face-to-Face

01 Tuesday Nov 2011

Posted by Scott Southard in business communication

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business management, business solutions, communication, hospital management, leadership, Scott Southard

I love my Iphone and all the things it can do.  E-mails and text messaging have made it possible for me to stay in touch daily with staff in eight different locations, not to mention with my fellow managers, and other valued contacts at the hospital and in the community.

I have found, however, that this technology is no valid substitute for meaningful dialogue with clear understanding of what was discussed and what actions are needed.  With e-mails, and even more so with text messages, attempts of cleverness or neglect to proof read may leave your client reading between the lines.  Inevitably, this will lead to confusion and, sometimes, hard feelings.  These hard feelings have a tendency to morph in some pretty strange ways you will have little control over.  The results are predictably bad for everyone involved.

In spite of its inconvenience in time, mileage on your car, and schedule strain, I have found it is more than worth all this extra work to schedule a face-to-face meeting.  I would go as far as advocate including a written agenda that both of you approve.  In cases of new customers, customers at risk, contacts that could influence how you perform your job, schedule the face-to face meeting.  Your staff will also appreciate you making the effort to spend time with them versus an e-mail response, or worse, not receiving any response.

When in doubt, arrange the face-to-face and come prepared.  The payoff is a real dialogue that will foster a healthier relationship and mutual respect.

Recent Posts

  • King of the Mountain
  • It’s the Same Old Story – Everywhere You Go
  • Digging For Answers
  • That Eohippus Blog Post
  • Healthcare Leadership in a Time of Change

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