My son has rolled his eyes at me 49 times out of the 50 that we have had conversations about ‘the change’ he is experiencing both emotionally and physically as a 14 year-old. The first time we talked, we went away for a weekend and listened to a set of CDs from Dr. James Dobson called Preparing For Adolescence. It was eye-opening for both of us. Neither of us rolled our eyes when we listened to Dr. Dobson discuss, in detail, everything that is going to happen. Since then, we have had several follow-up conversations and they have really opened doors to a deep relationship with my son that I never experienced with my father.
As I got to thinking about leading my son through this change, I thought about my approach as a leader in his life. First, I had a vision; I could see where he was going because I have been there. Second, I got support from his mother about talking to him. We had to get on the same page. The third focus in the process was communication, which was done with the help of an expert. The fourth focus was to be supportive of him. This is not a one-time event; I continue to do this through periodic ad hoc conversations. We go fishing and talk about it. We take a walk around the block and ask him what his friends are saying. These are not always easy conversations, but they are always fruitful. Finally, there has to be execution. If we had all this talk and nothing started to happen, I would lose a lot of credibility with him. Fortunately in this case, nature is taking its course and he is getting well along the way!
Vision, buy-in, communication, support, and execution are all necessary steps in leading through dramatic change. As CIOs we are managing change on many levels; some of it is happening rapidly and some on a more long-term basis, but these principles remain. Our organization has been marching toward the goal of achieving clinical integration in the form of a MSSP (managed security service provider). This will no doubt bring dramatic change to our relationship with the community physicians and our relationship with payers. The process that the organization has been going through has been well thought out and is a great example of strong leadership through change.
This vision emulated from our CEO and COO. Both are brilliant men who do a great job of setting a vision for this hospital. They realize that the landscape of healthcare is changing and their position is you can lead through this change, or let someone else lead you through this change, but either way it is happening. They casted a solid vision based upon what limited information they had and what limited experience the industry has with clinical integration.
While they were forming this vision, they quickly realized that they would need buy-in from key stakeholders. They immediately started speaking with the board of directors, physician leaders, and a major insurance company in our community. Through these conversations the vision was completed and buy-in was achieved.
There has been an extensive education and communication effort as the physician community learns more about clinical integration as we define it. We hold forums and retreats for the physicians and provide opportunities to ask questions and gain consensus.
This effort has been supported by the clinical integration executive team. They have developed sub-committees comprised of both physicians and hospital administration that not only do the planning for this new organization, but are also providing support to other hospital executives and community physicians. These teams are key, both in supporting those who have questions and concerns, and maintaining an open line of communication to key stakeholders.
This effort has led us to the execution phase where we currently find ourselves. Most of the sub-committee work has been completed; now, it is a matter of executing the plan. Without eventual execution, the credibility of hospital administration, the board of directors, and the physician leadership team would be compromised. At this stage in the process, could something come up that would cause us to rethink this strategy and go in a different direction? Absolutely. If that were the case, we would begin with step one — set a new vision and start the process all over again until we achieved the ultimate goal, which is to provide quality care to our community as cost effectively as possible.
This is a time of historic change in our industry. Most of this change is being fostered and led by the federal government. Regardless of how we arrived at this time in history, we are here, and it is our responsibility to take this generation through this change. A vision has been cast in the form of several federal programs, beginning with ARRA and MU and its impact on healthcare.
The other programs that are part of this vision are value-based purchasing, which includes both patient satisfaction and quality, and the controversial PPACA. Our democratic process calls for “buy-in” through a voting process and that was achieved. The ONC has done a great job partnering with organizations like HIMSS, CHIME, and others to communicate to the industry and provide support through this change. We are now in the execution phase. Value-based purchasing is in full effect, MU checks are being send out, and HIT is one of the fastest growing sectors of our economy. Many provisions of the ACA will be starting in 2013 and 2014, and that program is off and running.
Becoming a master in each phase of this process can help you as you raise your child through the teenage years, lead your organization through major change, or help lead a nation through historic change. Building your skills in each of these areas will help solidify your future as a leader and bring great benefit to any change effort you lead.