staff Integrating … community capabili ty promise physician s Solution s Single Source
staff
Integrating…
community
capability
promise
physicians
SolutionsSingle Source
New Challenges- Bringing Entities Together Integration
Cultures Employees Physicians Services Capabilities Facilities
Changing healthcare economics More (and/or different services)
while receiving less revenue Strategic shift while
maintaining core mission, vision and values
promise & capability
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Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 3
Integrating – Establishing the “New We” For a successful integration:
Clarify rationale of affiliation Create value Blend Cultures Communicate (Over communicate)
The Core of Every Entity …
CultureCommuni
tyLeadersh
ipOperatio
ns
• Assessment• Integration
• Assessment• Communication
• Assessment• Integration• Development
• Assessment• Innovation• Integration
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Bringing Entities Together-General Considerations Assessment of impact Evaluate potential
enhancements Identify similarities/differences Establish the operating
structure Determine communications
strategy
We need to know where we
are
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Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 6
Proposed Focus
Operations Integration
Innovation and Leadership Development
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Operations Integration
Establishing the New “We”
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Operations Integration For a successful integration:
Clarify rationale of affiliation Create value Blend Cultures Communicate (Over communicate)
First we need to know where we
are
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Assessment Offerings (Short Term Impact Analysis)
Clinical services Information technology Communications Logistics Sourcing Community expectations Leadership
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Clinical Services Assessment Processes, procedures, protocols and metrics Unique services Replicate services
Implication Potential redundancy
Leverage strengths IT specifications:
Communications Reporting Coding
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Information technology Assessment Respective site requirements Connectivity/compatibility Cross communication between entities Outpatient expectations and requirements Capabilities:
Strengths/Weaknesses Compatibility Cross-communication requirements Pending enhancements
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Communications Assessment Strategy and plan
Content Frequency Focal Point
Target audience and mode(s) for: Employees Physicians and physician leadership Community
You can’t over communicate!
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Logistics and Sourcing Assessments Logistics
Patient transport Employee assignment Employee transport Supplies and equipment
Sourcing and materials Vendor agreements Contract services Pricing advantages Order approvals and
processes Systems
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Leadership Assessment Leadership focus
Clinical services and Service Lines Clinical and Academic Chairs Physician Leaders Administrative Leaders Nursing Leadership Leadership Structure
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Integration Cornerstones: Post Assessment Steps
Clarify rationale of affiliation Create value Blend Cultures Communicate (Over communicate)
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Innovation and Leadership Development
Adapting to New Challenges
New Challenges Integration
Cultures Employees Physicians Services Capabilities Facilities
Changing healthcare economics More (and/or different services) while receiving less
revenue Strategic shift while maintaining core mission,
vision and values
promise & capability
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Focus Areas for Getting to the “New We”
CultureCommuni
tyLeadersh
ipOperatio
ns
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Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 19
Leadership Development and Organization Culture
According to a 2010 Harvard Business Review article, most leaders facing a failing business situation will :
• Tighten the purse strings• Take strict control over the organization • Put strategy first
“Culture eats strategy for breakfast.”
In the famous words of Peter Drucker:
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Culture
Strategy
Tradition/ Past Practices
Employees/ Leaders / Processes
CU
LTU
RE
Given the importance of CultureWhat is Culture?
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Culture
Culture
Community
Employees
Service
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Culture Current state assessments
Facilitate compiling a current state cultural assessment for: Allied health and support employees Nursing and Nursing leaders Physicians and Physician leaders Administration and Administrative leaders Communities served and local government
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Culture Given the importance of culture:
What drives culture?
How do you sustain culture?
How do you change or redirect culture?
A significant responsibility of a leader is to foster and develop
the organization culture
We need to give them the tools
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“Culture Eats Strategy for Breakfast” Culture is the “performance” cornerstone –
but … Strategy needs to adapt to changes in the
market How do you align/realign culture with
changing strategies necessary to adapt to changing demands?
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Integrating – Establishing the “New We” For a successful integration:
Clarify rationale of affiliation Create value Blend Cultures Communicate (Over communicate)
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Innovation and Leadership Development Center
Value of an Innovation and Leadership Development Center
How it would be developed at NBI Possible configurations Address possible barriers
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Innovation and Development Center Provide an ARCHITECTURE of PARTICIPATION and
ATTENTION (O’Reilly; Nielsen)
Create a collaborative atmosphere and a platform for collaborative leadership training
Real-time/real-work issues addressed, measured and improved
Showcase dynamic and engaged leadership Enhance enterprise wide engagement
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Innovation and Development Center Start by identifying leader
candidates Identify core groups Identify leaders in an intentional
way Physician Nursing Administration
Define individual and group expectations
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Innovation and Development Center Identify key objectives and
improvement areas as possible first stage targets
Present target list to leader candidate group for consolidation and finalization with leadership
Establish goals, metrics, and end points for the targets with the leader candidate group
Establish clear expectations for the group and define incentives and goals
Manage and monitor progress Stay Engaged
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Innovation Center Possible Impediments Possible Physician (or anyone's)
reaction: “Why will this work and what
makes this different?” “We have participated in these
activities hundreds of times and nothing changes – No one really seems to care.”
“This is the same old song-and-dance from administration because they want us to do something their way.”
“I don’t have time for this.” “How will this help my Patients,
practice or revenue?” (WIIFM)
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Program Model Physician driven Targeted site approach with “end-to-end”
perspective Targeted individual approach for maximum impact Blended learning-maximum impact-minimal time
“Off the floor” Experiential training Cultural assessment included Gap analysis incorporated
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Program Focus Training delivered as required by individual
assessment including but not limited to: Analytics
Finance Strategic planning Acquiring meaningful data and data analysis Format and delivery of meaningful and succinct
management reports Leadership
Team work Self-awareness Interpersonal interaction Conflict management Change management
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Program Features Clear messages delivered: Expectations and accountability of
participants Technologies/tools to efficiently lead
groups/teams Modern/current education and development
programs Performance management system
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What Makes this different? Clear messages delivered:
Mission, vision and value reinforcement Strategic adaptations required Expectations and accountability of participants Priorities clearly established
Model Requirement Organizational philosophy supporting physician
alignment Clear position descriptions Orientation to new physician responsibilities Staff support
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Leadership Development Center Value Engaged and cohesive workforce Engaged Physicians Clear and consistent message Provides structure for required improvements
Paid for by achieving the
targeted strategic improvements
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What we will provide (as required) Program is Enterprise driven/
Enterprise specific. The recommended approach is
blended-learning On-line/Class room/workplace Real world/real time enterprise
opportunities Training will be supplemented with case
study to encourage and fuel innovative thinking
Program will include: Culture Assessment
360 Evaluations -Self-assessments Bench-strength opinions with gap
analysis Executive Management
Managing innovation and technology Cross-functional collaboration -Managing
other professionals Negotiation Management and Financial Reporting
(format options-by audience): Data analysis and interpretation
Financial impact of impending marketplace changes: Healthcare economics ACA, VBP, ACO Impact
Communications Presentations Providing team feedback
effectively
Leading change and change management Team building and group processes How to be an Internal Consultant Diversity and Change Management Managing strategic transformations
Process and change management
Another way to look at Culture
Culture • Assessment• Integration
Community
• Assessment• Communication
Leadership
• Assessment• Integration• Development
Operations
• Assessment• Innovation• Integration
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Copyright 2010 Six Sigma Solutions, Inc. All rights reserved 38
Physician Integration
Allied Physicians Employed Physicians
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Physician Integration
Clinical Chairs/Physician Leadership
Employed Physicians
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Employee Integration