In Frank Luntz’s book “Words That Work: It’s Not What You Say, It’s What People Hear,” he analyzes problems in business communications and the words people use.
Luntz, a conservative pollster and frequent Fox News collaborator, did what a pollster might do if he were writing a book. He took a series of polls regarding which word Americans felt was the strongest in the context of business.
Of the following words, which do you feel is the most powerful?
The answer: consequences. That is an important word for leaders to remember. The decisions healthcare leaders make over the next five to seven years will be the most consequential of their careers. Facing a monstrous wave of change that will transform how we deliver care, virtually every major decision will take on a success or failure theme with huge consequences for the communities, physicians and the patients they serve.
This is not a time for leaders who are trapped in a narrow box and who base their decisions on a comfort level that is just a couple of steps away from “this is the way it has always been.” A leader’s skill sets and outlook must evolve faster now than at any time in the history of our industry.
Here are some random thoughts for leaders to consider:
© 2014 John Gregory Self
It was shortly after 8:30 AM when the rumor of a key resignation began to spread through the hospital. It was “hump day,” Wednesday, and as members of the senior leadership team wrapped up their morning operations council meeting, there was the hope that the ride into the long holiday weekend would be uneventful.
For the Chief Medical Officer, sitting in his office reading a letter of resignation, there was a deep sense of unease. The upcoming holiday was now the last thing on his mind. The news, that his star senior director responsible for quality and case management was resigning, and her last day on the job was 30 short days away, was devastating. His assistant buzzed his intercom; the CFO was on the line. “Is it true? What’s our plan? This is serious, potentially disastrous,” he said without waiting for a reply. “I just saw the boss, he has already heard. Bad news travels fast.”
That this key employee was leaving was bad enough. That she had been poached by a fierce cross-town rival added insult to injury.
The CMO felt a sense of dread. It got worse when his assistant called to say the CEO would like to meet for coffee in 30 minutes. Coffee was not the reason for the meeting.
He was right. There wasn’t a coffee mug in sight as he was ushered into the CEO’s office.
The CEO allowed the CMO to share the bad news, and then quickly followed with a series of questions:
The CEO knew the answer when he saw the CMO wince. Grooming talent had not been a high priority. They had been focusing on reducing length of stay and enhancing the quality of care for the last 18 months. This sudden departure of the CMO’s star employee was not even close to being on his radar. In his job for two years, with a full plate of other priorities, the CMO barely knew the second-in-command in these two critical areas.
The number two in the division would be named the interim senior director, the CMO reported, but a national search would have to be conducted because that individual was not strong enough for the job, he told the CEO.
Six months later the search languished. The national pool of talent was thin, and the competition was intense. The hospital’s length of stay was creeping up and there were signs that the laser focus on quality of care was slipping. The CFO was only too happy to remind the CMO that this resignation was inflicting real financial pain. (Disclosure: we were involved in a similar national search and we were not successful).
This pre-holiday crisis did not happen because the CMO was somehow negligent. It happened because the culture of the organization did not attach a high degree of importance to developing their talent. An enteprise-wide talent mapping initiative was shelved several years earlier because it was seen as an excessive expense, not an investment that would produce measurable value.
Consider this: healthcare employees, particularly the up and comers in the Millennial generation, want to belong to an organization where they can make a real contribution to their community. They want to embrace the organization, to know they are valued for the job they do today, and for the contribution they can make in the future. They know that training and mentoring will enable them to step up when a sudden resignation occurs.
© 2014 John Gregory Self
After spending several days in Las Vegas speaking to the American Academy of Medical Administrators, the bitter cold with snow and sleet in Dallas is more than a little jolting. Reviewing some notes in my Journal, I ran across several entries that were equally unsettling.
Tom was the manager of a blood bank within a large lab of a major medical referral center located in the Northeast U.S. He told me that he was recruited there two years ago and while he enjoyed the complexity of the work and camaraderie of working with his capable team, he was frustrated. It wasn’t the money – they paid him well and the benefits were the best he ever had. Nor was it the urban lifestyle; he liked living close to the best restaurants, museums and concert venues. His life outside work was great.
At work, he felt stuck. He was not getting any useful feedback on his performance or any support he sought to become a better manager. His boss, the Director, seemed incapable of providing ongoing feedback much less meaningful, in-depth guidance during the annual performance review. Every annual review session seemed rushed, always on the final day, or even a week late.
Unfortunately, Tom’s experience is not that far out of the ordinary. It would seem that in addition to problems with quality of care and patient safety, hospitals have a problem providing their employees with meaningful feedback regarding their performance. It is a recurring problem I hear from the northwest to the southeast, from California to New England. This is a shame because improving employee evaluations is not that complicated or expensive. It is sort of like the other broken part of most healthcare human resource departments – employee orientation that usually amounts to two days of listening to how you can get fired.
For the life of me I cannot figure out why hospitals continue to rely on the old fashioned orientation session to “onboard” a new employee given the evidence of alarming turnover rates, but I do understand how the hit-or-miss employee evaluation programs continue: a combination of poor training and weak supervisors who lack the real depth of experience and/or critical thinking skills that are necessary to deliver an insightful performance evaluation. No one taught them.
The bad news is that this is the same reason hospital employee performance evaluations were so bad 38 years ago.
© 2014 John Gregory Self