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21 THOUGHT LEADERSHIP 5 lessons from Hospital for Special Surgery's CEO on building a great organization By Carly Behm L ouis Shapiro, president and CEO of New York City-based Hospital for Special Surgery, outlined the five focuses that can help make an organization great for the "Becker's Healthcare Spine and Orthopedic Podcast" May 25. Question: What are some les- sons that you can share about building a great organization? Mr. Shapiro: My view of what we've been able to accom- plish at HSS is not unique to us, and I think it's completely transferable to any organization functioning at a certain level of capability. So if I reverse- engineered what we focused on, there's five things that are important: The first one is inspiration. I think people need to be in- spired by the organization they're part of. If they're in- spired, then the people who are part of the organization can accomplish a great deal on behalf of what that organi- zation is trying to accomplish. Even with the advent of tech- nology, organizations are still largely driven by the people who work there. For HSS, that comes from two things: our big purpose, and it comes from the aspirations that we have. We never declare victory. We're always working to get better. We're always trying to reach more people. We're always try- ing to make people healthier so they don't need us. If they're sick, we're always working to help them get better faster and more efficiently. No. 2 is culture. I've been an advocate of focusing on cul- ture in an organization for a long time, and it's been part of the fabric of HSS. I believe creating an environment where individuals who work there feel like they own the place and are leaders, regardless of what their particular role is in the en- vironment, causes them to be excited to be there. Third is I try to look at every- thing through the lens of peo- ple, structure and process. Do you have the right people in the right roles? Do you have the right structure that allows them to do their job, and do you have the right processes in place? There's a lot of moving parts, and organizations evolve over time, and you need to constantly evaluate things from a people, structure and pro- cess point of view. The fourth thing is strategy. One thing we do here is we are always reflecting on how we got to this point, what's going on in the environment around us, where we think we need to be in the future and how we're going to get there. We refer to that as our road map. That has kept us on the straight and nar- row path. The fifth thing is details. De- tails really matter. Blocking and tackling, getting things done, measuring progress and hav- ing a true shared leadership model throughout the organi- zation. You can only commu- nicate. So really focusing on making sure that your commu- nications are top notch. I think those are all fundamentals of what we do that contribute to our success that is not neces- sarily directly relevant to be- ing a Center of Excellence in healthcare. n 'We're at a perfect size now': EmergeOrtho sets sights on MSOs, clinically integrated networks By Alan Condon I n 2016, four orthopedic groups merged to form Durham, N.C.-based EmergeOrtho, which added a fih group the following year. Since then, the state- wide orthopedic group has expanded to more than 140 physicians and 46 locations. Frank Aluisio, MD, orthopedic surgeon and physician president of EmergeOrtho, spoke to Becker's about overcoming practice integration challenges, why he's excited about the transition to value-based care and how EmergeOrtho aims to grow in the next five years. Question: As a larger orthopedic group, what are some of the biggest advantages you have over smaller groups in your market? Dr. Aluisio: We cover a broad geographic area in North Carolina. Since we're covering multiple markets in the state, we have access to a greater number and larger variety of patients than any single orthopedic group or a single hospital franchise in one market. With our size, we have much greater economies of scale when it comes to purchasing, back-office functions, human resources, etc. We also have a greater ability to adapt to varying situations than smaller groups, both from a financial and manpower standpoint. When you compare us to the hospitals, as we transition to value-based care, just by definition — with value be- ing quality divided by cost — we feel as a large inde- pendent group we can provide higher value care be- cause we can provide equal or better quality at a much lower cost than the hospitals. We're poised to really thrive in a value-based system. Q: In terms of value-based care, how is EmergeOr- tho approaching bundled payments for joint re- placements? FA: A few of our regions have been participating in procedural bundles for quite a while, such as hip and knee bundles, but in the last year our overall group has been participating in these bundles. at's our primary inroad into value-based care. In the future, we aim to get involved in population health for mus- culoskeletal care across all regions in the state. We truly believe that value-based care is coming, and we're prepared to take the next steps beyond just procedural bundles, in which we've seen tremendous success — specifically in two of our markets, but now