When people see Norma Tirado’s title, they often do a double take. But while it may seem unusual to serve as VP of both IT and Human Resources, to Tirado, the dual role makes perfect sense in the world, especially in today’s turbulent health IT world, where change management expertise is as good as gold. In this interview, she talks about Lakeland’s “fast and furious” Epic rollout — an initiative that required significant buy-in; how she is able to balance the two roles; what it takes to retain staff and build a high-performing culture; and why achieving Stage 7 means so much to the organization and the community.
Chapter 2
- Post-implementation optimization
- Where HR & IT converge
- Applying change management skills to IT
- “I’m not afraid to hire people that are smarter than I am.”
- Maximizing talent & resources
- Leaders walking the walk
- Cultivating a high-performing culture — “Trying is just not good enough.”
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Bold Statements
Everyone is using the system the way we want them to use it for the most part. Now we have to figure out away to bring data from different systems — both financial and clinical — to make sense of the information.
If I needed to have or hold all the technical knowledge both in IT and HR, I could not do it. I’m highly reliant on the people that I work with.
You have to find ways to have the best talent possible and make sure that you’re growing people and keeping them challenged at a time when maybe you can’t offer them the big positions and the big dollars.
One of the hardest things to teach an organization about being a high performance culture is that trying is just not good enough; that you have to deliver results.
Gamble: What would you say is the biggest project on your radar right now? Are you looking at analytics?
Tirado: In December, we partner with a vendor to implement business intelligence software on top of the electronic medical record, and then obviously we all have ICD-10 coming and Meaningful Use Stage 2, which is a little bit more challenging than Meaningful Use Stage 1. But by far, analytics now becomes the focus of our optimization, so to speak, because now we have all this great data. Everyone is using the system the way we want them to use the system for the most part. Now we have to figure out away to bring data from different systems — both financial and clinical — to make sense of the information and help the organization and the clinicians deliver better care using predictive analytics and dashboards and more and better best practice advisories within the system.
Gamble: You’ve been at Lakeland since 2010. You’re the CIO, but you’re also VP of HR, and I wanted to talk about that. First about the HR part of your role — what does that entail and what are some of your key responsibilities under that purview?
Tirado: I was hired here in both roles right away because I was doing HR and IT at my previous organization. When I came here I actually was being recruited for the HR role, but because I was doing IT in my previous organization, I didn’t want to give it up. It just so happened that as I was interviewing, the person that was in that role was planning to retire. That, I think, worked really well for me and for the organization. As VP of HR, that’s my area of expertise more so than IT. I have responsibility for the HR function in the organization at Lakeland University.
I also, which is unusual for HR in this case, have responsibility for a lot of our community outreach programs like our parish nursing program, our senior nursing program, our diabetes education, outpatient and those types of things. It’s an unusual but interesting role. When I first took IT over in my previous organization, the CEOs were looking at my change leadership abilities to apply those skillsets to IT, because they knew that there was going to be a lot of change, both for the organization and for the IT function, given the role that technology now plays in organizations. So I think that’s where the two roles came together.
Gamble: It’s something that we don’t see a lot but really seems to make sense, especially when you’re talking about something like the Epic rollout, which happened so quickly. I can imagine that you were able to utilize your experience in things like talking about the training with the staff, as well as the change management piece.
Tirado: Yes, and particularly the change management piece. The training helps, but I think trying to get the people to develop or bring together a common purpose or shared purpose or shared calling that results in results that are probably beyond what they thought they were capable of, that’s usually what I focus on. And I’m able to do this for two reasons. One it’s a smaller organization. I think in larger organizations, you just simply can’t do it. And two, because I am able to build a really strong team that has the knowledge. I’m not afraid to hire people that are smarter than I am or are experts in areas that I don’t have expertise in. If I could not do that; if I needed to have or hold all the technical knowledge both in IT and HR, I could not do it. I’m highly reliant on the people that I work with.
Gamble: That’s an important facet of leadership; being able to put the right people in the right positions. That can’t be underestimated.
Tirado: No, not at all. I think that’s what has given us the success that we have. We have some very, very high performers on our team. We have some people with a great deal of creativity and self-motivation, and that makes all the difference in the world.
Gamble: It was at your last role that you first got into the IT part. What was it that made you interested in kind of sticking around and still having that type of role?
Tirado: When I got that job at my previous employer, we did it a little bit out of necessity. We had lost a VP, our COO, and we were in a position financially where I think many healthcare organizations find themselves where they need to find ways to do things more efficiently and more cost effectively. Our CEO talked to all of the VPs around the table and said, instead of filling this role with another person, how can we role-model what we’re expecting from our leaders and reduce an executive position? And so we all took responsibilities that the COO had and I was I think fortunate enough to be able to take over IT.
IT and people are at the center of the success of every organization. That’s what I really love about IT. If we don’t do IT right, we are not going to be successful, because as we’re trying to become efficient, we have to use technology in different ways and use that as a tool to enhance the care for the patient. You have to have people that embrace that technology for it to be effective. That combination is absolutely fascinating to me.
I know that if I was to go to a larger organization someday, I know that I couldn’t do both. Even here, at times it becomes overwhelming. There is just so much new stuff coming at you, particularly in the IT side right now. I think the HR side is a little bit calmer, but there is also a great deal of regulation on that side. The big thing on the people side is that because the healthcare industry is in such turmoil, you have to find ways to have the best talent possible and make sure that you’re growing people and keeping them challenged at a time when maybe you can’t offer them the big positions and the big dollars. You have to really appeal to mission and purpose. I think those two areas are fascinating. I absolutely love them.
Gamble: That’s a good point. As I’m sure you know, a lot of organizations are struggling with is being able to hold on to the good people even though they are being given more to do. That’s certainly a challenge, and it’s a question that comes up a lot just as for how do you deal with that and how do you try to hold on to those good people.
Tirado: Yeah. In some markets there are some positions right now — and technology is one of them — where if people want to move they’re going to find opportunities. You have to keep it attractive. We knew and were prepared to lose some people, for example, when we went live, but we didn’t necessarily lose our stars. We were very focused on putting retention programs to really make sure that we were retaining some of the people that we wanted to retain. We knew we were going to lose some, and we did lose some good people, but we were prepared for that. I think that because I had both the HR and the IT, I was able to accomplish things maybe faster and more efficiently than if these two areas had been separate, as it relates to talent retention.
Gamble: You mentioned briefly about having a high performing culture. Can you talk a little bit about what it takes to cultivate that?
Tirado: One of the hardest things to teach an organization about being a high performance culture is that trying is just not good enough; that you have to deliver results. You really, really have to make sure that people are constantly aware of what they’re delivering; what are the outcomes they’re delivering and how their job impacts the ultimate goal of the organization, which is to deliver the best patient care possible in all of our different entities, in whichever ways we do it. It takes time and it takes a committed senior leadership team, because we have to really watch what we reward and how we reward it. It requires that we make changes. People were used to getting automatic increases; we decided to go to a market driven approach to compensation instead.
We had to make a concerted effort to get rid of our low performers, and that, at times, is very, very painful, because it’s also people that have been in your organization for a long time but have ceased to produce. You have to sit down with those people and have a very, very straight conversation and let them know what the new expectations are. If they can’t meet those expectations, you have to act swiftly and compassionately to develop an exit strategy so that your organization can deliver what they need to deliver. Ultimately, it is your people that make the difference in any organization, so you have to make sure you have the best people possible. If you focus on that, you can then create a high performance culture. But you also have to focus on why are we here and just create that compelling vision for people to want to embrace.
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